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FOUNDATIONS EXAM 2 > Perioperative Nursing Part 2 > Flashcards

Perioperative Nursing Part 2 Flashcards

1
Q

what is the goal of intraoperative and postoperative nurses

A

get pts through the surgical experience the same or better than before

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2
Q

which nurse adds and verifies the preoperative checklist

A

everyone

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3
Q

who created the surgical safety universal protocol

A

the joint commission

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4
Q

what are the main goals of the universal protocol

A

prevent
-wrong person
-wrong procedure
-wrong site
-foreign objects left behind
-intra/postoperative death

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5
Q

what are the three main steps for a universal protocol

A

-patient identification
-marking the operative sight (Dr. does)
-Time out, involving the care team and pt

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6
Q

what are the types of anesthesia

A

-general
-moderate/analgesia
-regional
-topical and local

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7
Q

rules of general anesthesia

A

-given through IV or inhalation
-have to be intubated
-NPO
-given by the anesthesiologist or certified nurse
-causes analgesia, muscle relaxation, diminished reflexes, CNS depression

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8
Q

steps for general anesthesia

A

-induction – administration
-maintenance – maintain throughout
-emergence – waking up

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9
Q

key facts of moderate sedation/analgesia

A

-conscious sedation
-nurses can administer
-pt can respond with purpose with stimulation, maintain airway
-doesn’t have to be NPO but normally is
-can give something to wipe memory

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10
Q

types of regional/codal sedation

A

-nerve block
-spinal
-epidural

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11
Q

Key facts on topical and local anesthesia

A

-loss of sensation
-can be used for pain control
-the main side-effect is lowered BP
- doesn’t have to be NPO but normally is
-can be used alone or together

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12
Q

what type of anesthesia ends with -caine

A

local

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13
Q

what are tropars used for

A

to make puncture holes, fill abdomen with air and remove objects

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14
Q

benefits of laparoscopic surgery

A

less complications and shorter recovery

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15
Q

if only one nurse can be in the OR what is their job

A

circulator

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16
Q

key points of circulator nurse

A

-not sterile
-insures pt rights
-coordinate care –radiology, lab, etc
-control environment, and monitor asepsis
-sets up table with scrub

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17
Q

key points of scrub nurse

A

-can be RN, LPN, or tech
-hands equipment to the surgeon
-needs to know the procedure, equipment, and anatomy

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18
Q

key points of RNFA

A

-the first assist
-has to have 2 years OR experience
-certified
-participates in surgery

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19
Q

key points of CRNA

A

-anesthesia nurse
-has additional schooling and testing

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20
Q

jobs of surgical nursing

A

-safety
-communication
-positioning –discussed with multiple roles
-prep
-draping
-observation and assessment
-documentation –done by circulator
-device placement (foley, SCD, grounding pad, suction)
-runner –getting new equipment
-counting equipment
-prep for transfer

21
Q

what is malignant hypothermia

A

the increase of skeletal muscle metabolism, causing increased oxygen need, increased temp, and can cause circulatory collapse, can also cause kidney failure
-it is autosomal dominant, seen more in males

22
Q

signs of MH

A

-muscle rigidity –seen in jaw first
-increased CO2 –hypercapnia
-tachycardia and dysrhythmias
-tachypnea and cyanosis
-increased temp – 2 Celsius per hour
-mottled skin
-sweating
-DIC – decimated idiopathic coagulation

23
Q

interventions for MH

A

-ice packs
-cooling blanket
-dantrolene — med
-reversal of anesthesia
-monitor UOP

24
Q

signs of MH-related kidney failure

A

cola urine and muscle aches

25
Q

What does SBAR stand for

A

Situation, background, assessment, recommendations

26
Q

give an example on an SBAR from OR to PACU

A

name, procedure, past medical history
anesthesia type, neds, intraoperative events, complications
Vitals, surgical sight, EBL, IV, fluids, pain, foley, skin issues
plan of care, family

27
Q

what does EBL stand for

A

estimated blood loss

28
Q

respiratory concerns in pacu

A

awake enough to breathe

29
Q

CV concerns in pacu

A

vitals every 5-15 minutes

30
Q

temperature concerns in pacu

A

hypothermic response is common

31
Q

CNS concerns in pacu

A

are they waking up, what is the level of sedation

32
Q

fluid concerns in pacu

A

maintaining their BP and urine output

33
Q

wound concerns in pacu

A

bleeding internal and external, make sure to roll pts for observation

34
Q

pain concerns in pacu

A

management

35
Q

GI and GU concerns in pacu

A

complications, NV, urine output needs to be 30ml per hr

36
Q

list postoperative complications

A

-hemorrhage
-shock
-temperature regulation
-DVT
-PE
-aspiration
-atelectasis- collapsed alveoli
-pneumonia
-site complications
-Fluid and electrolyte imbalance
-bowel and bladder dysfunction
-infection
psychosocial
-nutrition

37
Q

assessments and interventions to do for respiratory complications

A

ASSESS: lung sounds, respirations, WOB (work of breathing), Sp02, respiratory depression, sputum
INTERVENE: elevate HOB, 02, C &DB coughing and deep breaths q2h, IS spirometer 10hr, ambulation, hydration, pain control

38
Q

assessments and interventions for CV complications

A

ASSESS: VS, UOP, skin, calves, peripheral pulses
INTERVENE: leg exercise, TED/SCD, ambulation, anticoagulants, hydration, positioning

39
Q

assessments and interventions for hydration complications

A

ASSESS: I&O, weight, electrolytes, skin, mucus membranes, lung sounds (crackles), time since voided, bladder scan
INTERVENE: IV fluids, encourage void, catheterize, progressive fluid intake

40
Q

assessments and interventions for GI complications

A

ASSESS: bowel sounds, ABD assessment, nutrition, flatus (gas), stool
INTERVENE: ambulation, antiemetics (nausea), stool softener, NPO, NGT, IVF, progressive diet

41
Q

what is an ileus

A

bowel not waking up for days, will need bowel rest

42
Q

when does constipation become a concern

A

late post-op

43
Q

what are skin complications to be aware of

A

infection, dehiscence (wound edges separate), evisceration (organ protrudes)

44
Q

Assessments and interventions for skin complications

A

ASSESS: skin, incision, temperature, WBC
INTERVENE: turning/movement, ambulation, splinting (comfort measure for coughing), hydration/nutrition, handwashing, wound care, teaching

45
Q

how is skin closed after surgery and what reasons for each

A

sutures
staples (cause less damage than sutures)
BOTH REMOVED 7-10 days
steri-strips (maybe used after suture/staples)
Glue (most commonly used, no foreign body)

46
Q

evisceration interventions

A

semi-fowlers
notify physician
cover the intestine with sterile gauze and saline
monitor vs
prepare for OR

47
Q

assessments and interventions for psychosocial complications

A

ASSESS: pain, sleep, ability to do ADLS, assess for image disturbances
INTERVENE: emulation, quiet environment, hygiene, managing drainage, social support, self-care, pain meds, nonpharm interventions, providing preferences

48
Q

what to go over before discharge

A

activity restrictions, incision care, dietary restrictions, when to notify physicians, medications, arrange for home care if needed

FOUNDATIONS EXAM 2 (6 decks)

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