Pre-op and Intra-op nursing Flashcards
what are the categories of surgeries?
elective
urgent
emergent
what are the classifications of surgeries?
diagnostic
curative
repair
palliative
reconstructive or cosmetic
rehabilitative
what are examples of conditions that require emergent surgery?
severe bleeding
bladder or intestinal obstruction
fractured skull
gun shot or stab wound
extensive burns
when is an emergent surgery done?
ASAP
what are conditions that require urgent surgery?
gallbladder infection
kidney stones
hip fractures
how soon is an urgent surgery done?
within 24-30 hours
what are conditions that fall under “required” surgery, and how soon is it done?
plan for next few weeks or months
thyroid conditions, cataracts, prostate resection for BPH
what is an elective surgery?
should be done, but not having it will not be a big deal either
hernia repair is an example of an elective surgery
what is an optional surgery?
cosmetic surgery, decision up to the patient
why is pre op education important for patients?
can reduce length of stay by about a day
how are knee replacements treated post-op?
PT starts on same day of surgery or next morning
analgesia strategy incorporates robaxin, tylenol, celebrex, and corticosteroids
what should we ask patients about before their surgery?
Name and DOB, allergies, vitals, physical assessment
assess pain, nutrition, mobility
psychosocial and spiritual considerations
current medications and substance use
when did they last eat or drink?
family history of malignant hyperthermia
check if informed consent is done
who obtains informed consent?
the surgeon
what is reviewed during informed consent?
surgeon’s name
what the surgery is and why it’s needed
risks of surgery
alternative options to surgery
outcome if surgery not performed
consent for anesthesia and blood products
what is included on the pre-op checklist?
lab work
imaging orders (xray)
remove piercings and nail polish
prep and mark surgical site
Insert IV, administer antibiotics and analgesia as ordered
patient should void
bedside report to OR nurse
who on the surgical team must be sterile?
surgeon
surgical assistant
scrub nurse/scrub tech
what does the scrub nurse/scrub tech do?
pass instruments
prep OR
count sponges and instruments
take care of specimens
who on the surgical team does not need to be sterile?
anesthesiologist or CRNA
circulating nurse - documents, positions patient
unlicensed assistive personnel
what are the “rights” of surgery
right patient
right location
right procedure
which kind of anesthesia requires intubation?
general anesthesia
what is regional anesthesia?
uses spinal or epidural
what is used for moderate sedation?
benzo and narcotic combo
what is Monitored Anesthesia Care?
local anesthesia with light sedation, patient still breathes on their own
what are common adverse effects of anesthesia?
hypotension
headache
delirium
hypothermia
N/V
anxiety
shivering
what are more seriouscomplications of anesthesia?
anaphylaxis
hypoxia
malignant hyperthermia
seizure
cardiac or respiratory arrest
stroke
nerve damage
anesthesia awareness
what occurs during malignant hyperthermia?
sustained muscular contraction
hypermetabolism
obviously they’re also overheating
signs and symptoms of malignant hyperthermia
tachycardia
rigidity
hyperthermia
increased CO2
hypertension
dark brown urine - rhabdomyolysis from muscle breakdown
how is malignant hyperthermia treated?
dantrolene to relax muscles
cooling methods: cold NS IV, remove blankets, ice bags
