Perioperative Review Flashcards
1
Q
Pre-Op Risk Factors
A
- Less physiologic reserve
- Comorbidities
- Health status
- Past surgical experiences
- Allergies
2
Q
Reduced Physiological Reserve Factors
A
- Old age
- Young age
- Pregnancy
- Many comorbid health conditions
3
Q
Renal Lab Markers
A
- Ability to metabolize anesthesia
- Manage fluid changes from surgery
4
Q
Hemoglobin Level
A
- Surgery causes blood loss
- Insufficient Hb pre-op = concern
5
Q
WBC Level
A
- All surgeries have infection risk
- Low WBC = difficult to fight infection
6
Q
Na Level
A
- Overall homeostasis
- Fluid balance
7
Q
K Level
A
Cardiac stability
8
Q
Consent
A
- Surgeon obtains
- No minimum age
- Informed consent is a legal mandate
9
Q
Scrub Nurse Responsibilities
A
- Setting up sterile field
- Prep equipment
- Passes supplies to surgical team
- Monitors aseptic technique
- Performs sponge, needle, instrument count
- Sends specimens to lab
10
Q
Circulating Nurse Responsibilities
A
- Monitors client
- Coordinates team
- Monitors aseptic practice
- Verifies consent
- Performs second surgical safety checklist
- Counts with scrub nurse
- Transfers client to PACU
11
Q
RN-First Assist (RNFA) Responsibilities
A
- Care under supervision of surgeon
- Intraoperative performance of surgical first assistant techniques
12
Q
RN-Anesthesia Assistant (RNAA) Responsibilities
A
- Provide anesthesia care under direct supervision of anesthesiologist/medical directives
- Similar role fulfilled by RTs who have completed anesthesia assistant program
13
Q
Transfer out of PACU
A
- Return to baseline vitals
- Sufficient pain management
- Improving LOC
- Nausea/vomit controlled
- Wound dressing intact
14
Q
LOC Complications
A
- Failure to return to baseline
- Delirium
- Low Glasgow coma
15
Q
LOC Expected Values
A
- Moving towards alert & oriented
- Expected drowsiness within 24hrs of surgery
16
Q
ABC’s Complications
A
- Hypoxia
- Atelectasis
17
Q
ABC’s Expectations
A
- Patent airway
- Normal rate, rhythm, depth
- Deep breathing & coughing
18
Q
Hypoxia Findings
A
- Dyspnea
- Bradypnea
- Low SpO2
- Cyanosis
19
Q
Atelectasis Findings
A
- Dyspnea
- Tachypnea
- Low SpO2
- Cyanosis
- Increased HR
20
Q
Opiate Caution
A
Airway depression
21
Q
Expected Circulation
A
- Normal HR/BP
- Temperature, colour
- Bleeding as expected based on surgery
- Heart rhythm
22
Q
Circulation Complications
A
- Hypotension
- Hypothermia
- Hemorrhage/hypovolemic shock
- Dysrhythmias
- DVT
- PE
23
Q
Hypothermia Findings
A
- Low temp
- Shivering
- Piloerection
24
Q
Dysrhythmias Findings
A
- Changes in BP/HR
- Abnormal rhythm
25
Deep Vein Thrombosis S/S
- Pain in lower extremities
- Cramping
- Leg swelling
- Red
- Pain
26
Pulmonary Embolism S/S
- SOB
- Chest pain
27
Prophylaxis (DVT Prevention)
- Low molecular weight heparins
- Decreased risk of bleeding compared to heparin
- SC injections - 2 inches from umbilicus
- Mild bruising normal
28
Mobility Interventions
- Pain management
- Compression stockings
- Sequential compression devices
- Elevate legs
- Interprofessional team
29
Surgical Site Expectations
- Appropriate drainage
- Edges approximated
- Healthy wound healing
- Dressing dry & intact
30
Dehiscence Findings
- Edges of wound unintentionally not-approximated
- Occurs 5-8 post-op
31
Evisceration Findings
- Edges of would unintentionally not-approximated
- Fascia +/-
- Organs visible or protrude
32
Paralytic Ileus Findings
- Abdominal distension
- Absence of bowel sounds
