Perioperative Care

Question 1

Define ambulatory surgery.

Answer 1

outpatient or short-stay surgery (ex: laparoscopic)

Question 2

Define diagnostic surgery.

Answer 2

Surgical exploration to confirm diagnosis (ex: exploratory laparotomy, biopsy)

Question 3

Define ablative surgery.

Answer 3

Excision or removal of a diseased body part (ex: appendectomy)

Question 4

Define palliative surgery.

Answer 4

Relieves or reduces intensity of disease symptoms; does not cure (ex: colostomy)

Question 5

Define reconstuctive/restorative surgery.

Answer 5

Restores function or appearance of traumatized/malfunctioning tissue (ex: internal fixation of fractures)

Question 6

Define procurement for transplant surgery.

Answer 6

Removal of organs from person pronounced brain dead for transplantation into another person (ex: liver transplant)

Question 7

Define constructive surgery.

Answer 7

Restores function lost or reduced as a result of congenital anomalies (ex: repair of cleft palate)

Question 8

Define cosmetic surgery.

Answer 8

Performed to improve personal appearance (ex: rhinoplasty)

Question 9

Define moribound.

Answer 9

At the point of death

Question 10

Whose responsibility is it to explain the procedure and obtain informed consent?

Answer 10

The surgeon’s

Question 11

If the patient has already signed the informed consent, but does not understand the procedure, what should the nurse do?

Answer 11

Have the surgeon come back to explain the procedure and ensure the patient understands all aspects

Question 12

When should you inquire about the patient’s expectations for pain control?

Answer 12

Before the surgery

Question 13

What are the three stages of general anesthesia?

Answer 13

Induction (administration of anesthetics and endotracheal intubation), maintenance (positioning, preparation, procedure), emergence (often occurs in OR)

Question 14

Define general anesthesia.

Answer 14

Loss of all sensation and consciousness by use of IV infusion and inhalation

Question 15

Define regional anesthesia.

Answer 15

Loss of sensation in one area of the body by infiltration and local application; no loss of consciousness, but pt is often sedated (ex: spinal or epidural)

Question 16

Define local anesthesia.

Answer 16

Loss of sensation at the desired site by local injection or topical application; often used in ambulatory surgery (ex: lidocaine)

Question 17

Define conscious/moderate sedation.

Answer 17

Depressed level of consciousness with post-procedure amnesia, able to respond to verbal stimuli or light tactile stimulation (ex: Versed)

Question 18

What is the role of the circulating nurse?

Answer 18

Caring for the patient, assisting with procedures, monitoring for breaks in sterile technique, providing additional supplies, verifying counts, documenting

Question 19

What is the role of the scrub nurse?

Answer 19

Maintaining sterile field, assisting in sterile procedures, counting sponges and instruments

Question 20

Define postoperative surgical phase I.

Answer 20

Close monitoring in PACU immediately after surgery (ex: for patients who have undergone general anesthesia)

Question 21

Define postoperative surgical phase II.

Answer 21

Recovery in ambulatory surgeries; patient is in observation and prepared for discharge

Question 22

Whose responsibility is it to provide information to the family regarding the patient’s status, the results of the surgery and any complications that may have occured?

Answer 22

The surgeon’s

Question 23

Define PARSAP.

Answer 23

Post anesthesia recovery score for ambulatory patients; assessment tool used post-operatively for ambulatory surgeries; must be 18+ before discharge unless pt was unable to walk or use extremities before the surgery

Question 24

Define PARS.

Answer 24

Post anesthesia recovery score; assessment tool used post-operatively; must be 8-10 before discharge from PACU; if PARS score is still low after 2-3 hours, pt is transferred to ICU

Question 25

Define postoperative convalescence.

Answer 25

Recovery after patient is stabilized; focuses on returning pt to a functional level of wellness

Question 26

Define malignant hyperthermia (MH).

Answer 26

Severe hypermetabolic state and rigidity of the skeletal muscles caused by an increase in intracellular calcium ion concentration; genetic disorder triggered by exposure to anesthesia and the depolarizing muscle relaxant succinylcholine

Question 27

What is one of the first signs of MH?

Answer 27

Increased expired CO2

Question 28

What is one of the late signs of MH?

Answer 28

Elevated temperature

Question 29

Define paralytic ileus.

Answer 29

Nonmechanical obstruction caused by lack of physiological, neurogenic or chemical imbalance associated with decreased peristalsis

Question 30

What might a distended abdomen indicate postoperatively?

Answer 30

Accumulation of gas, bleeding in a pt who had abd surgery (late sign) or paralytic ileus