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NUR 501 > Perioperative Nursing > Flashcards

Perioperative Nursing Flashcards

1
Q

Three phases of Perioperative care

A

Perioperative, Intraoperative, postoperative

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2
Q

Classification of Surgical procedures: Purpose

A

diagnostic, ablative, palliative, reconstructive, transplantation, constructive

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3
Q

Intraoperative

A

begins when the patient is transferred to the OR bed until transfer to the postanesthesia care unit (PACU)

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4
Q

Perioperative

A

begins with decision to have surgery, lasts until patient is transferred to operating room or procedural bed

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5
Q

Postoperative

A

lasts from admission to the PACU or other recovery area to complete recovery from surgery and last follow-up health care provider visit

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6
Q

Classification of Surgical procedures

A

Urgency, Risk, Purpose

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7
Q

Classification of Surgical procedures: Risk

A

Minor or major

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8
Q

Classification of Surgical procedures: Urgency

A

elective, urgent, emergency

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9
Q

Ablative surgery

A

Ablative surgery is performed to remove a diseased part.

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10
Q

Diagnostic surgery

A

Diagnostic surgery is performed to make or confirm a diagnosis.

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11
Q

Palliative surgery

A

Palliative surgery is performed to relieve or reduce intensity of an illness.

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12
Q

Reconstructive Surgery

A

performed to restore function to tissue.

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13
Q

Types of Anesthesia

A

General, Moderate sedation/Analgesia, Regional, Topical/local

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14
Q

General Anesthesia

A

administration of drugs by inhalation or intravenous route

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15
Q

Moderate sedation/Analgesia

A

(conscious sedation/analgesia): used for short-term, minimally invasive procedures

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16
Q

Regional Anesthesia

A

anesthetic agent injected near a nerve or nerve pathway or around operative site

*abdominal surgery

17
Q

Topical/local anesthesia

A

used on mucous membranes, open skin, wounds, burns

18
Q

Three phases of General anesthesia:

A

Induction, Maintenance, Emergence

19
Q

Three phases of General anesthesia: Induction

A

from administration of anesthesia to ready for incision

20
Q

Three phases of General anesthesia: Maintenance

A

from incision to near completion of procedure

21
Q

Three phases of General anesthesia: Emergence

A

starts when patient emerges from anesthesia and is ready to leave operating room

22
Q

Types of Regional anesthesia

A

Nerve blocks
Spinal anesthesia
Epidural anesthesia
Intravenous anesthesia with pneumatic tourniquet-ing

23
Q

Informed Consent

A

Description of procedure and alternative therapies
Underlying disease process and its natural course
Name and qualifications of person performing procedure
Explanation of risks and how often they occur
Explanation that the patient has the right to refuse treatment or withdraw consent
Explanation of expected outcome, recovery, rehabilitation plan, and course of treatment

24
Q

Outpatient/Same-day surgery

A

Reduces length of hospital stay and cuts costs
Reduces stress for the patient
May require additional teaching and home care services for certain patients
-Older patients, chronically ill patients, patients with no support system

25
Q

Outcomes for the Surgical Patient

A

Receive respectful and developmentally and culturally appropriate care
Be free from injury and adverse effects
Be free from surgical site infection
Maintain fluid and electrolyte balance; skin integrity, normal temperature
Collaborate in management of pain
Demonstrate understanding of physiologic and psychological responses to surgery
Participate in rehabilitation process

26
Q

Patient Risk Factors and Strengths (8)

A

Developmental level
Medical and surgical history
Medication history
Nutritional status
Use of alcohol, illicit drugs, or other drugs
Activities of daily living and occupation
Coping patterns and support systems
Sociocultural needs

27
Q

Surgical Risks of Medications

A

-Anticoagulants: precipitate hemorrhage
-Diuretics: electrolyte imbalances, respiratory depression from anesthesia
-Tranquilizers: increase hypotensive effects of anesthetic agents
-Adrenal steroids: abrupt withdrawal may cause cardiovascular collapse
-Antibiotics in mycin group: respiratory paralysis when combined with certain muscle relaxants

28
Q

Usual Presurgical Screening Tests

A

Chest x-ray
Electrocardiography
Complete blood count (CBC)
Basic (BMP) or complete (CMP) metabolic profile
Urinalysis

29
Q

Nurse’s Role in Presurgical Testing

A

-Ensure that tests are explained to the patient
-Ensure that appropriate specimens are collected
-Ensure that results are recorded in patient records before surgery
-Ensure that abnormal results are reported

30
Q

Preparing the Patient Through Teaching

A

Surgical events and sensations
Pain management
Physical activities
Deep breathing
Coughing
Incentive spirometry
Leg exercises
Turning in bed
Early ambulation

31
Q

Nursing Interventions for Surgical Patients (5)

A

Hygiene and skin preparation
Elimination
Nutrition and fluids
Rest and sleep
Preparation and safety the day of surgery

32
Q

Typical Preoperative Medications (3)

A

-Benzodiazepines to alleviate anxiety and produce sedation
-Opioids to facilitate sedation and relaxation
-Alpha 2-adrenergic receptor agonist to reduce anesthesia requirements

33
Q

Error Prevention

A

-Preoperative patient identification verification process
-Marking the operative site
-Final verification just prior to beginning the procedure, referred to as the time-out

34
Q

Postoperative Assessments and Interventions (Every 10 to 15 Minutes) (8)

A

Respiratory status (airway, pulse oximetry)
Cardiovascular status (blood pressure)
Temperature
Central nervous system status (level of alertness, movement, shivering)
Fluid status
Wound status
Pain management
General condition

35
Q

Cardiovascular Complications

A

Hemorrhage
Shock
Thrombophlebitis
Thromboembolism
Deep vein thrombosis
Pulmonary embolus

36
Q

Respiratory Complications

A

Atelectasis
Pneumonia
Pulmonary embolism

37
Q

Additional Postoperative Considerations

A

Preventing surgical site complications
Promoting a return to health
Elimination needs
Fluid and nutrition needs
Comfort and rest needs
Helping the patient cope

38
Q

Interventions to Prevent Respiratory Complications

A

Monitoring vital signs
Implementing deep breathing
Coughing
Incentive spirometry
Turning in bed every 2 hours
Ambulating
Maintaining hydration
Avoiding positioning that decreases ventilation
Monitoring responses to narcotic analgesics

NUR 501 (6 decks)

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