Pre-op nursing 2 Flashcards
What are some findings that would require notifying the PCP
New diagnosis
New medication
significan change like pregnancy or terminal illness
What if you find the patient has an URI what should you do
ask the doctor to reschedule
Why should the patient with a URI have a rescheduled sugery
bx they are at higher risk for laryngospasms or bronchospasms and they will have lower SaO2
What do you teach to COPD patients and why
teach about deep breathing exercises, ambulating and incentive spirometer bx they have an increased risk for atelectasis
What should you recommend to smokers before surgery
try to quit at least 6 weeks prior
Patients with hitory of urinary or renal disease have an increased potential for
F & erythropoietin imbalances
coagulopathies
infection
imparied wound healing
What things should we get and pay attention to for renal urinary disease patients
renal function tests
analyze their voids
What are some considerations for people with a history of skin ulcers
they are at a higher risk to get them again
they may have slower postop healing
What is an intervention that may be good for a pt with a hist of skin ulcers
using extra padding
What are considerations caring for a arthritis patient
postop positioning
ambulation
airway management
Who needs to be informed about arthritis for surgery patients
anesthesia bx of spinal anesthesia problems
What are some considerations for patients with a history of heart value replacement
Heart medications
they are at risk for clots and endocarditis
What is a key medication for heart value patients
antibiotics
How many days prior to surgery do heart valve patients start antibiotics
5-9 days
What foods are related to latex alergies
eggs, avocados, bananas, chestnuts, potatoes, peaches
What do you teach the patient before surgery
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
How do you know if the patient is informed
They generally know what is going to happen
What do you need to include in your education so the patient can receive adequate information to be informed
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
What some things to assess for when doing the pre-operative assessment
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
What can preop teaching reduce
fear and anxiety postoperative vomiting postoperative pain use of pain medication number of complications duration of hospitalization recovery time
What needs to be done the morning of the procedure
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
What are some common drug class given pre-op
antibiotics anticholergenics antidiabetics antiemetics benzodiazepines betablockers H2 receptor antagonists opioids
What is a antibiotic and what is its purpose
cefazolin
prevent postop infection
What are some anticholergenics and purpose
atropine, glycopyrrolate, scopalamine
atro and glyco decrease oral and resp secretions
scopalamine prevent NV and cause sedation
What are some antidiabetics and purpose
insulin (humulin R)
stabalize BS
what are some antiemetics and purpose
metoclopramide, ondansetron
meto increases gastric emptying
ondansetron prevents NV
What are some benzodiazepines and purpose
midazolam, diazepam, lorazepam
all decrease anxiety, induce sedation and have amnesic effects
What are some beta blockers and purpose
labetalol
HTN
What are some H2 antagonists and purpose
famotidine and ranitidine
decrease gastric volume and HCL secretion and increase ph
What are some opioids and purppose
morphine and fentanyl
pain relief during pre-op procedures
How long before surgery are antibiotics usually given
30-60 minutes
