PPO & Sensory Flashcards
Reasons for surgurey?
Diagnostic Exploratory Curative/reparative Pallitive Cosmetic Prenetive/prophalactic Reconstructive
Categories Surgerys are based on?
Emergancy- Imidiate
Urgent- within 24-30 hours
Required- planned for a few weeks or for months
Elective- Client will not behar,ed if surgery is not
performed
Optional- Personal prefrence
Ambulatory Surgery
Sometimes reffered to as same day or outpatient surgery, requires fewer than 24 hour of hospitilation
Pt. admitted for ambulatorey surgery must meet these requirments to be admitted.
Pt not critically ill
The surgical procedure is not extensive
Does not require hours of antesia
Pt. has few/or none coextiting /disabiling illness
Quick recovery is expected
Pt/fam can provide adequate Postopertive care
What are the three phases of periopertive care?
Preopertive
Intraopertive
Postopertive
Preopertavive
Begins with the descison to perform surgery and continue until the client reaches the operatig area
Intraoperative
Includes the entire procedure until transfer of the client to the recovery area
Postoperative
Begins with admissinon to the recovery area and continues until pt. recevies a follow up evaluation at home or is discharged to rehabilitation unit.
Preopertive Assessment
Review Postop Lab and diagnostic studies Review clients health Hx and preperation for surg Assess Physical needs Assess physiological needs Assess cultural needs
Surgical consent
- Required for any invasive procedure that requires anasthsia and has risk for complications
- notify sergeon if pt has any concern or questions before consent form is signed
- this indicates that pt consents to procedure and understands the risks/benifits
- In emergancy a surgeon may have to operate without consent
- DO NOT USE FAMILY TO TRANSLATE
- Know all physicans for surgery and exact procedure for consent
Voluntary Consent
Valid consent must be freely given, pt must be 18= unless emencipated.
-physcian must obtain consent and a professinal staff member must wittness the clients signature
Incompetent Client
Idividual who is cognitivley impaired , mentally ill, or nuerologically iimpacted.
Informed Subject
Should be in writing and should include;
- explanation of procedure and risks
- description of benefits and alternatives
- an offer to answer ?’s about procdure
- Instructions that the py may withdraw consent
- a statement informing pt if the protocol differs from customary procedure.
Surgical risk factors and complications
Age
Nutrional Staus
Substance Abuse
Medical Problems
What are some things we will teach our patients about postoperative care?
teach about surgical procedure and expactations before and after surgery.
- Preopertave meds
- Postoperative pain control
- explanation/ description of the postanethesia recovery room or postsurgical areas
Physical Preperation
- Skin- decrease bacteria w/out comprimising integrity
- Elimination- cliet void or insert a cath. enema or lax may be needed as well
- Food/Fluid- must be withheld at least 8-10 hours before surgery
Preoperative Meds
- Antianxiety drugs- Lorazepam, reduce anxiety
- Histamine-2 receptor antagomist- cimetidine, decrease gastric acidity and volume.
- Anticholinergics- Glycopyrrolate, decrease respitory secreations
- Neuromuscular blocking agents- succinylchiline, promote skeleltal relaxation
- Opioids- fentanyl, sedate and decrease the amount of anesthesia
- Sedatves- midazolam, promote sleep, reduce anxiety
- Antibotics- kanamycin, destroy enteric bmicrorganisms
Preoperative Checklist
Assesment Preoperative Medication IV Peroperative Preperations Medical Record Other info Signatures
What is the purpose of time out?
it includes the imediate members of the procedure team; the one performing procedure,anesthsia providers, circulatory nurse, operating rm tech, - during the time out ever one needs to agree on; correct identy and site and procedure to be done
Who is responsible for the time out?
A designated member of the team
Types of anesthesia
General
Regional
Procedural
General Anesthesia
acts on central nervous system to produce loss of sensation, reflexes, and consciousness.
4 stages used to describe general anesthesia
- Stage 1- induction;producing unconciousness
- Stage 2- Excitement; might struggle,shout,talk,sing,laugh or cry
- Stage 3- Surgical Anesthesia; Stays on unconcious by countinous administration of the anestatic agent
- Stage 4 medullary depression- when client recesives to much anesthesia
Regional Anesthesia
uses local anesthetics to block the conduction of nerve impulses in a specific region
- he or she does not lose conciousness
Procedural Sedation
Moderate/conciousness
pt is free of pain, fear, and anxiety
maintiain iependemt cardirespiartory fucnion unable to respond with verbal response
3 phases of the sedation process
Titration- sedative mon meds
Performance-the diagnostic or theraputic procedure
Recovery plans
OR enviroment
stainless Steel
Tempature is kept below 70 degree F
bright lights
surgical attire
Intraopertive complications
Infection Fluid volume Excess or deficit Injury related to positioning Hypothermia Malignant Hyperthermia
Agents used to sedate clients for diagnostic and theraputic procedures
Antianxiety
Amnesics
Analgesics
Antidotes
Zones in the operating room
Unrestricted
Semi-Restricted
Restricted
What are we trying to prevent in postoperative care?
Hemmorage
Shock
Hypoxia
Aspiration
Ongoing assessment for Posopertavive care?
Respirations Circulation Pain Managment Fluids and Nutrition Skin integrity/wound healing
resuming oral fluids for the postoperative
client
Most pt can begin taking oral fluids 4-24 hours after surgery unless its GI realated, Check orders
If cant take oral fluids provide swabs, ice chips
Pt/ Fam teaching of postoperative care for wounds/incision
Until sutures are removed -Keep clean/dry -Follow Physcians instructions on bathing/showering -do not remove dressing unless soiled -wound clean -imdeilty sign of infection -if sore apply cold pack After surgery -Keep clean and dry -follow instructions -wash dry and apply dressing
What is the snellen chart?
Chart with letters
What do we use snellen chart?
To check eyesight
