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FOUNDATIONS EXAM 2 > Perioperative Nursing > Flashcards

Perioperative Nursing Flashcards

1
Q

What is the AORN and their goals

A

organization for perioperative nurses
- patient-centered
safety, physiological, and behavioral

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2
Q

What are the three phases of perioperative nursing

A

preoperative
intraoperative
postoperative

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3
Q

define preoperative nursing

A

-inpatient or outpatient
-varying amount of planning time
-begins with the decision to have surgery
-lasts until pt is transferred to the operating room

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4
Q

define intraoperative nursing

A

begins when pt is transferred to OR until pt goes to PACU

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5
Q

What is the PACU

A

post anesthesia care unit

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6
Q

define postoperative nursing

A

-can be in ICU, same-day surgery suite, outpatient, rehab
-can be a day or months
-lasts from admission to recovery room to last follow-up visit

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7
Q

what is perioperative nursing

A

surgical nursing
-before, during, and after

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8
Q

define major surgery

A

inside a body cavity, has a longer/more complicated recovery

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9
Q

define minor surgery

A

does not expose the body cavity, has an easier recovery

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10
Q

define elective surgery

A

choosing to have done, may not preserve life/function

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11
Q

what kind of surgery is a joint replacement

A

elective

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12
Q

define urgent surgery

A

has to be done promptly, within two days
-is done to preserve life and function

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13
Q

what kind of surgery is a fracture repair

A

urgent

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14
Q

define emergent surgery

A

done immediately, life-saving, do not need consent

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15
Q

what kind of surgery is the removal of an aneurysm

A

emergent

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16
Q

give an example of diagnostic surgery

A

exploratory surgery

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17
Q

what is ablative surgery

A

the removal of a diseased body part

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18
Q

what is a palliative surgery

A

eliminating symptoms, promoting improvement

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19
Q

define reconstructive surgery

A

repair a deformity

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20
Q

define transplantation surgery

A

replacement by a donor or artificial source

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21
Q

what is a common constructive surgery

A

cleft lip surgery, normally birth defects

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22
Q

what is the main goal of a preoperative nurse

A

identify and minimize risks

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23
Q

What are the assessments of a pre-op nurse

A

-history and physical (normally done by a physician)
-identification of risk factors and allergies
-medication and treatment assessment
-facilitating/reviewing diagnostic tests
-identification of teaching and psychosocial needs (what will happen after?)
assessing for postsurgical support and referral needs

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24
Q

What are some things to ask about in an H&P

A

-development
-medical history and comorbidities
-surgical history and complications
-allergies and medications taken
-nutritional status
-ADLs and occupation
-sociocultural needs
-support system

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25
Q

why is nutritional status important for surgery

A

can affect albumin levels

26
Q

what are examples of sociocultural needs?

A

may need a translator
-be aware of things that could be culturally important to them

27
Q

how can nicotine affect surgery

A

it is a vasoconstrictor, raising bp and can decrease hemoglobin function
-surgeons may refuse to operate

28
Q

what are things important to a physical exam

A

-height and weight (for dosing) –can use wingspan if unsure
-vital sign baseline
-integumentary system and skin integrity
-respiratory health, infections are a cause for cancelation
-cardiovascular health
-neurological health (can they make their own decisions)
-GI/GU
-musculoskeletal (what are their abilities, important for post-op assessment)

29
Q

biggest concern/comorbidity for surgery

A

-heart health, may not be able to handle surgery
-diabetes, impacts the vascular system, electrolytes, CV health and infection risk

30
Q

common comorbidities for surgery

A

-HTN, MI, HR, arrhythmias, CVA, thrombocytopenia, anemia
-COPD, asthma, pneumonia, bronchitis, URI
-renal and hepatic health
-diabetes
-medication (warfarin)

31
Q

risk factors for surgery

A

-age (very old and young)
-nutritional status (underweight and obese)
-malnutrition=more dangerous, may not have enough resources
-obese=increased operation time and smaller lung capacity
-fluid and electrolyte balance, can shift during surgery
-A pregnancy, test needs to be done
-previous complications with surgery

32
Q

what is a part of a BMP or CMP

A

-electrolytes
-BUN and creatinine
-glucose
-liver function

33
Q

what is tested for a coagulation study

A

PT/INR
PTT

34
Q

Other than BMP & CMP & coagulation needs to be done for blood work

A

Blood type, HCG, complete blood count

35
Q

what are the parts of a complete blood count

A

-RBC
-Hemoglobin Hgb
-Hematocrit Hct
-WBC
Platelets

36
Q

what should RBC be

A

men: 4.6-6.2
women: 4.2-5.4

37
Q

what should hemoglobin be

A

men: 13-18
women: 12-16

38
Q

why is hemoglobin important

A

carries oxygen and CO2, is important for healing

39
Q

what should hematocrit be

A

men: 42-52%
women: 35-47%

40
Q

how is hematocrit measured

A

amount of blood that is RBC, a high level means dehydration
-should be 3x the amount of hemoglobin

41
Q

what should WBC be

A

4.5-11

42
Q

what should platelets be

A

150-450

43
Q

why are platelets important

A

ability to bleed/clot

44
Q

what are the electrolytes

A
  • sodium Na
  • potassium K
  • Chloride Cl
  • bicarbonate HCO3
    -Glucose
45
Q

what should sodium level be

A

135-145

46
Q

what should potassium level be

A

3.5-5

47
Q

what should chloride be

A

95-105

48
Q

what should bicarbonate levels be

A

22-26

49
Q

what should glucose levels be

A

70-110

50
Q

what do glucose levels do after surgery

A

spike

51
Q

what should kidney levels be

A

creatinine: 0.7-1.4 (more specific)
BUN (blood urea nitrogen): 10-20

MONITORS WASTE LEVELS

52
Q

explain how coagulation numbers work

A

the higher the number the longer it takes for a clot to form

53
Q

Prothrombin levels PT

A

9.5-12
rarely used

54
Q

international normalized ratio INR levels

A

0.76-1.27 when not on meds
2-3 when on meds
-established by the World Health Organization for accuracy

55
Q

activated partial thromboplastin time aPTT and when is it used

A

20-39
-used when taking heparin

56
Q

anti-factor Xa assay levels and when is it used

A

0.3-0.7
-used when taking heparin, more accurate than aPTT

57
Q

Imaging that may be done before surgery

A

chest x-ray
joint/bone x-ray
CT
MRI

58
Q

Cardiac workup done before surgery

A

EKG –electrical conduction
cardiac stress test
sleep study – sleep apnea

59
Q

when should teaching be done

A

before surgery

60
Q

rules of informed consent for nurses

A

can verify consent and sign over the phone
advocate for pt education

61
Q

important interventions for the day of

A

-NPO
-IV placement
-bowel/bladder emptying
-taking preoperative meds on time
-skin prep
-removal of items
-finish documentation
-provide direction and emotional support

62
Q

what does the preoperative checklist cover

A

-consent
-advanced directives
-preoperative checklist

FOUNDATIONS EXAM 2 (6 decks)

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