Perioperative Quiz Flashcards
aseptic
free from contamination of bacteria
peri-operative
whole surgery
pre-operative
decide to have surgery - OR
intra-operative
OR - PACU
post-operative
PACU - Recovery
elective surgery
planned/scheduled - with no time crunch
urgent surgery
surgery within 24 hours
emergent surgery
immediate surgery needed to save life or limb
diagnostic
obtain tissue sample
exploratory
confirms condition
curative
removal of diseased tissue
cosmetic
requested removal
plasty
formation/repair
otomy
incision
ostomy
permanent artificial opening
oscopy
looking into
orrhaphy
suture of/ repair
ectomy
removed by cutting
anesthesiologist
nurse that works with anesthesia
circulating nurse
obtain supplies, count equipment, document on surgery
surgical scrub nurse
scrubs in and hands tools to surgeon
RN FA
helps surgeon by suctioning wound, or holding tools, or stitching up. stands right by surgeon
CRNA
registered nurse that works with anesthesia
surgeon
doctor that does surgery
adjunct
something added to other thing as supplementary…not an essential part
anesthesia
helps numb or put to sleep
atelectasis
alveoli stick together
dehiscence
suture that comes apart
debridement
removal of damaged tissue from wound
evisceration
guts come out
hematoma
solid swelling of clotted blood
hypothermia
abnormally low body temperature
hyperthermia
abnormally high body temp
malignant hyperthermia
muscles tense up (allergic reaction to anesthesia)
what are some risk factors when going into surgery
infection, cardiac disease, hypertension, kidney, liver disease, anesthesia, previous surgery
after general anesthesia, many patients occlude their airway, what can be done to open this up
intubate
what is wound healing by first intention
edges together
what is wound healing by second intention
open wound , granulation tissue grows
what is wound healing by third intention
wound is infected - leave open wait for infection to stop - close up
what is the reversal agent for opioids
nalaxone
what is the reversal agent for benzodiazepines
flumazenil
how long is the action of the reversal agent compared to the action of some of the meds
wear off sooner than meds
what does the nurse need to assess for
breathing
when should post op teaching begin
before surgery - pre-op
what is a PCA and how does it work
patient controlled analgesic - push button to get dose as wanted
should anyone else hit the PCA button
no
who is to give information to the patient about the surgical procedure, risks and benefits prior to the patient signing the informed consent
surgeon
if the nurse is witnessing the informed consent and the patient still has questions regarding the risks and benefits of surgery what should the nurse do
call surgeon to talk with patient
if a wedding ring cannot be removed what should the nurse do
tape it
what are the zones of the operative area and what must be worn in each different zone
OR restricted zone - mask, gown, cap, shoe covers
what is the priority in a patient post op after general anesthesia
check vitals, watch for malignant hyperthermia
what are possible complications of surgery
infection, DVT, shock, hemorrhage, pulmonary embolism, urinary retention, reaction to anesthesia
symptoms of DVT
clots in legs - warm, red, veins in legs
treatment of DVT
lay down, blood thinners, compression stockings
symptoms of Pulmonary embolism
shortness of breath, chest pain, low O2
treatment of pulmonary embolism
anticoagulants
symptoms of atelectasis
dyspnea, tachypnea, decreased R, increased HR
treatment of atelectasis
breathing exercises, oxygen, may need surgery
symptoms of infection
fluid volume excess, injury related to positioning, hypothermia, (no symptoms for a few days)- increased T, increased WBC, red, warm
treatment for infection
antibiotics,
symptoms of pneumonia
fever, increased R, crackles, hypoxia
treatment of pneumonia
antibiotics, oxygen therapy, IV fluids
symptoms of dehiscence
edges come apart, undernourished, elderly
treatment of dehiscence
use binder, splint incision, put back together
symptoms of evisceration
guts come out
treatment of evisceration
semi fowlers, knee up, cover w/ sterile soaked gauze, IV fluids, monitor for shock
symptoms of hemorrhage
can see blood (look at incision)
if it’s internal (increased HR, decreased BP)
treatment of hemorrhage
elevate head, IV fluids, reversal anticoagulation therapy
symptoms of malignant hyperthermia
allergic reaction to anesthesia - muscles twitch and tighten, increased T, muscle rigidity, tacypnea, flushed, cyanosis, acidosis
treatment of malignant hyperthermia
stop surgery, O2, notify DR STAT, cool with ice, (Dantrolene Sodium - Dantrium - muscle relaxant)
symptoms of urinary retention
doesn’t pee, dribbling, restless, lower abdominal pain, increased BP
treatment of urinary retention
catheter it
symptoms of constipation
don’t poop, abdominal pain, sound, firm abdomen
treatment for constipation
stool softener, fiber, increase fluid, ambulation (exercise)
paralytic ileus
absence of peristalsis in an area
symptoms of paralytic ileus
lack of bowel sounds, distention, severe abdominal pain, emesis
treatment for paralytic ileus
NG inserted for to suction from stomach
what are the inhalant anesthetics
nitrous oxide and O2
what color tank is nitrous oxide
blue
what color tank is O2 in
green
sodium channel blockers are considered
numbing medicine
sodium channel blockers all end in
caine
this type of anesthesia is considered
local
name the opioids commonly used in surgery and post op
fentanyl, morphine, meperidine (Demerol)
what is given pre op to decrease secretions - what class of med is it
Atropine (anti cholinergics)
what are adjuvents classes and how do they affect anesthesia
opioids, antiemetics, sedatives - muscle relaxants
what is a common type of anesthesia used for women in labor
regional(epidural)
how can the nurse attempt to avoid a spinal headache in the client
lay flat for a few hrs after spinal, give fluids
if a sedating preanesthetic med is given, what is an important safety measure
check respirations
what are 2 common classes of medications that patients can build a tolerance and dependence on if used long term
opioid, benzodiazipines
if a patient is taking anti anxiety medications, opioids, or any CNS depressant, what should be avoided for safety sake
overdose
what class of medications are used for insomnia
barbiturates
meperidine
demerol
what are the 4 stages of anesthesia
induction, maintenance, recovery, rapid recovery
what is the induction stage
time from patient awake - consciousness
what is the maintenance stage
ability to keep patient safe
what is the recovery stage
moving back to stage 1
what is rapid recovery stage
recovery without side effects
