Perioperative Nursing Care Flashcards
What does the prefix -peri mean?
Around something
What does ablative mean?
‘Getting rid of’ or removing a diseased body part surgery
What is palliative surgery?
The sole purpose is to minimise symptoms, without curing or fixing anything
What is preventative surgery?
To prevent something from going wrong, like removing moles before they become malignant
What is -ectomy
removal by cutting
What is -oscopy
Looking into
What is -ostomy
Formation of a permanent artificial opening
What is -otomy
Incision or cutting into
What is -plasty
Formation or repair
What is -orrhaphy
Suture or repair
What are the four goals for pre-operative care?
- Assessing problems that may increase surgical risks
- Teaching guidelines regarding surgery
- Instructing exercises that will benefit the patient during post-operative period
- Planning for discharge
What are some of the things you need to assess with a patient coming in for surgery?
- Baseline data (mobility, normal life is like)
- Physiological factors
- Use of medications (non prescription and prescription)
- Laboratory tests (like for HB baseline, electrolyte status) (remember this is a medical responsibility, not nursing)
- Psychological status of the patient (assess anxiety)
- Cultural factors
What does a physiological assessment assess for?
- Presence of pain
- Allergies
- Presence of trauma and infection
- The use of medications
- Assess for pre-existing conditions (heart, respiratory, neuro, urinary, GIT etc)
- Assess for fears and anxiety
How do we manage fear of unknown?
- By patient education
- By therapeutic relationship
After what age is it routine to do a chest x-ray before surgery?
55
Why is it important to do routine preoperative screening tests?
Because if the pt has a low prothrombin clotting time, this will affect risk of bleeding
Screening for UTI etc
Why are pt’s NIL by mouth before operations?
Because then they will be at risk of aspiration (vomiting under anaesthesia and then suffocating)
What is a lymphedema bracelet?
To make others aware that they have lymphedema on that arm and to avoid using it for BP or medical procedures
What does the nurse have to ensure goes with the pt to the operating theatre?
At least 20 name labels
What is the pre-operation checklist?
Generic part Patient prep Consent forms Blood availability status Investigations Documentations Nil by mouth status Pre-operative medication
What are the Parameters for discharge from PACU?
Easy, noiseless breathing Protective reflexes are active Patients are conscious and orientated Vital signs have been stable Intake and output is adequate
What are the signs of haemorrhage?
Restlessness Cold, moist, pale skin Deep rapid respiration, Tachycardia Hypotension Progressive weakness
What are the signs of Thrombophlebitis?
Pain Redness Swelling Warmth Positive Homan’s sign
What are the signs of intestinal obstruction?
Abdominal distention
No bowel movement
No bowel sounds
What are the signs of wound complications?
Wound infection
Wound dehiscence
Wound haemorrhage
How do you manage a haemorrhage? (on advice from medical of course)
Administer Vitamin K as ordered
Pressure dressings
Blood transfusion
IV fluids
How do you manage thromboplebitus?
Hydrate adequately
Encourage leg exercises and ambulate early
Elevate the affected leg with pillow support
Wear anti-embolic stockings
To be discharged from PACU what has to happen?
- You cannot be dependent on anything (like oxygen)
- Vital signs need to be within 20% of ‘normal’ vital signs
How frequently do you monitor vital signs after an operation?
Every 15 minutes for a few hours- all depends on the Ward and what the surgery is.
What is thromboplebitus?
Inflammation of the wall of a vein with associated thrombosis
What is a Homan sign?
A positive Homans’s sign (calf pain at dorsiflexion of the foot) is thought to be associated with the presence of thrombosis.
What is atelectasis?
partial collapse or incomplete inflation of the lung.
What is splinting?
If the client has an abdominal or chest incision that will cause pain during coughing, instruct the client to hold a pillow firmly over the incision (splinting) when coughing (Figs. 1 and 2). Rationale: Coughing uses abdominal and accessory respiratory muscles, which may have been cut during surgery.
