Perioperative Nursing Flashcards
caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them…
medical errors, IOM
2017 National Patient Safety Goals
- prevent infection after surgery
- Right surgery, right patient, right site
- Surgical site marking
- Pause before surgery
Process of passing patient information from one caregiver to another for the purpose of ensuring the continuity and safety of the patient
hand-off communication
SBAR
situation, background, assessment, recommendations
need to be admitted and watched
inpatient
one day surgery center
ambulatory
surgery that needs to be immediately to ensure survival
emergency
choosing to have a surgery completed that is not necessary
elective
surgery that needs to be completed but not immediately
urgent
minor vs major
minor = wisdom teeth removal major = open heart surgery on bypass
surgery classifications
diagnostic curative restorative palliative cosmetic transplant
from when the patient and physician decide surgery is necessary until patient is transferred to OR bed
preoperative
OB red until transfer to PACU
intraoperative
PACU admission until the last followup physical appointmet
postoperative
assess health hx physical assessment (VS, CXR, EKG, blood type and screen,, CBC, CMP, electrolytes, coagulation studies, urinaylsis) outcome identification education physical preparation care plan evaluation
preoperative care
when a patient autonomously and cognitively grants permission to a provider to perform a surgery procedure after considering all alternatives, benefits, and risks of the procedure
informed consent
Description
underlying disease process and course
name and qualifications of surgeon
explanation of risks and expected outcome
right to refuse or withdraw consent
must be 18 or an emancipated minor to sign consent
parents sign for dependent children as legally responsible
needed for informed consent
clarity information provided by physician
ensure consent prior to administering mood affecting drugs
witness to signature
nursing responsibilities for informed consent
preoperative mediations
sedatives anticholinergies neuroleptanalgesics narcotics H2 receptor blockers
accurate patient ID last known oral intake safe transport with 4 side rails up IV infusing at prescribed rate preoperative medications taken or sent with patient OR checklist and easily accessible
Immediate pre op responsbilities of the nurse
maintenance of sterile technique contrinuous pt monitoring fire safety instrument and sponge count breaks for personnel - use SBAR! positioning - monitor pressure points
intraoperative safety
genetic condition; familial; anesthesia triggers a lot of overactive muscle movements earliest sign = unexplained tachycardia then = ventricular dysrhythmia hypotension hyperthermia decreased CO Oliguria cardiac arrest
malignant hyperthermia
loss of consciousness
relaxation of skeletal muscles
reduce reflex action
correct uses of general anesthesia
being put to sleep
inhalation of IV
general anesthesia
rapid induction, longer-lasting
inhaled general anesthesia
pleasant onset, less post op N/V, brief duration
IV general anesthesia
injected around nerves to area
pt. alert and awake
regional anesthesia
types of regional anesthesia
epidural
spinal (C-section)
conscious state sedation/monitored
midazolam (Versed) = preferred agent
excellent amnesia, short-acting
moderate anesthesia
conduction block; reversible nerve block
injection into peripheral nerves
local anesthesia
beginning anesthesia
stage I
excitement
stage II
surgical anesthesia
stage III
medullary depression; irreversible brain death
stage IV
pain hypervolemic shock N/V thrombophlebitis-DVT pulmonary embolus fluid overload atelectasis pneumonia airway obstruction surgical site infection (SSI)
post op complications
prevent respiratory complications
prevent cardiovascular complications
monitor and prevent SSI
maintaining glycemic control
post-op safety
