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Med Surge 4th exam > Perioperative care > Flashcards

Perioperative care Flashcards

1
Q

Surgery that is carefully planned/prefferred treatment for a condition that’s not life threatening or improves a pt’s life is defined:

A

elective surgery

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2
Q

A surgery that’s performed immediately to preserve the function or life of the pt is defined as:

A

Emergency surgery (controlling internal hemorrhage)

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3
Q

This suffix means: an excision or removal of

A

-ectomy

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4
Q

This suffix means: destruction of

A

-lysis

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5
Q

This suffix means: repair or suture of

A

-orrhaphy

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6
Q

This suffix means: looking into

A

-oscopy

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7
Q

This suffix means: creation of opening into

A

-ostomy

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8
Q

This suffix means: cutting into or incision of

A

-otomy

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9
Q

This suffix means: repair or reconstruction of

A

-plasty

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10
Q

Pts who are going to be admitted to the hospital are usually admitted on the day of surgery:

A

same-day admission

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11
Q

The majority of surgical procedures, sometimes called ambulatory/same-day surgery, may be conducted in emergency departments, endoscopy clinics…,all performed using general, regional, and local anesthetic with operations typically less than 2 hrs is defined as:

A

outpatient surgery (Eg: laparoscopic)

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12
Q

This type of surgery is typically preferred by pts and insurers (medicare, medical, private insurances) d/t lest costs r/t minimal labs/meds/and reduces pt’s susceptibility to hospital acquired infections:

A

outpatient surgery

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13
Q

This type of preop assessment includes: identifying pt’s stressors, anxiety, common fears (to anesthesia, disruption of life roles…), hope or coping strategies:

A

Psychosocial assessment

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14
Q

This type of preop assessment includes: PMHx (previous medical conditions/surgeries), medications taken (insulin is elevated when NPO), herbs (teas may cause interaction with anesthesia), anything that can directly/indirectly affect the surgery:

A

Physiological assessment

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15
Q

Besides the psychosocial and physiological preop assessments, what are the other preop assessments that should be gathered:

A

baseline; identify/document surgical site, identify meds, document lab results, identify cultural/ethnic factors, determine if adequate info was disclosed to the pt about surgery

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16
Q

What is the last component of the pt hx for preop:

A

review of systems

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17
Q

This type of system review occurs when we ask the pt about hx of skin problems and assessment of skin for any abnormalities:

A

Integ system (a pt w/hx of pressure ulcers may require extra padding during surgery)

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18
Q

This type of system review occurs when asking for PMHx and current meds for cardiovascular, risk for DVT is high for pts w/hx of thrombosis/smoking/COPD… SCDs are applied in pre-op holding area:

A

Cardiovascular system

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19
Q

This type of system review occurs when asking if there’s a presence of upper airway infection (surgery will be postponed in such a case); asthma pts should be asked for what meds they take as they are more at risk for for post-op pulmonary complications; pts who smoke should be encouraged to stop 6 wks pre-op to decrease risk of pre/post-op respiratory complications:

A

Respiratory system

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20
Q

This type of system review occurs when assessing pt’s ability to respond to questions/commands/maintain orderly thought patterns and documented for post-op comparison; guardian of pt with impaired cognitative function needs to be present to provide informed consent; elderly cognitative baseline is important d/t that they are more affected cognitavely to the anesthesia and we don’t want to falsely label them senile or dementia:

A

Neurologic assessment

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21
Q

This type of system review occurs when asking the pt about PMHx of urinary/renal diseases; problems with voiding/incontinence/enlarged prostate; pregnant women:

A

Genitoruinary system

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22
Q

This type of system review occurs when you inquire about hx of hepatic function which may cause a pt to have an increase for clotting abnormalities:

A

Hepatic system

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23
Q

This type of system review occurs when you’re taking note of any joint, musculskeletal issues that may restrict postioning during surgery; POST-OP PAIN IS D/T CHRONIC MUSCULOSKELETAL PAIN AND POSTIONING DURING SURGERY, rather than acute pain of the actual procedure:

A

musculoskeletal system

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24
Q

This type of system review occurs when you inquire about a pt’s hx of DM as DM pts have increased risk for adverse effects to anesthesia/surgery (delayed healing, ketosis…), to determine if pt has hx of thyroid issues d/t metabolic rates during surgery:

A

Endocrine system

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25
Q

This type of system review occurs by inquiring hx of compromised immune system, use of corticosteroids (usually tapered before surgery), acute infections such as sinustits will post pone a surgery

A

Immune system

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26
Q

This type of system review occurs when gathering info if pt has been vomitting or diarrhea; drugs that may alter balances of fluids in the body; espescially critical for the elderly pts

A

Fluid electrolyte imbalances

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27
Q

This type of system review occurs when a nutritional deficit is gathered to correct pre-post op; if a pt is thin, extra padding may be used to protect bony prominances; obesity stresses cardiac and pulmonary systems (caffeine withdrawal can cause severe HA that may be mistaken for spinal HA):

A

Nutritional status/dietary habits

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28
Q

What is used to assign a pt a physical status rating for anesthesia:

A

H&P (history and physical)

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29
Q

What are the routine preop screening tests:

A

CBC, bld type/cross, electrolytes, glucose; BUN/creatinine, LFTs, urinalysis, EKG, CHR, pregnancy test even if pt says no to it

30
Q

What type of nsg intervention is utilized to reduce a pt’s post-op fear/anxiety/stress by explaning what will occur/when/what the pt will experience:

A

Preoperative teaching

31
Q

What type of is the nsg giving the pt during preop teaching:

A

sensory (what they will see/hear/smell), procedural (NPO status, what to bring, meds, where to report/IV lines), process info (where they will be admitted/where they will wake up)

32
Q

What are the skills that preop pts should be taught:

A

Ambulation such as moving or leg exercises and deep breathing/coughing

33
Q

Why is early ambulation important:

A

Increases: GI function/muscle tone/stimulates circulation/maintains respiratory function and prevents venous stasis while speeding up wound healing

34
Q

There are three phases to a surgery. This phase begins with admission of pt to PACU/PAR and ends when healing is complete:

A

Post-op

35
Q

There are three phases to a surgery. This phase begins when the pt is transferred to op table; ends when pt is admitted to postanesthesia care unit (PACU) or postanesthesia recovery room (PAR):

A

intra-op

36
Q

There are three phases to a surgery. This phase begins with the decision to have surgery and ends when pt is transferred to op table:

A

pre-op phase

37
Q

Purpose of surgical procedure, degree of urgency; and degree of risk are all what type of classifications:

A

general surgical classifications

38
Q

Emergency surgery and elective surgery belong to what type of general surgical classification:

A

degree of urgency

39
Q

Surgery is classified according to the risk of the pt. If surgery is going to be prolonged/complicated, lrg amounts of blood will be lost, vital organ involvement, and post-op complications are most likely to occur, then this is deemed a:

A

Major surgery: high risk

40
Q

Surgery is classified according to the risk of the pt. If the surgery has few complications and is performed in an outpt setting, then the surgery is deemed:

A

Minor surgery: low risk

41
Q

What are the factors affecting the degree of risk:

A

Age, psychologic status, general health, mudication use

42
Q

These types of skills promote venous return, prevent thrombophlebitis and thrombus formation:

A

Leg exercises

43
Q

These types of skills enhance lung expansion and mobilize secretions, prevents atelectasis and PNA:

A

deep breathing and coughing

44
Q

True or false: Rationale for skills teaching should be done pre-op and instruction on skills teaching should be done post-op:

A

True

45
Q

For ambulatory surgery info, time and generaly hygiene instructions are given. What are they:

A

Arrive 1-2 hrs before scheduled time; general hygiene includes pre-op shower, enema; and NPO status to prevent pulmonary aspiration and N/V s/s post-op

46
Q

What is the NPO status for clear liquids, milk, light meal (toast/clear liquid) and reg meal:

A
  • clear liquid=2 hr
  • milk=6
  • light meal with toast and clr liq=6
  • reg meal=8 or more hr
47
Q

An active, shared decision making process between the health care provider and the recipient of care where there must be a witness involved in the signing and three conditions must be met for it to be valid:

A

Informed consent

48
Q

What are the three conditions that must be met for the informed consent to be valid:

A
  1. adequate disclosure of the dx/purpose of tx/risks of tx/probability of succesful outcome
  2. pt must demonstrate CLEAR understanding.comphrehension
  3. The pt must give consent VOLUNTARILY
49
Q

When is the need of an informed consent over-ridden:

A

true medical emergency and no one is there to consent for the pt

50
Q

Why are pts encouraged to void prior to surgery:

A

Meds will cause imbalance when ambulating to bathroom, prevents involuntary elimination under anesthesia, reduces urinary retention

51
Q

What type of medications are given to reduce anxiety, induce sedation, and has an amnesic effect:

A

Benzodiazepines: versed/valium/ativan

52
Q

What type of pre-op meds are given for relieving pain/discomfort during preop procedure:

A

Opioids: morphine/merperidine/fentanyl

53
Q

What type of pre-op meds are given to decrease HCI acid secretion, increases pH and decreases gastric volume:

A

H2 antagonists: Tagamet/pepcid/zantac

54
Q

What type of meds are given for preventing N/V and increase gastric emptying:

A

Antiemetics: reglan/inapsine/zofran

55
Q

What type of meds are given to decrease oral/respiratory secretions, to prevent n/v; prevent bradycardia:

A

Anticholinergics: atropine/robinul/scopolamine

56
Q

What are the additional meds that are given preop:

A

Abx: 1 hr before; eyedrops; routine Rx drugs

57
Q

This purpose of a surgical procedure is to remove a diseased body part:

A

ablative

58
Q

This purpose of a surgical procedure is determine the presence/extent of patho:

A

Dx

59
Q

This purpose of a surgical procedure is to enhance apperance:

A

cosmetic improvement

60
Q

This purpose of a surgical procedure is to cure/eliminate of patho:

A

cure

61
Q

This purpose of a surgical procedure is to examine the nature or extent of a disease:

A

exploration

62
Q

This purpose of a surgical procedure is alleviatie s/s without cure:

A

palliation

63
Q

This purpose of a surgical procedure is to preform an action (removal of a mole) to prevent CAand to promote health:

A

prevention

64
Q

A pt is scheduled for a laparoscopic cholecystectomy at an ambulatory surgery center. The nurse would expect: A) curative surgery for CA of the pancreas, B) palliative surgery for a resection of a tumor, C) surgery w/small incision for removal of the liver, D) removal of the gallbladder using a minimally invasive technique

A

D: removal of the GB

65
Q

While assessing a pt pre-op the nurse notices a hx of latex allergy. Which of the following would be an appropriate intervention: A) notify the surgeon so that the case can be canceled, B) give the pt antihistamine to prevent anaphylactic shock, C) question the pt about his latex allergy came about, D) notify the op room staff so that latex-free supplies will be used:

A

D: notified staff to use latex-free supplies

66
Q

A pt who’s scheduled for a hysterectomy reports using ginko to improve her memory. Which of the following questions is most important to ask: A) how long have you been using ginko, B)have you been taking this herb during the past two weeks, C) how have you been able to tell if this herbal supplement is effective, D) have you experienced any side effects from taking this herba; supplement

A

B: have you taken this in the last two weeks

67
Q

An 85 yo F with a hip fx is scheduled for surgery. She has Alzheimer’s disease and is only oriented to her name. Which of the following should the nurse look for on the informed consent: A) the pt’s mark witnessed by the surgeon, B)the pt’s explanation of the operative procedure, C) a signature of a person who has legal guardianship of the pt, D) the MDs note saying the surgery was explained to the pt

A

C: a caregiver’s signature

68
Q

A priority nsg intervention to assist a pre-op pt in coping with fear of pain would be to: A) inform the pt that pain meds will be available, B) teach the pt to use guided imagery to help manage pain, C) describe the type of pain expected with the pt’s particular surgery, D) explain the pain management plan, including the use of pain intensity scale

A

D: explain the pain management plan

69
Q

The nurse asks the pt who is scheduled for general anesthesia at an ambulatory surgical center when he ate last. He replies that he had a light breakfast a couple of hours before coming to surgery center. Which of the following would the nurse do first: A) ask the pt to void the surgery, B) notify the surgeon and anesthesia care provider, C) tell the pt to come back tomorrow since he ate a meal, D) proceed with the pre-op checklist including site identification

A

B: notify the MD and anesthesia care provider

70
Q

Pre-op considerations for the elderly include: select all that applies: A) only use lrg print educational materials, B) speak louder for pt’s with hearing aids, C) recognize the sensory defieicts may be present, D) provide warm blankets to prevent hypothermia, E) teach important info early in the morning

A

C:recognize that sensory deficits may be present, D: provide warm blankets to prevent hypothermia

71
Q

T or F: the elderly and infants are considered high risk d/t hypothermia and body functions

A

T

72
Q
A

Med Surge 4th exam (8 decks)

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