Perioperative Nursing Flashcards
How are surgical procedures classified
+ Urgency
+ risk
+ purpose
 By URGENCY - what is the difference between elective, urgent, emergency surgery
Elective surgery:
+ non-urgent or emergent, preplanned based on patients and doctors availability
+ Example – breast augmentation, tonsillectomy
Urgent surgery:
+ Done within reasonably short time frame to preserve health but is not an emergency
Emergency surgery:
+ Must be done immediately to preserve life, body part, a function
By RISK – what are the two categories of surgery
Minor and major
+ minor surgery is mostly outpatient, patient goes home the same day
+ major surgery requires hospitalization and specialized care, with a higher degree of risk involving major organs or life-threatening situations
Three phases of general anesthesia
+ Induction - administration of anesthesia
+ maintenance – continues through procedure
+ emergence – from point when patient awakes continuing until completion of the procedure
Types of anesthesia
+ General
+ moderate/analgesic
+ regional
+ local
+ topical
What is informed consent
Patient’s voluntary agreement to undergo a particular procedure or treatment
+ signed upon HCP providing all pertinent information for patient to make their decision to go ahead with the procedure
+ occasionally may require a secondary HCP signature in emergency situations
+ signature of patient or of designated signatory happens after
What is included in informed consent
+ description of procedure or treatment, alternative therapies, option of non-treatment, possible complications
+ site of treatment
+ underlining disease process
+ name & qualifications of HCP providing procedure
+ explanation of risks and benefits
+ explanation of patient rights, right to refuse
+ explanation of expected outcome, recovery, rehabilitation plan
Role of RN in informed consent
+ Witness the signature
+ assess patient level of coherence, ability to sign
+ nurse may not explain procedure!! If patient does not understand or has additional questions, HCP must be notified to come speak with patient directly
Informed consent VS. consent
+ Emergencies – procedure can/may happen to save life without informed consent
+ HCP and second HCP would then “consent” – then explain to patient and family post surgery
What is an advanced care directive
+ Legal document — allows patient to specify instructions for healthcare treatment – example: no blood transfusions
+ Living will: includes DNR – “do not resuscitate“
+ who has ‘Durable power of attorney,’ or ‘medical power of attorney’ - to make decisions for patient
+ Religious/cultural: certain religions have certain directives — example needing the body within 6 to 12 hours for burial
Responsibilities of the RN preop
+ Preop assessments for baseline data of vital signs, signs of infections, medication‘s
+ Retrieve cultural and spiritual information for special nursing care
+ engage family about how to prepare for released from hospital
+ provide timeline of anticipated convalescence to patient
+ assess patient’s feeling and anxiety level, Coping abilities
+ Make sure patient understands medical information of what is to come
Responsibilities of RN on day of surgery
+ Make sure patient has everything needed in room for a return from surgery: safety measures, pain meds, personal care needs
+ bath, hygiene, final tests and exams, documentation
+ remove prosthetics in jewelry
+ prep bowels and bladder/catheter
+ antiembolism devices
+ IV, and G-tube
+ preop checklists
Roles of the RN post operative
+ Maintaining respiratory function: incentive spirometry, sitting up, ambulation
+ preventing circulatory stasis: leg exercises, Tedhose, compression devices, early ambulation, promote hydration
+ Administer anticoagulants
+ promote urinary elimination
+ promote normal bowel elimination and adequate nutrition — ONLY AFTER NORMAL BOWEL SOUNDS PRESENT
+ Promote wound healing
+ promote rest & comfort
+ promote maintaining self-concept
What patients should never receive a PCA pump
+ dementia
+ confused
+ disoriented
+ unresponsive
Groups at high risk during/post surgical procedures
+ #1 at risk ➡️ OBESE persons
+ Age: young/ old
+ nutritionally deficient
+ immunocompromised: steroid users, poorly oxygenated, those with fragile tissues
+ fluid and electrolyte compromised: hydration & volume
+ pregnant persons: considerations for both mother and fetus
