Perioperative Care Flashcards
What are the three phases of perioperative care?
Preoperative, intraoperative, and postoperative.
What happens during the preoperative phase?
Assessment, patient education, preparation for surgery.
What happens during the intraoperative phase?
Surgical procedure, anesthesia administration, patient safety monitoring.
What happens during the postoperative phase?
Recovery, complication prevention, pain management.
What key factors should be included in a preoperative assessment?
Medical history, allergies, medications, smoking/alcohol use, NPO status, psychosocial factors.
Why is smoking history important in preoperative assessment?
Increases the risk of postoperative respiratory complications.
Why should a latex allergy be assessed before surgery?
Patients allergic to bananas or kiwi may have a latex allergy.
What medications can affect the surgical experience?
Anticoagulants, opioids, thyroid medications, anticonvulsants, herbal supplements.
What are key components of preoperative patient education?
Deep breathing, mobility exercises, pain management, NPO instructions.
Why is incentive spirometry important for surgical patients?
Prevents atelectasis and promotes lung expansion.
What are immediate preoperative nursing interventions?
Gowning patient, removing jewelry, administering preanesthetic meds, documentation, transport to OR.
What special considerations are needed for older adult patients?
Higher risk of confusion, slower anesthesia metabolism, increased fall risk.
What are perioperative concerns for obese patients?
Increased risk of wound dehiscence, hypoventilation, and infections.
How should perioperative care be adapted for disabled patients?
Assess mobility limitations, communication needs, involve caregivers.
What are the legal requirements for informed consent?
Must be signed before psychoactive meds, surgeon explains risks, nurse witnesses signature.
What preoperative documents must accompany the patient to surgery?
Informed consent, preoperative records (health history, allergies, lab results).
What is the ‘Time-Out’ protocol in surgery?
Final verification of correct patient, procedure, and surgical site before incision.
What is the role of the circulating nurse?
Coordinates care, documents, ensures patient safety.
What is the role of the scrub nurse or surgical technologist?
Prepares and hands sterile instruments to the surgeon.
What is the role of the anesthesiologist or CRNA?
Administers and monitors anesthesia.
What does the RN First Assistant (RNFA) do?
Assists the surgeon with suturing, hemostasis, and tissue handling.
What is malignant hyperthermia?
A life-threatening reaction to anesthesia causing rapid fever, tachycardia, and muscle rigidity.
What is the treatment for malignant hyperthermia?
Dantrolene, cooling measures, IV fluids.
What intraoperative complications can occur from anesthesia?
Hypotension, allergic reactions, respiratory depression.
How do positioning injuries occur during surgery?
Improper positioning can lead to nerve damage, pressure ulcers, and joint strain.
What are the three main types of anesthesia?
General, regional (spinal/epidural), and local.
What are the risks of general anesthesia?
Respiratory depression, aspiration, malignant hyperthermia.
What are the advantages of regional anesthesia?
Patient remains awake, better postoperative pain control.
What is a common side effect of spinal anesthesia?
Hypotension and spinal headache.
What is the role of the nurse in anesthesia management?
Monitor vital signs, airway, pain, and signs of complications.
What is the primary responsibility of the PACU nurse?
Maintain airway, monitor vital signs, prevent complications.
Why is elevating the head of the bed important after surgery?
Helps maintain airway and prevents aspiration.
What should the nurse do if a patient vomits postoperatively?
Turn patient to their side to prevent aspiration.
What medications are commonly used for postoperative nausea and vomiting?
Ondansetron (Zofran), metoclopramide (Reglan), promethazine (Phenergan).
What are signs of hypovolemic shock?
Pallor, weak pulse, hypotension, rapid breathing.
How is hypovolemic shock managed?
IV fluids, oxygen, monitor vital signs.
What are the signs of a deep vein thrombosis (DVT)?
Leg pain, swelling, redness, warmth.
How can postoperative deep vein thrombosis (DVT) be prevented?
Early ambulation, compression stockings, anticoagulants.
What should a nurse do if wound dehiscence or evisceration occurs?
Cover wound with sterile saline dressing, place patient in low Fowler’s position, call surgeon immediately.
What are the three types of wound healing?
Primary Intention, Secondary Intention, Tertiary Intention.
What is tertiary intention wound healing?
Delayed closure due to infection risk.
What is secondary intention wound healing?
Heals from inside out (e.g., pressure ulcer).
What is primary intention wound healing?
Closed with sutures/staples (e.g., surgical incision)
What factors affect wound healing?
Age, infection, poor nutrition, smoking, chronic disease (diabetes).
What are the purposes of postoperative dressings?
Protect the wound, absorb drainage, prevent infection, immobilize if necessary.
When should the first postoperative dressing change occur?
Per surgeon’s orders; usually the nurse can perform subsequent changes.
