Perioperative- chapter 40 Flashcards
What is usually signed during the Perioperative phase?
Surgical Consent Form
Perioperative nursing involves care of the client in the:
- preoperative stage: before surgery
- intraoperative stage: during surgery
- Postoperative stage: after surgery
The Preoperative phase focuses on:
- identifying existing health concerns & planning for Intra and postoperative needs
- Educate patient on and preoperative care
The assessment done before surgery is called the:
AORN
- full physical assessment + nursing history
Preventable perioperative errors cause ___% of surgery related death
10%
Preoperative care begins with ___ and ends when ___.
the client’s decision to have surgery and ends when he enters the operating room
The examination that determines wether the pt is physiologically, psychologically, and cognitively prepared for the surgery.
Nursing Assessment
if during the physical assessment you notice the pt has a “cough” or “lower airway congestion” what do you do?
consult the surgeon & anesthesia ASAP
surgery may be delayed due to pt’s safety and possible respiratory distress during procedure
Surgeries are classified by? (4)
- Body system
- Purpose (palliative- not life saving vs Life threatening)
- Degree of urgency (life threatening vs elective)
- Degree of risk (high risk pt vs not)
Factors contributing to surgical risk?
- age (very old, very young)
- type of wound (appendix rupture vs elective)
- preexisting conditions (copd, asthma)
- Mental status
- Medications
- Personal Habits
- Allergies
Preoperative nursing responsibilities include: (6)
- Complete Nursing History (health history, clients understanding of surgery)
- Physical Assessment (symptoms that indicate risk)
- Screening tests (CBC, ECG, Urinalysis)
- Surgical Consent Form (confirm its presence)
- Educate pt
- Printed materials (procedure, post-procedure process, home vs. hospital, turn deep breath and cough)
Examples of Preoperative teaching:
what they can/can't eat (NPO) prepping skin for pt explain foley usage bowel prep anti-embolism stockings
Examples of Postoperative teaching:
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
What’s something important that you need to address during pre-op of older adults?
- special risks and potential complications
risk: age related respiratory issue, complication: pneumonia & impaired gas exchange
what does a CBC detect?
irregular hemoglobin & hematocrit
WBC’s for immune function
platelets
What does UA detect?
UTI
glucose or proteinuria (diabetes uncontrolled or renal disease)
During “signing of the surgical consent form” what is the physician responsible for vs the nurse?
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
Nurse check-off for FINAL steps before pt goes into surgery
- 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
Intraoperative care starts at ___ and ends at ___
operating suite and ends at postanesthesia care unit (PACU)
The sterile team consists of:
surgeon, surgical assistant & scrub person
The scrub nurse is responsible for: (3)
- setting up sterile field
- assist pt to sterile drapes
- MAINTAINING STERILE FIELD
The clean team consists of:
- anesthesiologist
- nurse anesthetist
- circulating nurse
- biomed techs
- radiology techs
The goals of the circulating nurse assessment in Intraopertive stage:
prevent aspiration, hypothermia keep fluid volume balanced prevent allergic reactions prep skin position patient properly
The circulating nurse is responsible for preventing:
positioning injury
from both pre surgery positioning and post surgery positioning
