Perioperative Nursing Flashcards
All activities that prepare the patient for surgery
Preoperative
All activities that occur from the time the patient is transferred to OR until he is transferred to recovery
Intraoperative
From the time the patient is admitted to recovery and ends with the resolution of all surgical consequences
Postoperative
Satellite patient
23 1/2 hour stay
Surgery that confirms a diagnosis (ex. biopsy, endoscopy)
Diagnostic
Surgery that confirms type and extent of disease (ex. laprotomy)
Explorative
Surgery to repair or improve
Reconstructive
Type of surgery that replaces joint or organ (ex. knee replacement)
Transplant surgery
Surgery that removes or repairs diseased organ or structure (ex. appendectomy)
Curative
Surgery that alleviates pain or symptoms (ex. tumor debulking)
Palliative surgery
Type of surgery that preserves function or life of client. Could die ex. heart surgery
Emergent
Type of surgery that requires prompt attention within 24-48 hrs. ASAP ex. incision drainage
Urgent
Type of surgery that is indicated for health problems. ex. gallbladder surgery
Required surgery
Type of surgery that satisfies a client, nonurgent. Ex. tonsillectomy
Elective
Type of surgical facility located within 1 mile of hospital
Ambulatory surgical center
PONV
Post anesthesia nausea and vomiting
2 or more health conditions. Ex. Obesity and diabetes
Comorbidity
Surgery using small keyhole incisions
Laparoscopic Surgery
Ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different.
Thermoregulation
Body temperature of 96.8 or greater
Normothermia
Proof that antibiotic given within 1 hr of surgery is effective
Evidence based practice
An elevated resting energy expenditure (REE) 110% of predicted REE. Characterized by weight loss, anemia, high HR, excessive sweating, etc.
Hypermetabolic
An inherited severe reaction to certain drugs used for anesthesia. This severe reaction typically includes a dangerously high body temperature, rigid muscles or spasms, a rapid heart rate, etc.
Malignant hyperthermia
A medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Below 95 degrees
Hypothermia
Urinary elimination post op minimum with foley
30 c.c. an hr
Urinary elimination post op without foley
Within 8 hrs of surgery
Another word for stable
Hemodynamic
Paralyzed bowel
Paralytic ileus
Actions taken to optimize recovery of patients after bowel surgery. Antibiotics, bowel prep, clear liquids up to 2 hrs before surgery.
ERAS - Enhanced recovery after surgery
Done to prevent fecal contamination for bowel surgeries
Bowel prep preop
Sequential compression device
SCD’s
Informed consent must be done by….
Surgeon and witnessed by nurse
Sedation during procedures that don’t require general anesthesia but do require you to remain calm and relaxed, such as a colonoscopy.
Versed
Antibiotics are given within ___ before incision and discontinued within___ hours
1 hr and 24 hrs
Coughing exercises
- Opens alveoli to prevent pneumonia
- Sitting position
- Deep breath hold for 3 seconds then cough deeply 2 or 3 times
- Done every 2-3 hrs post op
- Contraindicated for brain and intraocular surgeries
Also known as sitting position, patient positioning is typically used for neurosurgery and shoulder surgeries.
Fowler’s position
Surgical position where patient is flat on their back
Supine
Surgical position where patient is on their stomach
Prone
Surgical position of the body for medical examination or operation in which the patient is placed head down on a table inclined at about 45 degrees from the floor with the knees uppermost and the legs hanging over the end of the table
Trendelenburg
A common position for surgical procedures and medical examinations involving the pelvis and lower abdomen
Lithotomy
Surgical position where the patient’s head and feet are both lower than the hips.
Kraske or Jackknife position
When the patient is positioned with the non-operative side placed on the surgical surface.
Lateral position
Device used to help you keep your lungs healthy after surgery or when you have a lung illness, such as pneumonia.
Incentive spirometer. Done every 1-2 hrs
Antiembolic stockings must be removed how many times a day?
Twice daily
OR BP is set for every ___ minutes
Every three minutes
Assists the surgeon by providing him with required supplies. Must anticipate needs. Prepares sterile table
Scrub nurse (sterile)
Manages care, protects patient safety and health needs. Monitors asepsis. Maintains count with scrub nurse
Circulating nurse (non-sterile)
What is not sterile on scrubbed staff?
Anything below the waist and on back
Unscrubbed staff must stay ___ ft away
One ft.
Standard air exchange in OR
16-20 air exchanges an hour
400-500 air exchanges an hour in OR
Laminar flow units
Type of anesthesia that produces decreased sensation and pain to selected body parts
Regional or epidural
Type of anesthesia that can trend upwards through body and cause respiratory distress
Regional
Type of anesthesia that decreases consciousness. Helps to reduce the awareness of pain
Conscious sedation AKA moderate or procedural
Anesthesia is removed from the body by what organ?
The lungs
Catgut and chromic sutures
Absorbable sutures
Nylon, synthetic, polypropylene and silk sutures. Used in wet body parts.
Non absorbable sutures
Heavy reinforcing sutures used within muscles. Used to support primary suture line
Retention sutures
Liquid adhesive suture
Dermabond
EBL meaning
Estimate blood loss
Sample of tissue sent for testing
“Frozen section”
Excess CO2 in body
Hypercapnia
Weakened pharynx after surgery. Pick up chin to improve breathing
Hypopharyngeal obstruction
Blood loss greater than 500 ccs causing organ shut down
Hypovolemic shock
Type of shock that causes cardiac pump failure
Cardiogenic shock
Shock caused by spinal cord injury
Neurogenic shock
Shock treatment
- Modified Trendelenburg
- Lactated Ringer IV
- Blood product
Slow oozing bleed comes from
Capillaries
Dark red, quick bleed comes from
Veins
Quick, bright red bleed comes from
Artery
Rapid breathing
tachypnea
Score scale used to determine if patient is able to be discharged from PACU
Aldrete score
Minimum of 9 needed to be moved from PACU. Consciousness, mobility, breathing, circulation, and color
Aldrete Score
Series of muscle contractions
Peristalsis
Hot, red, painful, site with yellow drainage. 4 to 5 days after operation.
Signs of infection
Condition where an area of the lungs collapses and leads to pneumonia, difficulty breathing. High mortality rate in children and seniors. Preventable with patient mobility
Atelectasis
On demand pain medication
patient-controlled analgesia (PCA pump)
- Must understand self-dose
- Must be alert and oriented
Pain relief using 2 drugs
Multimodal
Red, swollen, shiny looking, extremity
DVT
Scan used to determine airflow and blood flow in lungs
VQ scan (ventilation-perfusion scan)
Medication that has cut down on DVT embolisms
Heparin
*Wound Classification
Uninfected, no trauma or inflammation
Clean
*Wound Classification
An incision through which the respiratory, alimentary or genitourinary tract is entered under controlled conditions but with no contamination encountered
Clean contaminated
*Wound Classification
Open, Traumatic wound especially in GI tract. No drainage
Contaminated
*Wound Classification
Wound with purulent drainage
Dirty
Stages of Wound Healing
This phase begins at the time of injury and lasts up to four days.
Inflammatory phase
Stages of Wound Healing
This phase begins about three days after injury and overlaps with the inflammatory phase.
Proliferative
Stages of Wound Healing
This phase can continue for six months to one year after injury.
Remodeling
Primary intention- suture
Secondary intention- granulation & fills in
Tertiary intention- deep wounds sutured later
Types of Wound Healing
Wound dehiscence
Reopening of wound
Protrusion of wound where organs come out
Wound eviseration
77% of surgical patients who die succumb to_______
sepsis associated with infection
