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Assessment > Pre op Assessment/ERAS > Flashcards

Pre op Assessment/ERAS Flashcards

1
Q

What is the purpose of a pre-op assessment?

A

To gather complete health history and physical exam in order to determine surgical risks

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2
Q

What are surgical risks determined by?

A

Patient baseline medical conditions
History of current diagnosis / condition
Anticipate changes to baseline status as a result of surgery

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3
Q

What is covered in patient history that uncover risk factors?

A 
Medical conditions 
Medications
Allergies
Family history ex. Bleeding disorders 
Difficulties in previous surgeries
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4
Q

What are some patients rights during assessment?

A 
Respect 
Information 
Autonomy 
Honouring wishes 
Privacy 
Confidentiality 
Medical records
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5
Q

What is some patient responsibilities during assessment?

A

Providing accurate info
Info about known medical conditions
Participating in decisions

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6
Q

Who has the speak up program to learn about patients rights?

A

The joint commission

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7
Q

Patients Bill of rights was founded by who?

A

American hospital Association

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8
Q

What are SDOH?

A

Social determinants of health

Environmental conditions that affect quality of life

How a place is experienced by population groups and impact on health

Ex. Where you’re born, live, work

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9
Q

Elements of social determinants of health?

A 
Economic status 
Education 
Social/community context 
Health and health care 
Neighbourhood/built environment
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10
Q

Examples of economic SDOH?

A

Employment
Food insecurity
Housing insecurity
Poverty

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11
Q

Examples of health/health care SDOH?

A

Access to health care

Health literacy

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12
Q

Examples of neighborhood/built environment SDOH?

A

Access to healthy food
Crime/violence
Environmental conditions
Quality housing

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13
Q

Examples of education SDOH?

A

Early childhood
Enrolment in higher education
High school graduation
Language/literacy

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14
Q

Examples of social / community context SDOH?

A

Discrimination
Incarceration
Social cohesion

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15
Q

History and physical assessment is regulated by who?

A

Centers for Medicare and Medicaid (CMS)

The TJC provides accreditation requirements for facilities to follow

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16
Q

What is the nurses responsibility during medical and physical assessment?

A

To do assessment
To gather relevant info about care, treatment and services that address patient condition, plan of care and needs
Must be completed prior to procedures within scope

17
Q

What is done in data collection?

A

Collecting pt data
Establishing nursing diagnosis
Identifying desired outcomes
Making data available to surgical team

18
Q

Primary vs secondary data?

A

Primary data is most relatable
Comes from patient directly

Secondary data is from family, medical records, health care providers

19
Q

What is ERAS?

A

Enhanced recovery after surgery

20
Q

Goals of ERAS?

A

Decease patient stress response
Optimize patient physiological function
Facilitate recovery

21
Q

Key components of ERAS?

A 
Education 
Optimization of pt condition 
Minimal fasting pre op
Multimodal pain relief
Return to diet/activity the day of surgery 
DC home
22
Q

Advantages to ERAS?

A

Fast recovery
Decrease hospital stays
Fewer post op complications

23
Q

Pre hospital phase of ERAS?

A

Education
Pain plan
Pt optimization
Prehabilitation

24
Q

Pre-op phase of ERAS?

A

Limit/fasting

Initial multimodal medication and/or regional block

25
Q

When can you eat / drink with ERAS pre-op?

A

Light snack 6hrs pre-op

Carbohydrates drink 2hrs prior

26
Q

Intra - op phase of ERAS?

A 
Multimodal meds 
Normovolemia
N/V prophylaxis 
Normothermia 
Normoglycemia 
Avoid tubes and drains
27
Q

Post - op phase of ERAS?

A 
Early nutrition 
Early mobility 
Multimodal pain relief 
N/V management 
No or very little IV fluid 
Education
28
Q

Discharge of ERAS?

A

Monitor S&S and when to seek help
Follow up
Continuing planned therapy

29
Q

ERAS challenges for patients?

A

Needs/experience
Health literacy/understanding
Attitude/beliefs
Health history

30
Q

Staff challenges with ERAS?

A

Attitude/behaviour
Engagement
Communication
Skills/competency

31
Q

Facility challenges with ERAS?

A

Leadership/support
Education
Availability of resources

32
Q

When does skin decline in function?

A

Starts between 30-44yrs

Elasticity decreases
Skin thins
Sweat glands atrophy
- difficult temp regulation

Assessment (6 decks)

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