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post op > post op > Flashcards

post op Flashcards

1
Q

goal of post op care

A

support healing and recovery

prevent complications

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2
Q

what is the first priority of the RN when a pt arrives on the unit?

A

take vital signs and compare to baseline

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3
Q

post op complications

A 
pain
exhaustion
immobility
loss of control
exposure
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4
Q

what is the most common cause of obstruction with a post op pt

A

tounge

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5
Q

what is the first sign of a respiratory problem

A

restlessness

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6
Q

alveolar collapse causes airless condition of the lungs

A

atelectasis

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7
Q

what is the cause of atelectasis

A 
hypoventation
prolonges bedrest
ineffective cough
pain
tachypena
dyspnea
fever
tachycardia
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8
Q

inflammation of lungs

A

pneumonia

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9
Q

how are the most effected with repiratory complications

A

elderly
obese
malnourished
chronic respiratory disease

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10
Q

inhalation of gastric contents

A

aspiration pneumonia

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11
Q

when should deep breathing and coughing begin

A

as soon as pt is responsive

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12
Q

what is the most important intervention to prevent post op complications

A

ambulation

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13
Q

what does early ambulation do

A

increases vital capacity of lungs

increase muscle tone, and increase circulation

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14
Q

what is the goal of interventions

A

maintence of adequate respiratory function to prevent complications

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15
Q

what directly affects cardiac output

A

fluid status

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16
Q

what can contribute to cardiovascular alteration

A

fluid and electolyte imblance

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17
Q

inflammation with clot

A

thrombophlebitis

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18
Q

clot dislodges and travels

A

embolus

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19
Q

what helps to prevent DVT

A

early ambulation
EPCs
leg excercises

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20
Q

clot lodged in pulmonary circulation

A

plumonary embolus

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21
Q

what are signs and symptoms of pulmonary embolus

A 
restlessness
dyspnea
tachypnea
sudden sharp chest pain
crackles
change in mental status
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22
Q

clot and inflammation in superfical veins

A

superficial thrombophelbitis

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23
Q

brief lapse in consciousness caused by transient cerebral hypoxia

A

syncope

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24
Q

signs and symptoms of sycope

A

postural hypotension

vascular pooling

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25
Q

if pt faints what should you do

A

assist to floor to prevent injury

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26
Q

how long does fluid retention lasts

A

2-5 days post op

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27
Q

what can cause fluid deficit

A

vomiting bleeding drainage

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28
Q

hypokalemia

A

low potassium

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29
Q

what are signs and symptoms of hypokalemia

A

muscle weakness, irritability, weakness, confusion, arrhythmias

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30
Q

the first void after surgery should be ?

A

200 mL

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31
Q

what is the biggest risk for UTIs

A

indwelling catheters

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32
Q

when do you want to remove a catheter

A

within 24 hours

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33
Q

rapid decline of kidney function

A

acute renal failure

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34
Q

what are some signs of acute renal failure

A

elevated BUD, elevated creatinin

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35
Q

how long must you listen for bowel sounds in order for them to be absent

A

5 minutes each quadrant

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36
Q

what is the first sign of bowel function

A

flatus

gas

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37
Q

what increases peristalsis

A

early ambulation

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38
Q

temporary paralysis of the bowel

A

paralytic ileus

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39
Q

signs and symptoms of paralytic ileus

A

pain
abd destention
N&V

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40
Q

singultus

A

hiccups

intermittent spasms of diaphragm

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41
Q

what are hiccups caused by

A

irritation of phrenic nerve

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42
Q

inflammation of soft palate

A

palatitis

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43
Q

what is the largest organ of the body and its the first line of defense

A

skin

integumentray skin

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44
Q

injury in which there is a break in the continuity of body tissues

A

wound

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45
Q

wound in which each tissue layer is cut and sepreated smoothly by sharp bladed instruments

A

incision

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46
Q

irregular tear in tissue layers

A

laceration

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47
Q

scraping away of protion of skin or mucus membrane as resulr of injury or mechanical means

A

abrasion

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48
Q

injury to tissue where skin is not broken

A

contusion

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49
Q

wound made by sharp instrument

A

puncture or stab

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50
Q

puncturing or tearing of tissue from inside by broken bone

A

fracture

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51
Q

exudate

A

drainage

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52
Q

clear watery plasma drainage

A

serous

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53
Q

bloody drainage

A

sanguineous

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54
Q

combination of plasma and blood pinkish to light red

A

serosanguineous

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55
Q

thick, infected (yellow, green, brown) pus

A

purulent

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56
Q

what is the most common after 48 hours after surgery

A

hemmorrage

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57
Q

what are signs and symptoms of hemmorrage

A

restlessness, pale, cold, clammy, vital sign change decrease b/p, increase hr & rr

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58
Q

when assessing the dressing what should you do

A

place date and time and circle any drainage on the dressing, look under pt for any additional bleeding

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59
Q

what is the objective of wound care

A

promote hemostasis
prevent infection
prevent furtur wound injury

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60
Q

when wound edges are neatly approximated

A

primary intention

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61
Q

what pahse of wound healing lasts 3-5 days, the area fills with blood and clots form

A

inital phase

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62
Q

what wound healing pahse lasts 5 days to 4 months the immature connective tissue cells migrate to healing site and the wound is pink and vascular

A

granulation phase

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63
Q

wound is pink and vascular

A

granulation tissue

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64
Q

what phase of wound healing has remodeling of collagen the scar is formed and fibroblasts disappear

A

maturatino phase

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65
Q

what wound healing phase are the edges not neatly approximated

A

secondary intention

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66
Q

what phase of the wound healing process is there delayed suturing of the wound, the wound is left open for infection to clear

A

tertiary intention

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67
Q

what sub phases are in primary phase of the wound healing process

A

inital
granulation
maturation

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68
Q

in surgical wounds infection is apparent in how many days

A

3-5 days

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69
Q

in traumatic wounds infections are apparent in how many days

A

2-3 days

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70
Q

who is at an increased risk for infection

A

malnourished or obeses pts

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71
Q

what are signs and symptoms of infection

A 
fever
pain or tenderness at site
edges of wound inflamed
WBCs up
drainage (green, yellow, brownish)
72
Q

dehiscence

A

edges of wound open up, partial or total separation of wound edges

73
Q

signs and symptoms of dehiscence

A

sudden increase in serosanguineous drainage

feels like something gave way

74
Q

wound edges separte and abdominal contents protrude to outside

A

evisceration

75
Q

excess production of collagen tissue

A

keloid or hypertrophic scars

76
Q

flexible material placed thru tissues to hold edges together

A

sutures

77
Q

what kind of sutures are used in abdominal wounds

A

retention sutures

78
Q

large, wire encased in rubber to prevent skin trauma

A

retention staples

79
Q

when are sutures removed

A

7-10 days

facial are 3-5 days

80
Q

what is used when non absorbable sutures would be used

A

staples (external only)

81
Q

adhesive skin closure

A

steri-strips, butterfly

82
Q

what is the purpose of wound dressings

A 
protect from microorganisms
aides hemostasis
promotes haling
supports splinting]covers wound
cusion and protect
83
Q

what wound dressing product permits drainage from wound and allowes air to get to the wound

A

gauze

84
Q

what wound dressing product requires secondary dressing to secure in place
also impregnated with an agent

A

impregnated non adherent dressings

85
Q

what wound dressing product allows visualization of wound, adhesive, plastic and non absorbant dressing

A

transparent adhesive film

86
Q

when does dischage planning begin

A

on admission

87
Q

what is the average length of stay

A

24 hours to 5 dyas

88
Q

what does dischage planning include

A 
care of wound site and dressings
medications
activities
dietary
symptoms to be reported 
follow up care
89
Q

somnology

A

study of sleep

90
Q

state of decreased physical or mental work that leave the individual feeling mentally relaxed, phycially calm and free from anxiety

A

concept of rest

91
Q

a state of consciousness/preception and reaction to the enviornment is decreased

A

concept of sleep

92
Q

biological clock, 24 hour day

A

circadian rhythm

93
Q

REM sleep

A

rapid eye movement, restores brain

94
Q

what are the characteristics of REM sleep

A

active dreaming
difficult to arose
increased brain activity

95
Q

NREM Sleep

A

restores body physically

96
Q

what % is NREM sleep

A

75-80%

97
Q

what are the characteristics of NREM sleep

A

brain waves slow
vital signs decerased
skeletal muscles relax

98
Q

what are the stages of sleep

A

Stage 1: very light sleep, drowsy
Stage 2: light sleep, awakens easily
Stage 3: medium depth sleep, snoring may occur
Stage 4: deep sleep, difficult to arouse, rearely moves

99
Q

inability to obtain adquate amount of quailtiy of sleep

A

insomina

100
Q

sudden wave of overwheling sleepiness

A

narcolepsy

101
Q

periodic cessation of brathing during sleep caused by obstructive airflow

A

sleep apnea

102
Q

prolonges periods of inadequate sleep

A

sleep deprivation

103
Q

abnormal event that occurs during sleep

A

parasomnia

104
Q

somnambulism

A

sleep walking

105
Q

involuntary urination during sleep

A

enuresis

106
Q

grinding and clenching teeth during sleep

A

bruxism

107
Q

what kind of impact of sleep dysfunction has on the surgical pt

A

less energy

delayed healing and recovery

108
Q

a universal experience, reason many people seek health care, vital physicological warning system

A

pain

109
Q

what is McCafferys definition of pain

A

pain is whatever the pt says it is and exists whenever the pt says it does

110
Q

chronic pain

A

recurrent or longer than 6 months

111
Q

heightened response to painful stimuli

A

hyperalgesia

112
Q

nonpainful stimuli produce pain

A

allodynia

113
Q

unpleasent abnormal senstion

A

dysesthesia

114
Q

does the pain threshold change with age

A

NO

115
Q

what is the 1st step in experience of pain

A

transduction

116
Q

takes place after electrical implise enters the CNS

A

transmission

117
Q

beomce conscious of pain (occurs in brain)

A

perception

118
Q

“descending system” increase or decrease in pain signal intensity

A

modulation

119
Q

peripheral nerve fibers carrying pain to SC have input modified before transmission to brain

A

gate control theory

120
Q

what physiologic indicators of pain are caused by sympathetic nervous system

A

increased B/P, HR, RR
pallor
diaphoresis
pupil dialtion

121
Q

TENS

A

transcutaneous electrial nerve stimulation

122
Q

what is used to reverse the effects of narcotics

A

NARCAN

123
Q

opiods (narcotics) cause what

A

RR depression

124
Q

PCA

A

patient controlled analgesia

pt uses IV pump to does own analgesia

125
Q

infusion of opiets directly into epidural or intrathecal space around the spinal cord

A

epidural analgesics

126
Q

HAI

A

healthcare associated infections

127
Q

what are the most common tpes of HAI’s

A

catheter associated urinary tarct infections
surgical site infection
bacteremia
pneumonia

128
Q

microorganisms that cause disease

A

pathogen

129
Q

microorganisms normal in one region of the body

A

resident or normal flora

130
Q

source of microorganisms

A

reservoir

131
Q

ability to cause disease

A

pathogenicity

132
Q

strength or power of the pathogen

A

virulence

133
Q

condition marked by subjective complaints, clinical signs and symptoms

A

disease

134
Q

tracking infections

A

surveillance

135
Q

risk of host to infection

A

susceptibility

136
Q

resistance to infection

A

immunity

137
Q

practices to confine specific microorganism to a specific area, limiting the number , growth, and transmission

A

medical asepsis

138
Q

absence of most organisms

A

clean

139
Q

presence of microorganisms, capable of causeing infection

A

dirty

140
Q

practices to keep area or object free of all microorganisms as much as possible

A

surgical asepsis

141
Q

way microorganism leaves reservior

A

portal of exit

142
Q

from source to host

A

mode of transmission

143
Q

person to person

A

direct

144
Q

vehicle or vector borne

A

indirect

145
Q

from self

A

autogenous

146
Q

entry of mircroorganism into host

A

portal of entry

147
Q

person at risk for infection

A

susceptible host

148
Q

what is the chain of infection

A 
infections agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
149
Q

what are some defenses against infection

A

normal flora
body systems: dkin, respiratory tract, GI tract urinary tract
inflammaroty response4

150
Q

4 signs of inflammation

A

erythema
edema
warmth
pain

151
Q

antigens

A

foreign proteins

152
Q

bodys defense is a

A

antibody mediated defense

153
Q

what does healthcare associated infection occur

A

through poor aseptic practice

154
Q

what is the #1 way to prevent infection

A

hand washing

155
Q

what are unerviseral/standards precaustions

A

wear appropriate protective gear to prevent exposure to blood or body secretions

156
Q

what actively kills bacteria

A

bacteriocidal

157
Q

what prohibits growth so bacteria dies off

A

bacteriostatic

158
Q

process that destroys all microorganisms

A

sterilization

159
Q

wound involving a break in skin or mucous membranes

A

open wound

160
Q

wound involving no break in skin integrity

A

closed wound

161
Q

wound resulting from therapy

A

intentional wound

162
Q

wound that occurs unexpectedly

A

unintentional wound

163
Q

wound that involves only epidermal layer of skin

A

superficial wound

164
Q

wound involving break in epidermal dkin layer, as well as dermis and deeper tissues or organs

A

penetrating

165
Q

penetrating wound in which foreign object enters and exits an internal organ

A

perforating wound

166
Q

closed surgical wound that did not enter GI, respiratory or GU tract

A

clean wound

167
Q

wound entering GI, respiratory, or GU tract

A

clean/contaimintated wound

168
Q

open, traumatic wound, surgical wound with break in asepsis.

A

contaminated wound

169
Q

wound site with pathogens present, signs of infection

A

infected wound

170
Q

who is eligible for PCA

A

mentally alert

no allergy to anagelsia

171
Q

types of PCA drug delivery

A
  • Patient demand dose
  • Loading dose or bolus
  • Rescue dose
  • Basal dose (continuous infusion)
172
Q

when pt has PCA what should you assess for

A
  • Vital signs
  • SpO2 (pulse ox)
  • pain score
  • sedation score
  • side effects of medication
173
Q

how often do vitals have to be taken with PCEA

A

every 4 hours

174
Q

medication in PCEA bag causes nerve block / No feeling in feet and legs

A

Bupivicaine

175
Q

PCEA

A

patient controlled epidural anagelsia

176
Q

drug administered via catheter into epidural space around the spinal cord / Binds to nerve roots to block sensory impulses

A

PCEA

177
Q

drug administered via intravenous route into blood

A

PCA

post op (1 decks)

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