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Chapter 4 Unit 1 Medsurg 1 > POSTOP&PREOP > Flashcards

POSTOP&PREOP Flashcards

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1
Q

Planned for correction of a non-acute problem

Cataract removal, hernia repair, hemorrhoidectomy

A

Elective Surgery

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2
Q

Immediate intervention to prevent life-threatening consequences (Gun shot,stab, severe bleeding, abdominal aortic aneurysm, compound fracture, appendectomy)

A

Emergency Surgery

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3
Q

To relieve symptoms of a disease process, but does not cure (colostomy, nerve root resection, tumor debulking, ileostomy)

A

Palliative surgery

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4
Q

Performed to determine the origin and cause of a disorder or the cell types for cancer

A

Diagnostic Surgery

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5
Q

Performed To improve patient’s functional ability (total knee replacement,finger reimplantation)

A

Restorative Surgery

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6
Q

Perform to resolve a health problem by repairing or removing the cause
(Laparoscopic, cholecystectomy, mastectomy, hysterectomy)

A

Curative Surgery

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7
Q

Primarily to alter or enhance personal appearance (liposuction, revision of scars, rhinoplasty blepharoplasty)

A

Cosmetic Surgery

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8
Q

Requires prompt intervention may be life-threatening if is delayed more than 24 to 48 hours (intestinal obstruction, bladder obstruction,or ureteral stones, bone fracture,eye injury, acute cholecystitis)

A

Urgent Surgery

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9
Q

Procedure without significant risk; often done with local anesthesia ( incision & drainage, implantation of a venous access device, muscle biopsy)

A

Minor Surgery

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10
Q

Procedure of greater risk usually

A

Major surgery

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11
Q

2 degrees of risks for surgery

A

Minor & Major

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12
Q

What is an autologous blood transfusion?

A
  • Pts blood is withdrawn at the blood bank several weeks before surgery
  • Prepared & stored to be re administered during the surgery
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13
Q

Epoetin Alfa may be given before surgery to stimulate RBC production & hemostatic agents may be given before & during surgery to promote clotting

A

How bloodless surgery is performed.

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14
Q

What types of patients are at higher risk for surgical complications?

A
  • Infants & older pts above 75

- Pts on steroids

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15
Q

Why should a pt that is taking herbal supplements discontinue them 2-3 weeks prior to surgery

A

Many herbal supplements interact with anesthetic agents or interfere with blood clotting.
-if going w/ out supplements is impossible, the herbal supplement container should be brought to anesthesiologist

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16
Q

Surgical Risk factors for pt w/ diabetes mellitus

A

May cause swings in blood glucose levels that are difficult to control even for a pt w/ out diabetes.

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17
Q

Surgical risk factors for pts w advanced age w/ inactivity

A

Healing is slower in older adults
Risk of disuse syndrome
Hypostatic pneumonia
Thrombus formation is higher in inactive older adults

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18
Q

Surgical risk factors for very Young age

A

Infants have difficulty with temperature control and in maintaining normal circulatory blood volume they are at risk of dehydration.

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19
Q

Surgical Risk factors for patients with malnutrition

A

Inadequate nutritional stored leads to infection, poor wound healing, and skin breakdown

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20
Q

Surgical risk factors for pt w/ dehydration

A
  • Reduced circulation volume reduces kidney perfusion, which predisposed the pt to a reduced iron output & thrombus formation.
  • Dehydration also alters electrolyte values
  • A dehydrated patient is more at risk for problems with pressure areas during surgery
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21
Q

Surgical risk factors for pts w/ obesity

A
  • Extremely heavy patient does not breathe as deeply and is at risk of hypostatic pneumonia.
  • excessive fatty tissue also is a factor in poor wound healing
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22
Q

surgical Risk factors for patient with cardiovascular problems

A

Pts w/ hypertension, left ventricular hypertrophy, cardiac dysrhythmias or a hx of congestive heart failure are at a higher risk for myocardial infarction from the high stress of surgery and anesthesia.

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23
Q

Surgical risk factors for patient with peripheral vascular disease

A
  • Poor circulation in the extremities predisposed the pt to possible thrombus formation & pressure sores on the lower legs & feet.
  • Embolism stocking or devices are prescribe for use during & after surgery
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24
Q

Surgical risk factors for patient with substance abuse

A

May alter reaction to anesthetic agents.

-alcohol dependence may cause w/drawl symptoms if the use of alcohol is discontinued abruptly

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25
Q

Surgical risk factors for patient that smokes

A
  • Causes increased lung secretions from anesthesia and predisposes the patient to atelectasis & pneumonia post operatively.
  • smokers are more prone to thrombus formation
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26
Q

Surgical risk factors for patient on anti-coagulant

A

Makes patient more prone to excessive bleeding

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27
Q

Measures to prevent surgical site infection

A

-cleanse the wound with special -cleanser (antibacterial)

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28
Q

Removal or destruction of

A

Lysis

Ex- Neurolysis ( freeing nerve from adhesion )

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29
Q

Tumor

A

Oma

Ex- excision of fibroma ( removal of a connective tissue tumor)

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30
Q

Cutting out or off

A

Ectomy

Ex- colectomy ( cutting out a part of the colon )

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31
Q

To furnish with an outlet

A

Ostomy

Ex - colostomy ( creating an outlet for the colon from the body)

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32
Q

Cutting into

A

Otomy

Ex- thoracotomy (cutting into the chest cavity)

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33
Q

Revision,molding, or repair of tissue

A

Plasty

Ex- mammoplasty ( revision of the breast)

34
Q

Fixation, anchoring in place

A

Pexy

Ex- orchiopexy ( fixation of undescended testicle in the scrotum)

35
Q

General topics of pre op teaching

A
  • teach correct breathing
  • correct coughing
  • correct turning
  • teach leg exercises ( high priority )
36
Q

Perioperative nursing

A

Refers to care before during & after surgery.

37
Q

Why must the pt be NPO prior to surgery? How long should they be NPO?

A
  • To prevent nausea, vomiting & aspiration

- 8 hours NPO

38
Q

What are some of the common medication that the patient may be allowed to take prior to surgery?

A
  • BP meds
  • Thyroid meds
  • anticonvulsant
  • Heart med
39
Q

Important considerations for skin prep prior to surgery

A
  • Night b4 surgery pt should take shower w/ special antibacterial cleanser or just soap & water to remove as many microorganisms as possible
  • remove hair from operative site
  • nail polish removed
  • makeup is removed
  • Jewelry & oral piercings removed
40
Q

Why is temp kept at 66-70 degrees in the OR at all times?

A

To discourage microbial growth and to keep the surgical team comfortable under the bright lights, & in layers of surgical clothing.

41
Q

Major functions of scrub tech or nurse?

A
  • Gathers all equipment for the procedure
  • prepare sterile supplies
  • gown & gloves surgeons
  • Assist with sterile draping of the pt
42
Q

Major functions of circulating nurse

A
  • Coordinates care
  • Verifies that the consent is signed & accurate & that surgical site is correctly marked
  • setting up operating room
  • gathers supplies
43
Q

Induced by the administration of an inhalant gas or medication introduced intravenously

A

General anesthesia

44
Q

Extensive surgery for which it is desirable for patient to be unconscious with relax muscles ( well controlled with assisted ventilation; few effects)

A

Inhalation anesthesia

45
Q

Shorter surgery rapid induction ( little post op nausea or vomiting )

A

Intravenous anesthesia

46
Q

Accomplished by administering a nerve block more economical than general, injecting in spinal epidural Caudal or peripheral nerve

A

Regional anesthesia

47
Q

Surgery in lower half of body (pt can be conscious; does not require fasting; no nausea or vomiting after)

A

Spinal anesthesia

48
Q

For gynecologic procedures & childbirth

no diet restrictions post operatively

A

Epidural anesthesia

49
Q

Foot surgery & some orthopedic surgeries ( pt is conscious; can cooperate with instructions)

A

Nerve block anesthesia

50
Q

Minor surgical procedures ( can produce good pain control; pt may remain conscious)

A

Local anesthesia

51
Q

Surgery of short duration for which unconsciousness is undesirable, may be used in combination with local or spinal, ( rapid reversal, pt is away but can breathe w/ out life assistance; little to no nausea/vomiting, amnesia or surgery)

A

Procedural/ conscious sedation

52
Q

Surgery for pt who are unable to have general anesthesia

A

Hypnosis

53
Q

Surgery for pt who cannot tolerate other anesthesia, such as in life-threatening trauma ( provides decrease in pain )

A

Cryothermia

54
Q

What are 3 stages of anesthesia ?

A
  • induction
  • maintenance
  • emergence
55
Q

Induction ( stage of anesthesia )

A

Unconsciousness is induced

56
Q

Maintenance (stages of anesthesia)

A

Period during which the surgical procedure is performed.

57
Q

Emergence ( stages of anesthesia )

A

Surgery is completed & the pt is prepared to return to consciousness; neuromuscular blocking agents are reversed.

58
Q

What pt measurement is needed for the appropriate dosage of anesthetic?

A

Weight & height

59
Q

Who’s responsible for obtaining an informed consent ?

A

Surgeon

60
Q

What info is including on the surgical consent?

A
  • procedure explained
  • risks & benefits
  • pt must be mentally competent
  • Full name & DOB
  • surgical procedure
  • no abbreviations on the consent,
  • pt signature & witness
61
Q

Who is responsible for answering the pts questions regarding the procedure?

A

Surgeon

62
Q

Who cannot give their own surgical consent?

A

Someone not capable of giving consent & a relative cannot be reached

63
Q

What is the nurses responsibility regarding the surgical consent?

A

Check the consent form has been signed before giving the preop medication

64
Q

Patient can sign an “X” for their name if unable to sign there own signature? True or false ?

A

True

65
Q

Who is able to give consent for emergency surgery when the pt cannot give consent ?

A
  • Next of kin

- Power of attorney

66
Q

What happens if no family can be found & the patient cannot give their own consent in an emergency?

A

The surgery can continue

Two surgeons have to agree to have the surgery done

67
Q

Before surgery begins, while all members of the team are present a time out occurs during which a final verification of the correct pt, procedure, site, & implants ( if applicable). Any ?’s or concerns must be resolved before the procedure begins

A

Time out

68
Q

What are the priority things that the patient should be taught during the pre-operative period?

A

Teaching the pt the correct breathing, coughing, turning & leg exercises is a high priority

69
Q

Important things to remember when teaching the elderly pt

A
  • observe signs of toxicity because liver & kidney function decreases.
  • Will give a decreased dose of narcotics & sedatives
  • Teach them the use of the inspirometer
  • breathing exercises
  • To prevent falls informed them to use the call bell
  • slow position changes
  • Handouts
70
Q

Purpose for administering preoperative medications?

A
  • Reduce anxiety & promote a restful state
  • Decrease secretion of mucus & other body fluids
  • counteract nausea & reduce emesis
  • enhance the effects of the anesthetic.
71
Q

What are the room preparations for the pt returning from surgery to the floor?

A
  • make bed with fresh linens
  • raise the bed to height of the stretcher
  • Place an IV pole
  • Gather an emesis or bags
  • chucks pad
  • vitals
72
Q

Type of surgery that uses special light beams instead of instead of instruments for surgical procedures.

A

Laser surgery

73
Q

Miniaturization of medical instruments is a key trend encouraging the use of small and efficient optical fibers

A

Fiber optic surgery

74
Q

Allows doctors to perform many types of complex procedures with more precision, flexibility & control than is possible with conventional techniques

A

Robotic surgery

75
Q

What happens if telephone permission is needed for the surgical consent ?

A
  • Call power of attorney or next of kin

- 2 nurses get 2 signatures over the phone from power of attorney or next of kin

76
Q

What needs to be done if the patients name is misspelled on the surgical consent?

A

Get a new consent form with the correct information

77
Q

Purpose of the blood consent

A

Gives consent to give blood products

78
Q

Process for surgical site identification

A
  • Surgeon puts their initials on the surgical site

- they follow the universal protocol to check the correct surgical site markings are checked

79
Q

What is done with their dentures before surgery ?

A

Give them to the family members or put them in the pts belongings

80
Q

What is the purpose for administering preoperative meds?

A
  • Reduce anxiety & promote a restful state
  • Decrease secretion of mucus and other body fluids
  • counteract nausea & reduce emesis
  • enhance the effects of the anesthetic

Chapter 4 Unit 1 Medsurg 1 (1 decks)

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