Perioperative Nursing (the whole shebang!) - Unit 2 Flashcards
What is the difference between major and minor surgery?
Major is like having heart surgery. Minor is like if you have tubes put in your ear!
What are some types of surgery?
Exploratory/Diagnostic/Biopsy, Curative, Elective
Do people get anxious and stressed before a procedure?
Yes - and we need to try our best to reduce it!
What are the 2 most important assessors of disease and risk during surgery?
History and physical!
What is the purpose of the patient interview before surgery?
Let’s see if the patient knows what’s going on!
What are some parts of the history and physical assessment before surgery?
Vital signs, past surgical history/general anesthesia issues, allergies, nutritional/body state, fluid and electrolyte balance and infections.
Are there certain habits that can cause problems for a patient during surgery?
Yup, things like smoking and all that can cause problems!
What are parts of the pre-op legal preparations? (Along with what happens if a person can’t sign…)
We have to make sure we have informed consent (where even if they can’t sign, they can put an X if 2 people witness it) and if applicable, a DNR form.
What are parts of the day of surgery preparation?
Physical preparation, medications, preoperative checklist/transport to the OR
What is a surgical TIME OUT?
This is when someone pauses the surgery and goes over the procedure, etc.
Anesthesia - not just drugs, it’s a ___.
Process.
Anesthesia is the half-asleep, watching the half-awake. T/F?
True!
A good anesthetic is when the patient is more asleep than you are. T/F?
True!
What is conscious sedation?
This is when you have minor surgery and are kind of knocked out, but not totally. You are in “la-la land.” You can still move and do stuff but you probably won’t remember it. Meds given here are like versed!
Regional Anesthetic - what is it?
This is when a region is knocked out - like for carpal tunnel surgery. Drugs given here usually the “caine” drugs. This type of surgery reduces the risk of blood clots, etc.
What is a general anesthetic?
This is when you are knocked the fuck out! You will need respiratory support and all that jazz!
What are the 4 stages of anesthesia?
Analgesia (induction)
Excitement (uncontrolled movements)
Operative (you better be intubated!)
Danger (uh oh!)
What are some complications of the anesthesia?
Well, we want to do the least we can, so if we go overboard, or give too much, etc……
Anesthesia Awareness - aka “Unintentional Intraoperative Awareness” - what is it?
That’s when you wake up during surgery, but you might not be able to move or anything…that’s effing scary! These people might even have PTSD from it!
What are some risks in surgery for elderly people?
Skin integrity, so we have to be careful on how we position them!
What does the circulating nurse do?
She basically runs the show in the OR!
Once transferred to PACU, what should the nurse do?
Look at vitals - sats, HR - everything! Do they have signs of shock?
What could be some immediate postoperative complications?
PONV, neurological problems, hypothermia, malignant hyperthermia (bad bad bad), and always check their ABC’s.
What is EBL during surgery?
Estimated blood loss during surgery!
Emesis is the postoperative outcome least preferred by patients. T/F?
True!
What are some ways to reduce the nausea and vomiting?
Zofran, Ginger, Peppermint Oil - even chewing peppermint gum after surgery can help!
What are some things to do/check during post-op care?
Rapid assessment (the important stuff!), vital signs and focused assessment, safety, pain, dressing, any drains?, Iv fluids, I/O.
If the patient hasn’t peed for _ to _ hours after surgery, it could be bad.
8-12.
Should we get patients up and moving and coughing/using spirometry as soon as possible after surgery?
Yes! We should!
Temperature elevations after surgery are due to wind, water and then the wound. T/F?
True!
What are some complications related to surgery?
Pulmonary problems (maybe a pulmonary embolism, which can mimic a heart attack!), cardiovascular problems, hypothermia, pain (which is what the patient says it is!), fluid and electrolyte imbalance, incisional problems, etc.
What is “dehiscence” (Wound) ?
That’s when there’s a wound that has opened up, but not all the way!
What is evisceration? (Wound)?
That’s when the wound has completely opened up and you might have things coming out of it, like intestines!
What happens when you have an eviscerated wound? How do you care for it?
You cover it with wet saline - just keep it protected until the surgeon gets there!
If you think there surgery site has opened up during a walk, what do you do?
You take them back to their room, have them put their legs up, and then look! Don’t do it in the middle of the hall!
What is a penrose drain?
It’s a drain that looks like a flat straw! It pulls the fluid out!
What is a jackson pratt drain?
It’s like a little grenade - it sucks the shit out!
What is a hemavac drain?
It looks like a disc - it pulls the shit out!
What are vac drains?
They are electronic drains that suction the shit out!
What are some parts of discharge teaching for patients?
Diet, activity, prescriptions, complications to look for, sexual activity, special exercises, visits with the surgeon, removal of sutures, care of the incision, etc.
