Perioperative Care Flashcards
Define ambulatory surgery.
outpatient or short-stay surgery (ex: laparoscopic)
Define diagnostic surgery.
Surgical exploration to confirm diagnosis (ex: exploratory laparotomy, biopsy)
Define ablative surgery.
Excision or removal of a diseased body part (ex: appendectomy)
Define palliative surgery.
Relieves or reduces intensity of disease symptoms; does not cure (ex: colostomy)
Define reconstuctive/restorative surgery.
Restores function or appearance of traumatized/malfunctioning tissue (ex: internal fixation of fractures)
Define procurement for transplant surgery.
Removal of organs from person pronounced brain dead for transplantation into another person (ex: liver transplant)
Define constructive surgery.
Restores function lost or reduced as a result of congenital anomalies (ex: repair of cleft palate)
Define cosmetic surgery.
Performed to improve personal appearance (ex: rhinoplasty)
Define moribound.
At the point of death
Whose responsibility is it to explain the procedure and obtain informed consent?
The surgeon’s
If the patient has already signed the informed consent, but does not understand the procedure, what should the nurse do?
Have the surgeon come back to explain the procedure and ensure the patient understands all aspects
When should you inquire about the patient’s expectations for pain control?
Before the surgery
What are the three stages of general anesthesia?
Induction (administration of anesthetics and endotracheal intubation), maintenance (positioning, preparation, procedure), emergence (often occurs in OR)
Define general anesthesia.
Loss of all sensation and consciousness by use of IV infusion and inhalation
Define regional anesthesia.
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)
Define local anesthesia.
Loss of sensation at the desired site by local injection or topical application; often used in ambulatory surgery (ex: lidocaine)
Define conscious/moderate sedation.
Depressed level of consciousness with post-procedure amnesia, able to respond to verbal stimuli or light tactile stimulation (ex: Versed)
What is the role of the circulating nurse?
Caring for the patient, assisting with procedures, monitoring for breaks in sterile technique, providing additional supplies, verifying counts, documenting
What is the role of the scrub nurse?
Maintaining sterile field, assisting in sterile procedures, counting sponges and instruments
Define postoperative surgical phase I.
Close monitoring in PACU immediately after surgery (ex: for patients who have undergone general anesthesia)
Define postoperative surgical phase II.
Recovery in ambulatory surgeries; patient is in observation and prepared for discharge
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?
The surgeon’s
Define PARSAP.
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
Define PARS.
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
Define postoperative convalescence.
Recovery after patient is stabilized; focuses on returning pt to a functional level of wellness
Define malignant hyperthermia (MH).
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
What is one of the first signs of MH?
Increased expired CO2
What is one of the late signs of MH?
Elevated temperature
Define paralytic ileus.
Nonmechanical obstruction caused by lack of physiological, neurogenic or chemical imbalance associated with decreased peristalsis
What might a distended abdomen indicate postoperatively?
Accumulation of gas, bleeding in a pt who had abd surgery (late sign) or paralytic ileus
