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Clients with Health Challenges - N3600 > Perioperative care - things in red > Flashcards

Perioperative care - things in red Flashcards

1
Q

Suffix meaning: Excision or removal

A

Ectomy

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2
Q

Suffix meaning: Destruction of

A

lysis

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3
Q

Suffix meaning: repair or suture of

A

orrhaphy

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4
Q

Suffix meaning: looking into

A

oscopy

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5
Q

Suffix meaning: creation of opening into

A

ostomy

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6
Q

Suffix meaning: cutting into or incision of

A

otomy

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7
Q

Suffix meaning: repair or reconstruction of

A

plasty

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8
Q

During the preoperative assessment, it is vital to take note of any prescription and OTC medications, and ______ used.

A

herbs

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9
Q

Describe the preoperative rating.

A

Rating from I to V - done by anesthesiologist
I - healthy
II - mild risk
III - severe risk
III - severe threat to life
V - unlikely to survive 24 hours with or without surgery
Done to protect surgeon

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10
Q

There are three patient information types, what are they? Describe them.

A

Sensory information - what patient will see, hear, smell, taste, feel during surgery

Process information: patient wants general flow of what will happen, but not specific details

Procedural information: specific details - want to know everything

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11
Q

Consent:
- Anyone undergoing invasive procedure must sign an _________ consent
Pt. or legal designate must receive full explanation of the operation, including reasons for the surgery, alternatives available, _____ and ______, and probability of a successful outcome from the “_______”

A

informed
risks, benefits
surgeon

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12
Q

What is an important consideration in preoperative care when preparing the GI tract to receive GA?

A

Remove the water jug from the patient’s bedside

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13
Q

Although we generally remove everything from the patient and put their belongings in a safe area, what can they have on their person?

A

A wedding band taped in place

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14
Q

Immediate care prior to OR:

  • Ensure patient has done this
  • Complete this.
A

Ensure patient has voided

Complete and sign preoperative checklist

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15
Q

Immediate care prior to OR - preoperative medications.

What is important?

A

Check written preoperative Dr’s orders for which medications are to be given the DAY OR SURGERY

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16
Q

What is one of the more important meds to be given prior to surgery?

A

Insulin - up to doctor to determine, but best to ask; dose often elevated due to insult to body

17
Q

What are the most important roles of the circulating nurse?

A

Ensures pt safety

Advocates for the patient

18
Q

Admitting client to OR

  • Done by?
  • Pt identified by arm band, and ID number as well as asked to state name, surgeon’s name, operation and _______ (verified against consent)
A

circulating nurse

location

19
Q

What do we use to report in between transfers?

A 
SBAR
Situation
Background
Assessment
Recommendation
20
Q

What is the MOST important part of post-operative care on the unit?

A

Reunite the family!

21
Q 
Post-operative assessment:
Assess respiratory status:
- \_\_\_\_\_\_\_ airway
- \_\_\_\_\_\_\_ all lobes of the lungs
- \_\_\_\_\_, \_\_\_\_\_ and \_\_\_\_\_\_ of respirations
- Chest \_\_\_\_\_\_\_
- Body temperature > \_\_\_\_C in the first 24 hours or oxygen saturation \_\_\_ indicates this.
What do we do?
A 
patent
auscultate
rate, rhythm, depth
symmetry
37.7C; 92%
atelectasis
Encourage DB and C
22
Q

Post-operative assessment:

  • Assess Circulatory status:
  • thrombus can form in any blood vessel - be aware for _____, unilateral _______ or warmth in the _____
  • Encourage ______ and leg ______, apply _______
  • check ___, skin ____, and ______
A

pain, edema, calf
turning, exercises, stockings
VS, temperature, colour

23
Q

Post-operative assessment:
Monitor the IV, PICC lines:
- Patency, type of solution and rate of infusion
- Check insertion sites for?
- Intake and output monitoring - ?
- Can be switched to _____ _____ once the pt is stable

A

reptiles
I&O - 0.5mL/kg/hr or 30mL/hr or urine
saline lock

24
Q

Post-operative assessment:
Assess neurological status
- _______ first sense to return
- ______ more prone to confusion which can last for days to weeks - remember to observe for ______
- Anesthetics are ____ soluble so ______ patients require more anesthetic and take longer to clear drugs
- LOC, PERRLA, A&Ox3 - lingering effects of anesthesia for 24 hours

A

hearing
seniors - delirium
fat, obese

25
Q

Post-operative assessment:
Surgical wound status:
- wound infections tend to develop __-___ days post-op
- What do we assess?

Signs and symptoms of infection?
- What are the important ones to look out for?

A

3-4
dressing, amount and character of dressing

SnS

  • INCREASING pain
  • INCREASED drainage
26
Q

Post-operative assessment:
Monitor drainage tubes:
- Note whether they should be attached to _______ or ______
- is the drainage tube _____, if not irrigate with ____ _____ - this requires what?
- NG tubes inserted for decompression remain in place until _____ begins - how do we know it has begun?

A

suction or gravity
patent - irrigate with NS but with physician order
persistalsis - know when BS present, flatus or hunger present

27
Q

Small collapsible piece of tubing that removes drainage from inside the wound

A

Penrose drain

28
Q

Describe removal of a penrose drain.

A

MD will order for drain to be shortened by 1” per day (check order)
- Clean wound, pull drain out 1”, reattach safety pin and snip the drainage tube above the pin with sterile scissors and cover with a dry sterile dressing (DSD)
Document and keep doing this until drain is removed/falls out

29
Q

Inserted into the wound, stabilized with a suture on top, drainage collects via a vacuum into collection chamber
Ensures skin is dry. Drainage is emptied periodically from the reservoir and the vacuum is reestablished

A

vacuum drain

30
Q

Small balloon collection device; vacuum established by squeezing all the air out of the balloon then closing it.

A

Jackson-Pratt

31
Q

Flat circular collection device; vacuum established by pushing top down until chamber is flat then close device.

A

Hemovac

32
Q

Drain removal

  • most important thing?
  • often removed when there is _____ drainage in 24 hrs
  • Painful - what do we do?
A

check orders for removing the drain
often removed when there is <30mL drainage in 24 hr
Painful - pre-medicate pt, when removing having patient take a deep breath in and blow it out, remove drain while they are exhaling - quick and do not hesitate

33
Q

Post-operative assessment

- How do we control nausea and vomiting?

A

Give fluids, clear and flat
anti-emetics
k-basin near
position on side to prevent aspiration, etc.

34
Q

Post-operative assessment - Control pain

  • Analgesics should be given when needed and ______ pain becomes severe
  • Document the date and time of medication, amount given, pain location and the _________ of medication
A

before

effectiveness

Clients with Health Challenges - N3600 (22 decks)

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