Perioperative Review Flashcards

1
Q

Pre-Op Risk Factors

A
  • Less physiologic reserve
  • Comorbidities
  • Health status
  • Past surgical experiences
  • Allergies
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2
Q

Reduced Physiological Reserve Factors

A
  • Old age
  • Young age
  • Pregnancy
  • Many comorbid health conditions
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3
Q

Renal Lab Markers

A
  • Ability to metabolize anesthesia
  • Manage fluid changes from surgery
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4
Q

Hemoglobin Level

A
  • Surgery causes blood loss
  • Insufficient Hb pre-op = concern
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5
Q

WBC Level

A
  • All surgeries have infection risk
  • Low WBC = difficult to fight infection
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6
Q

Na Level

A
  • Overall homeostasis
  • Fluid balance
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7
Q

K Level

A

Cardiac stability

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8
Q

Consent

A
  • Surgeon obtains
  • No minimum age
  • Informed consent is a legal mandate
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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
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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
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11
Q

RN-First Assist (RNFA) Responsibilities

A
  • Care under supervision of surgeon
  • Intraoperative performance of surgical first assistant techniques
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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
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13
Q

Transfer out of PACU

A
  • Return to baseline vitals
  • Sufficient pain management
  • Improving LOC
  • Nausea/vomit controlled
  • Wound dressing intact
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14
Q

LOC Complications

A
  • Failure to return to baseline
  • Delirium
  • Low Glasgow coma
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15
Q

LOC Expected Values

A
  • Moving towards alert & oriented
  • Expected drowsiness within 24hrs of surgery
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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
Q

Deep Vein Thrombosis S/S

A
  • Pain in lower extremities
  • Cramping
  • Leg swelling
  • Red
  • Pain
26
Q

Pulmonary Embolism S/S

A
  • SOB
  • Chest pain
27
Q

Prophylaxis (DVT Prevention)

A
  • Low molecular weight heparins
  • Decreased risk of bleeding compared to heparin
  • SC injections - 2 inches from umbilicus
  • Mild bruising normal
28
Q

Mobility Interventions

A
  • Pain management
  • Compression stockings
  • Sequential compression devices
  • Elevate legs
  • Interprofessional team
29
Q

Surgical Site Expectations

A
  • Appropriate drainage
  • Edges approximated
  • Healthy wound healing
  • Dressing dry & intact
30
Q

Dehiscence Findings

A
  • Edges of wound unintentionally not-approximated
  • Occurs 5-8 post-op
31
Q

Evisceration Findings

A
  • Edges of would unintentionally not-approximated
  • Fascia +/-
  • Organs visible or protrude
32
Q

Paralytic Ileus Findings

A
  • Abdominal distension
  • Absence of bowel sounds