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Med Surg > Pre-op nursing 2 > Flashcards

Pre-op nursing 2 Flashcards

1
Q

What are some findings that would require notifying the PCP

A

New diagnosis
New medication
significan change like pregnancy or terminal illness

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2
Q

What if you find the patient has an URI what should you do

A

ask the doctor to reschedule

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3
Q

Why should the patient with a URI have a rescheduled sugery

A

bx they are at higher risk for laryngospasms or bronchospasms and they will have lower SaO2

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4
Q

What do you teach to COPD patients and why

A

teach about deep breathing exercises, ambulating and incentive spirometer bx they have an increased risk for atelectasis

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5
Q

What should you recommend to smokers before surgery

A

try to quit at least 6 weeks prior

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6
Q

Patients with hitory of urinary or renal disease have an increased potential for

A

F & erythropoietin imbalances
coagulopathies
infection
imparied wound healing

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7
Q

What things should we get and pay attention to for renal urinary disease patients

A

renal function tests

analyze their voids

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8
Q

What are some considerations for people with a history of skin ulcers

A

they are at a higher risk to get them again

they may have slower postop healing

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9
Q

What is an intervention that may be good for a pt with a hist of skin ulcers

A

using extra padding

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10
Q

What are considerations caring for a arthritis patient

A

postop positioning
ambulation
airway management

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11
Q

Who needs to be informed about arthritis for surgery patients

A

anesthesia bx of spinal anesthesia problems

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12
Q

What are some considerations for patients with a history of heart value replacement

A

Heart medications

they are at risk for clots and endocarditis

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13
Q

What is a key medication for heart value patients

A

antibiotics

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14
Q

How many days prior to surgery do heart valve patients start antibiotics

A

5-9 days

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15
Q

What foods are related to latex alergies

A

eggs, avocados, bananas, chestnuts, potatoes, peaches

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16
Q

What do you teach the patient before surgery

A 
What to expect (pre and post)
Include pre-op regimen (NPO, etc.)
Where will they be when they wake up?
Post op regimen 
Demonstrate things
17
Q

How do you know if the patient is informed

A

They generally know what is going to happen

18
Q

What do you need to include in your education so the patient can receive adequate information to be informed

A

Diagnosis
Nature and purpose of proposed treatment
Risks and consequences of proposed treatment
Probability of successful outcome
Availability, benefits, and risks of alternative treatments
Prognosis if treatment is not instituted

19
Q

What some things to assess for when doing the pre-operative assessment

A

Determine adequacy of patient’s health status to undergo the proposed surgery
Correct any operative risk factors
Determine what type of surgery is best inpatient?
Establish baseline
Select the anesthetic medication and technique best suited to the patient & type of surgery to be performed
institute preoperative care

20
Q

What can preop teaching reduce

A 
fear and anxiety
postoperative vomiting
postoperative pain
use of pain medication 
number of complications
duration of hospitalization
recovery time
21
Q

What needs to be done the morning of the procedure

A

Make sure they are dressed right, no make-up, no fingernail polish
All orders carried out (prep, NPO, etc)
Records complete
Valuables locked up
Prostheses removed (except hearing aid)
Have them Void
gather and give them their Pre-op meds (valium, versed, fentanyl, anti-nausea)
Afterward Bed rest, SR↑, call light within reach . . . Period! No exceptions!
Bring them a urinal if need be

22
Q

What are some common drug class given pre-op

A 
antibiotics 
anticholergenics
antidiabetics
antiemetics
benzodiazepines
betablockers
H2 receptor antagonists
opioids
23
Q

What is a antibiotic and what is its purpose

A

cefazolin

prevent postop infection

24
Q

What are some anticholergenics and purpose

A

atropine, glycopyrrolate, scopalamine
atro and glyco decrease oral and resp secretions
scopalamine prevent NV and cause sedation

25
Q

What are some antidiabetics and purpose

A

insulin (humulin R)

stabalize BS

26
Q

what are some antiemetics and purpose

A

metoclopramide, ondansetron
meto increases gastric emptying
ondansetron prevents NV

27
Q

What are some benzodiazepines and purpose

A

midazolam, diazepam, lorazepam

all decrease anxiety, induce sedation and have amnesic effects

28
Q

What are some beta blockers and purpose

A

labetalol

HTN

29
Q

What are some H2 antagonists and purpose

A

famotidine and ranitidine

decrease gastric volume and HCL secretion and increase ph

30
Q

What are some opioids and purppose

A

morphine and fentanyl

pain relief during pre-op procedures

31
Q

How long before surgery are antibiotics usually given

A

30-60 minutes

Med Surg (35 decks)

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