pre, intra, & post operative care Flashcards
preoperative phase
decision to have surgery till OR table
baseline data, teaching, and transportation
intraoperative phase
while in the OR
safety, monitoring, stay with conscious pt
postoperative phase
PACU to follow-up visit
communication, assessment, intervention, teaching
PACU
post-anesthesia care unit
-ectomy
removal
appendectomy
-lysis
destruction of tissue
electrolysis
-orrhaphy
repair
herniorrhaphy
-oscopy
view a structure
colonoscopy
-ostomy
create an opening
ileostomy
-otomy
cutting into (osteotomy)
-plasty
reconstruction
arthroplasty
diagnostic surgery
biopsy
curative/ablative surgery
remove tumor or organ
reconstructive surgery
repair of wounds
cosmetic surgery
improve appearance
transplant surgery
take and replace organs
constructive surgery
restores function
prevention surgery
removal of moles
exploratory surgery
laps
palliative surgery
pain relief
seriousness of surgery
classifications
minor: minimal physical damage with low risk
major: extensive
urgency of surgery
classifications
elective: suggested, not essential
urgent: 1-2 days needed for health
emergency: now, life-saving
physical status classification - what are P1-P6? which are in/outpatient?
P1 - healthy pt
P2 - pt w/ mild systemic disease
P3 - pt w/ severe systemic disease
P4 - pt w/ severe threatening systemic disease
P5 - moribund pt (won’t live w/o surgery)
P6 - brain dead pt undergoing organ harvesting
—P1-P3 outpatient; P4-P6 inpatient
informed consent
legal doc that gives pts permission
includes full disclosure, risks/benefits, alternative treatments, consequences of refusal
what does the nurse do to prepare pt for OR?
ID pt, gown, no hair clips or makeup, secure valuables, vitals, med sheet, start IV
factors that increase surgical risk?
age, obesity, nutrition, dehydration, nicotine use, meds
role of surgical assistant
expose site, retract tissue, suction, ligate bleeding vessels, suture
role of anesthesiologist/CRNA
consistent eval of meds and pt condition, supervise recovery in PACU
role of circulating nurse
oversee environment, move pt, skin prep, watch for sterile breaks, instrument and sponge counts, docs, meds
role of scrub nurse
mechanical aspects, hand instruments, suture
what do you do just before starting OR procedures?
take a surgical timeout: ask pt name, DOB, procedure location; verify info with ID bracelet and chart
surgical scrub
5-10 minutes, circular motion, inner to outer, removes micro-organisms, decreases infection
general anesthesia
IV, inhalation
induction, maintenance, emergence
regional anesthesia
spinal, epidural, nerve block
local anesthesia
for specific area only
monitored anesthesia care (MAC)
constant; formally known as conscious sedation
postoperative care
PACU/recovery room (monitoring)
ACP gives verbal report to PACU nurse
care goals (managing function and surgical site, pain and temp control)
postoperative assessment priorities
airway, breathing, circulation, neurologic, urinary, surgical site, pain
what type of problem is #1 after surgery?
oxygenation
in order to be discharged, what must the pt do?
be mobile, be alert, have pain controlled, have a driver and someone at home to help, have teaching completed
how are discharge instructions given?
verbally AND in writing
