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MedSurg > PPO & Sensory > Flashcards

PPO & Sensory Flashcards

1
Q

Reasons for surgurey?

A 
Diagnostic
Exploratory
Curative/reparative
Pallitive
Cosmetic
Prenetive/prophalactic
Reconstructive
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2
Q

Categories Surgerys are based on?

A

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

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3
Q

Ambulatory Surgery

A

Sometimes reffered to as same day or outpatient surgery, requires fewer than 24 hour of hospitilation

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4
Q

Pt. admitted for ambulatorey surgery must meet these requirments to be admitted.

A

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

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5
Q

What are the three phases of periopertive care?

A

Preopertive
Intraopertive
Postopertive

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6
Q

Preopertavive

A

Begins with the descison to perform surgery and continue until the client reaches the operatig area

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7
Q

Intraoperative

A

Includes the entire procedure until transfer of the client to the recovery area

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8
Q

Postoperative

A

Begins with admissinon to the recovery area and continues until pt. recevies a follow up evaluation at home or is discharged to rehabilitation unit.

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9
Q

Preopertive Assessment

A 
Review Postop Lab and diagnostic studies
Review clients health Hx and preperation for surg
Assess Physical needs
Assess physiological needs
Assess cultural needs
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10
Q

Surgical consent

A
  • 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
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11
Q

Voluntary Consent

A

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

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12
Q

Incompetent Client

A

Idividual who is cognitivley impaired , mentally ill, or nuerologically iimpacted.

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13
Q

Informed Subject

A

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.
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14
Q

Surgical risk factors and complications

A

Age
Nutrional Staus
Substance Abuse
Medical Problems

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15
Q

What are some things we will teach our patients about postoperative care?

A

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
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16
Q

Physical Preperation

A
  • 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
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17
Q

Preoperative Meds

A
  • 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
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18
Q

Preoperative Checklist

A 
Assesment
Preoperative Medication
IV
Peroperative Preperations
Medical Record
Other info
Signatures
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19
Q

What is the purpose of time out?

A

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

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20
Q

Who is responsible for the time out?

A

A designated member of the team

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21
Q

Types of anesthesia

A

General
Regional
Procedural

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22
Q

General Anesthesia

A

acts on central nervous system to produce loss of sensation, reflexes, and consciousness.

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23
Q

4 stages used to describe general anesthesia

A
  • 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
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24
Q

Regional Anesthesia

A

uses local anesthetics to block the conduction of nerve impulses in a specific region
- he or she does not lose conciousness

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25
Q

Procedural Sedation

A

Moderate/conciousness
pt is free of pain, fear, and anxiety
maintiain iependemt cardirespiartory fucnion unable to respond with verbal response

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26
Q

3 phases of the sedation process

A

Titration- sedative mon meds
Performance-the diagnostic or theraputic procedure
Recovery plans

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27
Q

OR enviroment

A

stainless Steel
Tempature is kept below 70 degree F
bright lights
surgical attire

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28
Q

Intraopertive complications

A 
Infection
Fluid volume Excess or deficit
Injury related to positioning
Hypothermia
Malignant Hyperthermia
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29
Q

Agents used to sedate clients for diagnostic and theraputic procedures

A

Antianxiety
Amnesics
Analgesics
Antidotes

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30
Q

Zones in the operating room

A

Unrestricted
Semi-Restricted
Restricted

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31
Q

What are we trying to prevent in postoperative care?

A

Hemmorage
Shock
Hypoxia
Aspiration

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32
Q

Ongoing assessment for Posopertavive care?

A 
Respirations
Circulation
Pain Managment
Fluids and Nutrition
Skin integrity/wound healing
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33
Q

resuming oral fluids for the postoperative

client

A

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

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34
Q

Pt/ Fam teaching of postoperative care for wounds/incision

A 
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
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35
Q

What is the snellen chart?

A

Chart with letters

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36
Q

What do we use snellen chart?

A

To check eyesight

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37
Q

How do we use the snellen chart properly?

A

Stand 20ft away
Cover right eye
then cover left eye

38
Q

Refractive errors

A

Myopia
Hyperopia
Presbyopia
Astigmatisim

39
Q

Myopia

A

nearsighedness

40
Q

Hyperopia

A

Farsightedness

41
Q

Presbyopia

A

Associated with aging and results in diffuculty with near vision

42
Q

Astigmatisim

A

Visual distortion caused by irregularly shaped corneas

43
Q

What are assemet findings for the Refractive errors?

A

Blurred vision

Headaches

44
Q

What are Medical managment for these refractive errors?

A

Glass

Contancts

45
Q

Surgical managment for refractive errors

A 
RK(incisional radial keratomoy)
LASIK
wave fronk guided LASIK
ICRSs( intrastromal corneal ring segments)
IOLs-(phakic intravascular lenses
CK- (conductive Keratoplasty)
46
Q

Pt. teaching after eye surgery

A

Avoid rubbing eyes for a week
Wear sunglasses
Avoid bending over
Take medication that is prescribed (antibotic/antiinflamatory)
healing takes about a week
expect discomfort 5-6 hours after procedure

47
Q

What to do to walk into a blind persons room

A

Introduce yourself eachtime you enter
Call pt by name during group convo so they know it is directed at them
Speak before touching pt
Tell client when leaving

48
Q

What is the most important with old people and eyesight?

A

good lightening

safety

49
Q

Diplopia

A

Double vision

50
Q

endophthalmitis

A

All three layers the eye and the viterous are inflammed

51
Q

Adminstering eyedrops

A 
Wash hands
wipe away from nose, use new wipe for each wipe
pull down on cheeck area
tilt head back
do not allow dropper to touch the eye
do not rub
52
Q

Conjunctivitis

A

inflamation of conjuctiva commonly called pinkeye

53
Q

Photophobia

A

sensitivity to light

54
Q

Med managment for conjunctivitis

A

antbotic drops
Warm soak
irrigation
baby soap

55
Q

Uveitis

A

inflamation of uveal tract (iris,ciliary body, choroid)

56
Q

Assessment findings for Uvetis

A

Blurred vision
photophobia
eye pain
eye apperars red/ congestied

57
Q

Treatment for Uvetis

A

oral and topical corticoisteriods
mydriatic (dialating Eyedrops
Anageliscs

58
Q

Keratitis

A

inflamation of the cornea

59
Q

Corneal ulcer

A

Erosion in the corneal tissue

60
Q

Blepharatis

A

inflamation of thr lid margins where eyelashes grow

61
Q

Assesment findings for blepharatis

A 
Lid margins appear inflammed
Patchy flakes cling to eyelashes
missing eyelasges
purlent drainage
watery red eyes
sollen eyelids
frewuent blinking
62
Q

Corneal ulcer med managment

A

Keratplasy patch, dark glasses, anagelesics, mydreatic drug

63
Q

Mydriatic drug

A

dialates the pupil

64
Q

Med managment for blepharatis

A

med in topical form (drops/ointment)

baby shampoo

65
Q

Macular Degeneration

A

Breakdown or damage to the macula, the point on the retina where light rays coverage for the most acute visual perception

66
Q

med managment Macular degeneration

A 
Angiogenesis inhibitors
photodynamic therapy
laser photocoagagulation
macular translocation
implantable minature telescop IMT
67
Q

Amsler Grid

A

used to check cetral vision

68
Q

Glaucoma

A

caused by imbalnce between the production and drainage of aqueous fluid/ increased intraocular pressure IOP

69
Q

Assessment findings for glaucoma

A

eye discomfort
temp blurred vision
feeling that eyeglass prescription nedds to be changed

70
Q

Meds used to manage glaucoma

A 
Alpha-2 adregernic agonist
Beta- adregenic blocking drugs
Carbonic anhydrase inhibitors
prostaglandin agonists
combo eyedrops
adregernic agonist
71
Q

Procedures to treat glaucoma

A 
Selective laser
Argon lasor
Canaplasty
Trbetcome surgery
Trabeculetomy
Aqueous shunt
Laser Iridomoty
PErphial iridectomy
72
Q

Cataracts

A

Lens of eye become opaque

73
Q

Assessment finding for cataracts

A 
Halo
difficulty reading
Changes in color vision
Glaring objects in bright lights
distortortion of objects
poor night vision
double eye vision
74
Q

Surgical managment for cataracts

A

surgically removed

clients are awake and can have conversation during procedure

75
Q

Nursing managment for cataracts

A
  • Outpatient
  • Protective eyesheild for 24 hurs
  • sunglasses whn in bright lights for at least a week
  • eydrops as perscribed
  • no crazy activity, heavy lifting do not bend over, do not immerse eyes in water, avoid activity that will get dust or something in eye
76
Q

Hearing range

A 
Normal- 0-25
Mild impairment- 24-40
Moderate impairment- 40-70
Severe impairment- 70-95
Profound impairment- 95-120
Total deaf- 120+
77
Q

Presbycusis

A

hearing imaiment associated with old age

78
Q

Risk of hearing loss

A 
Family Hx
Congenital malformation of ear
Use of otoxic medications
Recurrent ear infection
Chronic exposeure to loud noises
perforation of the tympanic membrane
79
Q

Tunning fork

A

An instrament that produces sound in the same range as human speech
- it is used to conductuctive or sensiory hearing loss

80
Q

Rinne test

A

Tunning for struck, placed on mastoid process behind ear and held their till pt indicates no sound

81
Q

Weber test

A

atriking tunning fork and placing its stem in the midline of pt forehead

82
Q

Impacted Cerumen

A

Accumalated earwax that obstructs the external acoustic meatus

83
Q

Otitis Externa

A

An inflammation of the tissue in external auditory canal

84
Q

Otitis Media

A

Acute inflamation/ infection in middles ear

85
Q

Medical managment for Otitis Externa

A

Warm soaks
Anagelics
Antibotic
Corticoid steriod medication

86
Q

Surgical managment for Otitis Media

A

fluid aspirated by needle

antibotics

87
Q

Vertigo

A

Sensation of movement when there is none

88
Q

Menieres disease

A

fluctuations in the fluid volumes and pressure in the endolymphatic sac of inner ear

89
Q

How to revent Otitis Externa

A

DO NOT use swaps or objects that cause trauma to ear
Avoid swimming in poluted water
Dry ear after immersed in water

90
Q

Assesment findings of Meneires Diease

A 
vertigo
N/v
tinnitus
Hearing loss
Headaches
Abd discomfort
91
Q

IOP introcular pressure can increase what?

A

Optic nerve damage

92
Q

IOP causes what?

A

Glaucoma

MedSurg (2 decks)

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