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Skills > Perioperative- chapter 40 > Flashcards

Perioperative- chapter 40 Flashcards

1
Q

What is usually signed during the Perioperative phase?

A

Surgical Consent Form

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2
Q

Perioperative nursing involves care of the client in the:

A
  • preoperative stage: before surgery
  • intraoperative stage: during surgery
  • Postoperative stage: after surgery
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3
Q

The Preoperative phase focuses on:

A
  • identifying existing health concerns & planning for Intra and postoperative needs
  • Educate patient on and preoperative care
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4
Q

The assessment done before surgery is called the:

A

AORN

- full physical assessment + nursing history

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5
Q

Preventable perioperative errors cause ___% of surgery related death

A

10%

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6
Q

Preoperative care begins with ___ and ends when ___.

A

the client’s decision to have surgery and ends when he enters the operating room

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7
Q

The examination that determines wether the pt is physiologically, psychologically, and cognitively prepared for the surgery.

A

Nursing Assessment

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8
Q

if during the physical assessment you notice the pt has a “cough” or “lower airway congestion” what do you do?

A

consult the surgeon & anesthesia ASAP

surgery may be delayed due to pt’s safety and possible respiratory distress during procedure

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9
Q

Surgeries are classified by? (4)

A
  1. Body system
  2. Purpose (palliative- not life saving vs Life threatening)
  3. Degree of urgency (life threatening vs elective)
  4. Degree of risk (high risk pt vs not)
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10
Q

Factors contributing to surgical risk?

A
  • age (very old, very young)
  • type of wound (appendix rupture vs elective)
  • preexisting conditions (copd, asthma)
  • Mental status
  • Medications
  • Personal Habits
  • Allergies
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11
Q

Preoperative nursing responsibilities include: (6)

A
  1. Complete Nursing History (health history, clients understanding of surgery)
  2. Physical Assessment (symptoms that indicate risk)
  3. Screening tests (CBC, ECG, Urinalysis)
  4. Surgical Consent Form (confirm its presence)
  5. Educate pt
  6. Printed materials (procedure, post-procedure process, home vs. hospital, turn deep breath and cough)
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12
Q

Examples of Preoperative teaching:

A 
what they can/can't eat (NPO)
prepping skin for pt
explain foley usage
bowel prep
anti-embolism stockings
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13
Q

Examples of Postoperative teaching:

A

deep breathing, coughing, ambulation
Use the bathroom ASAP
Use proper hand-washing before wound care
Avoid smoking
Ask about concerns for post surgery (at home call provider info) etc

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14
Q

What’s something important that you need to address during pre-op of older adults?

A
  • special risks and potential complications

risk: age related respiratory issue, complication: pneumonia & impaired gas exchange

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15
Q

what does a CBC detect?

A

irregular hemoglobin & hematocrit
WBC’s for immune function
platelets

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16
Q

What does UA detect?

A

UTI

glucose or proteinuria (diabetes uncontrolled or renal disease)

17
Q

During “signing of the surgical consent form” what is the physician responsible for vs the nurse?

A

surgeon: 1. give pt info 2. determine if pt is able to make informed decision about surgery

nurse: 1. Verify pt is educated by surgeon
2. Delay if pt still has ?’s & contact surgeon
3. Document that you contacted surgeon

18
Q

Nurse check-off for FINAL steps before pt goes into surgery

A
  • VERIFY name, dob, why pt is there
  • Use preoperative checklists (ensure doc are correct & in chart)
  • BRING CHART and store pt’s belongings away safely
  • Surgical site is MARKED CORRECTLY
  • COMMUNICATE with surgical team
  • BEGIN if possible to prep post-op room
19
Q

Intraoperative care starts at ___ and ends at ___

A

operating suite and ends at postanesthesia care unit (PACU)

20
Q

The sterile team consists of:

A

surgeon, surgical assistant & scrub person

21
Q

The scrub nurse is responsible for: (3)

A
  • setting up sterile field
  • assist pt to sterile drapes
  • MAINTAINING STERILE FIELD
22
Q

The clean team consists of:

A
  • anesthesiologist
  • nurse anesthetist
  • circulating nurse
  • biomed techs
  • radiology techs
23
Q

The goals of the circulating nurse assessment in Intraopertive stage:

A 
prevent aspiration, hypothermia
keep fluid volume balanced
prevent allergic reactions
prep skin
position patient properly
24
Q

The circulating nurse is responsible for preventing:

A

positioning injury

from both pre surgery positioning and post surgery positioning

25
Q

The final step a nurse is responsible before surgery begins:

A
  • UNIVERSAL LAST CHECK- Client, Procedure, Site

- sponge and equipment count

26
Q

What are the 2 phases that the Postop PACU nurse goes through:

A
  1. Recover from Anesthesia- ^ risk for resp/cardiac issues
27
Q

When a pt comes out of surgery, how often should you check on them?

A

every 15 minutes the first hour

- pt should have at least 30mL/hr urine output**

28
Q

What is the time schedule of checks for a pt that’s recovering well?

A

1’st hour- every 15 minutes
2nd hour every 30 mins
every hour for the next 4 hours after that

29
Q

General Anesthesia, pro’s and cons:

A

pro- person is completely still, easily adjusted so procedure isn’t interrupted

cons- depressed resp system so vent is needed
* CONSTANT VITAL MONITORING
^ risk of stroke or death
* Malignant Hyperthermia*

30
Q

Types of Anesthesia: (3)

A
  1. General: out
  2. Conscious sedation: sleepy and easily awoken but no memory
  3. Regional: local anesthesia (lidocaine or bupivacaine) awake during procedure
31
Q

Types of Regional Anesthesia: (4)

A
  1. Peripheral Nerve Block
  2. Spinal Anesthesia- injected into CS fluid= blocks sensation and movement below injury
  3. Epidural- still awake but don’t feel anything below injection
  4. Local- injected or topical loss of pain at specific location
32
Q

What are the circumstances in which a patient shouldn’t do the “deep-breathing, cough move?

A
  • has had nasal surgery
  • opthalmic surgery
  • neurological surgery
    ( increases intracranial pressure to too ^)
33
Q

when is the ideal time you apply anti-embolism stockings?

A

in the morning before the pt gets out of bed

prevents venous distention and edema that occurs when standing or sitting

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