Perioperative care Flashcards
Describe the time frame for the 3 levels of urgency : elective, urgent, emergent
- elective : can be scheduled more than 48 hrs out (does not mean that it is not necessary)
- urgent : need w/i 24-48 hours or else probably gonna die
- emergent : need rn or gonna die
What is the time frame for the preoperative phase?
from the time the surgery is scheduled to the time the pt enters the surgical suite/OR
–> this can vary based on level of urgency
What is the nurse’s priority in the preoperative phase?
What factors are a part of this?
- priority : getting the pt to the OR safely
- factors in this : pt edu, advocacy, evaluation of resources needed for recovery
What medications should be stopped prior to surgery?
What medications should we continue to give?
(both are drug categories)
- stop : blood thinners
- cont : beta blockers
If a pt states they have an allergy to strawberries or bananas what would the nurse’s follow up question be?
has the pt ever experienced a reaction to latex
if the pt states they have a peanut allergy the nurse knows they have an increased risk of hypersensitivity reaction to which drug?
propofol
Why would the nurse want to ask the pt if they have had anesthesia prior to this surgery? If the pt says no (they have never been under anesthesia) what should the nurse ask next?
- ask this to see if they had a previous reaction that is indicative of malignant hyperthermia
- the nurse should then ask about if anyone in their family has had a reaction to anesthesia
When asking about alcohol, drug, and tobacco use, the patient states they chronically use all of them what would the nurse be concerned about regarding each substance?
- EtOH : inc risk for cv complications, and withdrawal after surgery
- drugs : inc risk for cv event during surgery, interaction with anesthetic, tolerance to pain meds
- tobacco (smoking) : inc risk for pulmonary complications during surgery, and complications after surgery like PNA and atelectasis
Why would the nurse need to notify the surgeon if the pt has high BP before the surgery?
inc risk for bleeding
Why is a pt more likely to have a cv event during surgery if they have a high heart rate before/during surgery?
a high HR indicates an increased metabolic rate, anesthesia will further inc the metabolic rate –> inc risk for cv event
Why is it important to evaluate renal status before surgery?
to ensure they can clear the anesthetic effective or to make necessary adjustments
Why is it important to know the neurological baseline of the pt before surgery?
you need to know baseline so you can accurately assess the pt after surgery –> we are looking for a return to baseline
What labs are commonly ordered prior to surgery?
- urinalysis
- preg
- blood work : CBC, BMP, blood type, blood co-agg
What is the nurse’s role with informed consent?
- clarify facts presented by the surgeon
- verify the formed was signed (may be an order)
- serve as a witness to the formed being signed
What are the key components of informed consent? (6)
- nature and reason for surgery
- who is preforming the surgery
- who will be in the room
- alternatives to the surgery
- risks associated with the surgery and alternative options
- correct site verification between the pt and the surgeon
- consent for anesthesia is usually separate*
