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Foundations of nursing > Perioperative and skin integrity > Flashcards

Perioperative and skin integrity Flashcards

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1
Q

perioperative nursing involves the care of clients ___, ___, and ___ surgery and some other ___ ____
aka?

A

before, during and after
invasive procedures
aka operating room nursing

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2
Q

Who governs perioperative nursing practice?

A

AORN, joint commmission, medicaid, national priorities partnership, institute for healthcare improvement

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3
Q

These are called?

wrong patient, wrong site, wrong surgery, DVT or PE after knee or hip replacement; foreign body; surgical site infection

A

never events

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4
Q

Surgeries are classified by:

A

body system
purpose
degree of urgency
degree of risk

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5
Q 
purpose...
ablative?
diagnostic?
palliative?
cosmetic?
transplant?
harvesting?
A 
ablative-removal
diagnostic or exploratory-confirm diagnosis
palliative-relieves discomfort
reconstructive-restores fx
cosmetic-appearance improvement
transplant-replaces malfx. organ
harvesting-removing organ
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6
Q

emergent surgery happens…

A

within 24 hours if not immediately

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7
Q

urgent surgery happens within…

A

24-48 hours

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8
Q

elective surgery

A

has more time

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9
Q

risk? major or minor?

A

major-greater risk; higher infection risk

minor-lower risk

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10
Q

factors that contribute to surgical risk?

A

age, personal habits; allergies; type of wound; preexisting conditions; mental status; medications

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11
Q

preoperative screening tests

A

CBC, urinalysis (specific gravity tells hydration level), ECG (tells if heart rhythm is normal)

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12
Q

Intraoperative team…

sterile team

A

made up of surgeon, surgical assistant, RN 1st assist

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13
Q

Interoperative team…

clean team

A

anesthesiologist, CRNA, circulating nurse

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14
Q

time out

A

final verification of correct client, procedure and site

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15
Q

general anesthesia

A

most risk; loss of sensation; someone else maintaining airway; rapid unconsciousness

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16
Q

conscious sedation

A

IV sedation without unconsciousness; not necessarily in OR; can maintain protective reflexes

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17
Q

regional anesthesia

A

alert but numb; nerve block; spinal block, epidural; can’t feel (interrupts nerve impulses to and from area of procedure)

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18
Q

local anesthesia

A

loss of pain sensation at the desired site; minor procedures

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19
Q

PACU

A

postanesthesia care unit; immediate postoperative phase; aka post anesthesia phase
includes: recovery from anesthesia, airway management; vital signs/LOC; dressing assessment/drainage; fluid therapy; pain control

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20
Q

post op risks

A

surgical site infection; pneumonia; fall; pain; DVT

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21
Q

epidermis made up of

A

stratum corneum–outermost layer of skin

stratum germinativum–innermost layer; mostly new cells

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22
Q

what maintains the skin, repairs minor defects and preserves intravascular volume?

A

protein

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23
Q

what nutrition wise helps with the formation of collagen?

A

vit C, zinc, copper

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24
Q

what leads to increased risk for pressure and breakdown?

A

diminished sensation

25
Q

what negatively affects tissue metabolism?

A

impaired circulation

26
Q

medications can cause what side effects to the skin?

A

itching

rashing

27
Q

Moisture leads to?

A

maceration–softening of the skin

28
Q

two most common sources of moisture are?

A

fever and incontinence

29
Q

fever depletes ___ and increases ___ ___

A

moisture

metabolic rate

30
Q

open wound

A

break in skin or mucous membrane

31
Q

closed wound

A

no breaks in the skin

32
Q

acute wound

A

s/t; heals quicker

33
Q

chronic wound

A

L/t; longer duration to recovery

34
Q

clean wound

A

expected to be short duration; heal spontaneously

35
Q

contaminated wound

A

open, traumatic wound or surgical incision in which a major break in asepsis occurred

36
Q

infected wound

A

bacteria counts in the wound tissues are above 100,000 organisms per gram of tissue

37
Q

superficial wound

A

involve only the epidermal layer of the skin

38
Q

partial thickness wound

A

extend thru the epidermis but not all the way through the dermis

39
Q

full thickness wound

A

extend into the subcutaneous tissue and beyone

40
Q

penetrating wound

A

wound involves internal organs

41
Q

serous exudate

A

straw colored

42
Q

sanguineous exudate

A

bloody drainage

43
Q

serosanguineous

A

mix of bloody and straw

44
Q

purulent

A

yellow, contains pus

45
Q

regenerative healing

A

when the wound affects only the epidermis and dermis, regenerative/epithelial healing takes place; no scar

46
Q

primary intention

A

clean surgical incision/ edges approximated; minimal scarring

47
Q

secondary intention

A

wound edges not approximated; tissue loss; heals from inner layer to surface

48
Q

tertiary intention

A

granulating tissue brought together; delayed closure of wound edges; increased risk of infection

49
Q

complications of wound healing

A

hemorrhage; infection; dehiscence (pops open); evisceration (emergency; things protrude thru like bowel); fistula formation (abnormal passage; most common between GI and GU tracts)

50
Q

Braden scale based on

Total score…..= risk

A 
sensory perception,
moisture
activity
mobility
nutrition
friction or shear

<18

51
Q

debridement

A

removal of devitalized tissue or foreign material from a wound

52
Q

sharp debridement

A

uses a sharp instrument to remove devitalized tissue

53
Q

mechanical debridement

A

naturally remove with irrigation or hydrotherapy (book–lavage, wet to dry dressings or hydrotherapy (whirlpool))

54
Q

enzamatic debridement

A

uses proteolytic agents to break down necrotic tissue without affecting viable tissue in the wound (ointment with enzymes; clean first; cover with moisture containing dressing)

55
Q

autolysis debridement

A

use of occlusive moisture retaining dressing and the body’s own enzymes and defense mechanisms to break down necrotic tissue; slow process

56
Q

Jackson Pratt drainage device or Hemovac

A

compress device to create suction and facillitate removal of drainage

57
Q

hydrocolloids/hydrogels

A

thick foamy dressing

gel dressing to retain moisture

58
Q

binders

A

hold abdominal wound together

59
Q

pressure ulcer

A

caused by unrelieved pressure to an area resulting in ischemia

Foundations of nursing (2 decks)

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