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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
Procedural Sedation
Moderate/conciousness pt is free of pain, fear, and anxiety maintiain iependemt cardirespiartory fucnion unable to respond with verbal response
26
3 phases of the sedation process
Titration- sedative mon meds Performance-the diagnostic or theraputic procedure Recovery plans
27
OR enviroment
stainless Steel Tempature is kept below 70 degree F bright lights surgical attire
28
Intraopertive complications
``` Infection Fluid volume Excess or deficit Injury related to positioning Hypothermia Malignant Hyperthermia ```
29
Agents used to sedate clients for diagnostic and theraputic procedures
Antianxiety Amnesics Analgesics Antidotes
30
Zones in the operating room
Unrestricted Semi-Restricted Restricted
31
What are we trying to prevent in postoperative care?
Hemmorage Shock Hypoxia Aspiration
32
Ongoing assessment for Posopertavive care?
``` Respirations Circulation Pain Managment Fluids and Nutrition Skin integrity/wound healing ```
33
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
34
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 ```
35
What is the snellen chart?
Chart with letters
36
What do we use snellen chart?
To check eyesight
37
How do we use the snellen chart properly?
Stand 20ft away Cover right eye then cover left eye
38
Refractive errors
Myopia Hyperopia Presbyopia Astigmatisim
39
Myopia
nearsighedness
40
Hyperopia
Farsightedness
41
Presbyopia
Associated with aging and results in diffuculty with near vision
42
Astigmatisim
Visual distortion caused by irregularly shaped corneas
43
What are assemet findings for the Refractive errors?
Blurred vision | Headaches
44
What are Medical managment for these refractive errors?
Glass | Contancts
45
Surgical managment for refractive errors
``` RK(incisional radial keratomoy) LASIK wave fronk guided LASIK ICRSs( intrastromal corneal ring segments) IOLs-(phakic intravascular lenses CK- (conductive Keratoplasty) ```
46
Pt. teaching after eye surgery
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
What to do to walk into a blind persons room
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
What is the most important with old people and eyesight?
good lightening | safety
49
Diplopia
Double vision
50
endophthalmitis
All three layers the eye and the viterous are inflammed
51
Adminstering eyedrops
``` 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
Conjunctivitis
inflamation of conjuctiva commonly called pinkeye
53
Photophobia
sensitivity to light
54
Med managment for conjunctivitis
antbotic drops Warm soak irrigation baby soap
55
Uveitis
inflamation of uveal tract (iris,ciliary body, choroid)
56
Assessment findings for Uvetis
Blurred vision photophobia eye pain eye apperars red/ congestied
57
Treatment for Uvetis
oral and topical corticoisteriods mydriatic (dialating Eyedrops Anageliscs
58
Keratitis
inflamation of the cornea
59
Corneal ulcer
Erosion in the corneal tissue
60
Blepharatis
inflamation of thr lid margins where eyelashes grow
61
Assesment findings for blepharatis
``` Lid margins appear inflammed Patchy flakes cling to eyelashes missing eyelasges purlent drainage watery red eyes sollen eyelids frewuent blinking ```
62
Corneal ulcer med managment
Keratplasy patch, dark glasses, anagelesics, mydreatic drug
63
Mydriatic drug
dialates the pupil
64
Med managment for blepharatis
med in topical form (drops/ointment) | baby shampoo
65
Macular Degeneration
Breakdown or damage to the macula, the point on the retina where light rays coverage for the most acute visual perception
66
med managment Macular degeneration
``` Angiogenesis inhibitors photodynamic therapy laser photocoagagulation macular translocation implantable minature telescop IMT ```
67
Amsler Grid
used to check cetral vision
68
Glaucoma
caused by imbalnce between the production and drainage of aqueous fluid/ increased intraocular pressure IOP
69
Assessment findings for glaucoma
eye discomfort temp blurred vision feeling that eyeglass prescription nedds to be changed
70
Meds used to manage glaucoma
``` Alpha-2 adregernic agonist Beta- adregenic blocking drugs Carbonic anhydrase inhibitors prostaglandin agonists combo eyedrops adregernic agonist ```
71
Procedures to treat glaucoma
``` Selective laser Argon lasor Canaplasty Trbetcome surgery Trabeculetomy Aqueous shunt Laser Iridomoty PErphial iridectomy ```
72
Cataracts
Lens of eye become opaque
73
Assessment finding for cataracts
``` Halo difficulty reading Changes in color vision Glaring objects in bright lights distortortion of objects poor night vision double eye vision ```
74
Surgical managment for cataracts
surgically removed | clients are awake and can have conversation during procedure
75
Nursing managment for cataracts
- 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
Hearing range
``` Normal- 0-25 Mild impairment- 24-40 Moderate impairment- 40-70 Severe impairment- 70-95 Profound impairment- 95-120 Total deaf- 120+ ```
77
Presbycusis
hearing imaiment associated with old age
78
Risk of hearing loss
``` Family Hx Congenital malformation of ear Use of otoxic medications Recurrent ear infection Chronic exposeure to loud noises perforation of the tympanic membrane ```
79
Tunning fork
An instrament that produces sound in the same range as human speech - it is used to conductuctive or sensiory hearing loss
80
Rinne test
Tunning for struck, placed on mastoid process behind ear and held their till pt indicates no sound
81
Weber test
atriking tunning fork and placing its stem in the midline of pt forehead
82
Impacted Cerumen
Accumalated earwax that obstructs the external acoustic meatus
83
Otitis Externa
An inflammation of the tissue in external auditory canal
84
Otitis Media
Acute inflamation/ infection in middles ear
85
Medical managment for Otitis Externa
Warm soaks Anagelics Antibotic Corticoid steriod medication
86
Surgical managment for Otitis Media
fluid aspirated by needle | antibotics
87
Vertigo
Sensation of movement when there is none
88
Menieres disease
fluctuations in the fluid volumes and pressure in the endolymphatic sac of inner ear
89
How to revent Otitis Externa
DO NOT use swaps or objects that cause trauma to ear Avoid swimming in poluted water Dry ear after immersed in water
90
Assesment findings of Meneires Diease
``` vertigo N/v tinnitus Hearing loss Headaches Abd discomfort ```
91
IOP introcular pressure can increase what?
Optic nerve damage
92
IOP causes what?
Glaucoma

MedSurg (2 decks)

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