Perioperative Care

Question 1

Percentage of surgeries that are elective

Answer 1

90%

Question 2

What does elective surgery mean?

Answer 2

Can be scheduled, and it’s not needed to survive in the next couple of days

Question 3

Urgent surgery

Answer 3

Needed in the next 24-48 hours

Question 4

Emergent surgery

Answer 4

Needs to happen RIGHT NOW

Question 5

Reasons for surgery

Answer 5

diagnostic, curative, restorative, palliative, cosmetic

Question 6

diagnostic surgery

Answer 6

explore to understand

Question 7

curative surgery

Answer 7

like removing a tumor

Question 8

restorative surgery

Answer 8

restore to previous/ideal function

Question 9

palliative surgery

Answer 9

giving patient more time and quality of life (like debulking a tumor)

Question 10

cosmetic surgery

Answer 10

improving appearance (veneers would be cosmetic, dentures would be restorative)

Question 11

extent of surgery

Answer 11

simple, radical, minimally invasive

Question 12

preoperative phase from ____ to ____

Answer 12

from when surgery is scheduled until they arrive in the surgical suite

Question 13

Nursing priorities in preoperative phase

Answer 13

safety, informed consent, education, assessment, advocacy

Question 14

What med should be stopped before OR

Answer 14

blood thinners

Question 15

Why is HTN a risk for surgery

Answer 15

increases risk for bleeding and cv issues during surgery

Question 16

why is fast pulse a risk for surgery

Answer 16

high metabolic rate, can get higher with anesthesia

Question 17

Who is responsible for informed consent

Answer 17

The surgeon and anesthesiologist

Question 18

Informed consent considerations with blindness

Answer 18

can consent, but a second person needs to witness their signature

Question 19

Informed consent considerations with non-English speaking patient

Answer 19

interpreter

Question 20

Informed consent considerations with emergency and pt unable to sign

Answer 20

Surgeon can sign emergency consent and then go back and get one later

Question 21

When written consent isn’t possible, what do you do

Answer 21

Two witnesses of verbal consent

Question 22

Informed consent considerations with Patients who cannot (cognitively) write their name

Answer 22

pt can write an x

Question 23

Informed consent considerations with patient who refuses surgery

Answer 23

They can do that! Nurse role is to understand what the blocker is and to alert surgeon.

Question 24

Informed consent considerations with patient who doesn’t understand surgery and has questions for surgeon

Answer 24

Bring back the surgeon

Question 25

NPO evidence recommendations and practice

Answer 25

Evidence: NPO 6 hours solid food, 2 hours for clears
Practice: NPO after midnight

Question 26

Who in the surgical team needs to scrub up

Answer 26

Surgeon, surgeon assistant, scrub nurse, scrub tech

Question 27

malignant hyperthermia

Answer 27

often from inhaled anesthesia, hypermetabolic, rhabdo, super high temps (108-110), can happen in OR or recovery, ETCO2 increased

Question 28

Medication to resolve malignant hyperthermia

Answer 28

Dantrolene

Question 29

Early signs of malignant hyperthermia

Answer 29

drop in O2 sats, increased ETCO2, increased heart rate

Question 30

What needs to be removed before surgery?

Answer 30

dentures, attire, jewelry, contacts, hearing aids, glasses

Leave hearing aids and glasses on until they’re in the surgical suite

Question 31

postoperative period from ___ to ___

Answer 31

from completion of surgery until…. depends on the phase. Phase III extends through home/long-term care.

Question 32

Priority in post-op

Answer 32

Airway management (ABCs)

Question 33

Urine output minimum

Answer 33

30 mL/hour