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Nurs 186 > Pre/intra-op > Flashcards

Pre/intra-op Flashcards

1
Q

Risk factors for surgery

A
  • fever
  • obesity
  • age
  • alcohol abuse
  • smoking
  • diabetes
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2
Q

Expected diagnostics before surgery

A
  • complete blood count
  • EKG
  • coagulation study
  • blood type/cross panel
  • electrolyte panel
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3
Q

Teaching before surgery

A
  • how you’ll be assessing pain
  • there will be pain meds
  • expected outcomes
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4
Q

After surgery teaching

A
  • leg exercises

- IS

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5
Q

Surcigal care improvement project

A
  • infection prevention
  • DVT prevention
  • prevention of serious cardiac events
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6
Q

Skin preparation

A
  • do not shave patients prior to surgery
  • use clippers
  • chloraprep baths
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7
Q

Intestinal preparation

A
  • only clear GI if needing surgery
  • patient will be on NPO status before surgery
  • meds may be given PO if the risk is higher not to give them(Physician decides this)
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8
Q

Palliative surgery

A 
Relieves symptoms(usually pain) but does not change the course of events(disease/death) 
-comfort
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9
Q

Cosmetic surgery

A

performed primarily to alter or enhance physical appearance

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10
Q

Elective surgery

A

-planned for the correction of a non-acute surgery(patient chooses to have this done)

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11
Q

Emergent surgery

A

-requires immediate intervention because of life threatening consequences

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12
Q

Urgent surgery

A

Requires prompt intervention, may be life threatening if delayed more than 24-48 hours

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13
Q

Simple surgery(extent)

A

Small amount of tissue removed

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14
Q

Radical surgery(extent)

A

Extensive surgery beyond the area involved

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15
Q

Minor surgery(degree of risk)

A
  • Procedure without significant risk
  • minimal blood loss
  • low length of surgery
  • low length of anesthesia
  • minimal complication
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16
Q

Major surgery(degree of risk)

A
  • increases in blood loss
  • potential for lots of complications
  • longer surgeries
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17
Q

Ectomy

A

Removal of

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18
Q

Oscopy

A

To look into

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19
Q

Otomy

A

To make an incision

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20
Q

Ostomy

A

To make an opening with drainage

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21
Q

Plasty

A

Molding or shaping through a special procedure

22
Q

Pre-op check list

A
  • identify Patient
  • proper name band
  • check allergies(Diprivan is linked to egg allergies)
  • skin preparation
  • start IV
  • remove finger nail polish
  • pt. needs to void before surgery
23
Q

Pre-op medications

A
  • antibiotic(give within one hour of first incision)
  • midazolam(verses) Antianxiety
  • atropine:decreases secretions
  • ranitidine(Zantac) acid blocker
24
Q

Informed consent

A
  • consent is good for 30 days

- nurses serve as witness that patient signed consent(surgeon does the informing)

25
Q

Advance directive

A
  • does patient have a representative
  • pt. made wishes known?
  • in Michigan age for concent is 18 unless an emancipated minor
26
Q

Site specific marking

A

Surgeon, and Patient agree on site and sign it

27
Q

Minimally invasive surgery

A
  • surgery that uses an endoscope

- can use insufflation for a better view

28
Q

Advantages of minimally invasive surgery

A

Less blood loss,faster recovery time

29
Q

Disadvantages of minimally invasive surgery

A

Expensive, surgeon needs extra training, insufflation can cause CO2 bubble that causes shoulder pain(walking and movement is best to treat that)

30
Q

Robotic surgery

A

A form of minimally invasive surgery

  • very expensive equipment
  • lengthier procedure
31
Q

General anesthesia

A
  • causes sedation/loss of consciousness
  • potential for hypotension and arrhythmias
  • can be IV push or inhalation(ETT,LMA)
  • ETT allows an airway(sensitive oral care)
32
Q

Level 1 anesthesia

A
  • analgesia and sedation(relaxation)

- patient feels drowsy and ends with loss of consciousness

33
Q

Level 2 anesthesia

A
  • excitation and involuntary muscle movement

- may have irregular breathing patterns

34
Q

Level 3 anesthesia

A
  • depression of vitals
  • sensations to pain are lost
  • CRNA does intubation
  • level we want for surgery
35
Q

Level 4 anesthesia

A
  • danger/toxicity level
  • very low depression or vital functions
  • respiratory failure,cardiac arrest
36
Q

Malignant hyperthermia

A
  • genetic response:reactions interferes with calcium in muscles, muscles contract
  • treat with dantrolene sodium(skeletal muscle relaxant via IV)
  • monitor for tachycardia and increase CO2, and fever
  • discontinue surgery safely
37
Q

Regional anesthesia

A

Loss of sensation and movement of a body part

-patient remains conscious but often times can be sedated

38
Q

Spinal

A

-needle goes through duramatter into CSF

39
Q

-epidural

A

Injected into epidural space

40
Q

Reactions to both spinal and epidural

A
  • if drug rises too high can cause respiratory depression(lay patient down)
  • spinal headaches d/t loss of CSF
  • change in BP
  • urinary retention
41
Q

Nerve block

A

Local anesthetic inserted around the area

42
Q

Moderate sedation(conscious sedation)

A
  • state of reduced consciousness
  • patient can protect airway and follow basic commands
  • meds have amnesia effect
  • considered safer
  • cannot drive for 24 hours
43
Q

Positioning

A
  • OR nurse helps in positioning the patient
  • beware of skin integrity
  • patients who receive anesthesia are more flexible
44
Q

Supine(dorsal recumbent)

A
  • most common position

- when patient gets anesthesia(best trachial access)

45
Q

Lithotomy position

A

Lying on back legs up in air

46
Q

Trendelenburg

A

On back, bed is tipped back

47
Q

Safety concerns

A
  • timeout before and after surgery
  • grounding pad on pt. for electric shock(do not put near artificial metal body part)
  • fire concerns
  • supply count before and after
48
Q

Maintain patients normal body temperature

A
  • patients more prone to infection if get too cold and don’t warm up
  • goal is to get pt. back to 36-38C within one hour after surgery
  • bear hugger
  • warm blanket on head
49
Q

Sutures

A

May be absorbable or non-absorbable

50
Q

Glue(dermabond)

A

may have steel strips as well

51
Q

Retention sutures

A

Put in place when pt. is high risk for dehiscence(removed by surgeon)

52
Q

Fibrin spray

A

Spray helps control bleeding during surgery

Nurs 186 (12 decks)

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