Pre-Operative

Question 1

What are the 4 important assessments to be made preoperatively?

Answer 1

• Pt. identity and consent
• Allergies, health hx, meds
• Vitals and head to toe
• Lab work diagnosis. Imaging

Question 2

2 class of medications used pre operatively and rational

OTHERS?

Answer 2

• Antibiotic- for prophylactic tx
• Antacid- Gastric acid reducer (sodium citrate, ranitidine)

OTHERS
• Anti-inflm
• Benzodiazepines/Anti- anxiolytic (reduce anxiety, benzodiazepines (the pams))
Antihistamine or Anticholinergic- to reduce oral secretion

Question 3

Risks outlined in WHO surgical safety checklist?

Answer 3

BLANK

Question 4

What systems might you want to assess pre-operatively and why?

Answer 4

Looking to gain BASELINE for basically everything.

Homeostasis (Immune/Inflammation) – ensure pt can mount a response to surgery

Nervous System- baseline before medication and procedure

Respiratory System- All respiratory mechanism may be lost

Cardiovascular System- pt must meet oxygen, fluid and nutritional needs in the perioperative period

Gastrointestinal system
Nutrition/fluid/electrolyte
Dentition/obesity (intubation)
Hepatic/endocrine (ability process medications)
Renal system

Question 5

What Diagnostics might be helpful preoperatively and why?

Answer 5

Hematology profile
HgA1C (diabetics require)
INR ( those on blood thinner therapy requires)
Na, K, Cl, CO2 content, Creatinine those who are (dehydrated, children)
ECG (those with potential cardiac issues)
Others? (Know co morbidities)

Question 6

What is Anesthesia Physical Classification System and what are ASA levels?

Answer 6

ASA PS 1- Normal healthy patient (No organic, physiologic, or psychiatric disturbance; excludes the very young and very old; healthy with good exercise tolerance)
ASA PS 2- Patients with mild systemic disease

ASA PS 3 Patients with severe systemic disease

ASA PS 4- Patients with severe systemic disease that is a constant threat to life (Has at least one severe disease that is poorly controlled)

ASA PS 5- Moribund patients who are not expected to survive without the operation Not expected to survive > 24 hours without surgery; imminent risk of death

ASA PS 6- A declared brain-dead patient whose organs are being removed for donor purposes

Question 7

What are common nursing responsibilities pre op?

Answer 7

• NPO status
• Pre-op scrub
• Medications
o usual & preoperative

Question 8

Common Nursing Dx in Peri op period?

Answer 8

• Some major nursing diagnoses may include the following,,,,
o Anxiety related to expressed concerns due to surgery or OR environment
o Risk for perioperative positioning injury related to positioning in the OR
o Risk for injury related to anesthesia and surgery
o Disturbed sensory perception related to general anesthesia or sedation
o Impaired skin integrity due to incision
o Infection
o Adverse response to meds

Question 9

What could help deal with anxiety pre op?

Considerations around use?

Answer 9

Lorazepam: Anty anxiety. Crosses the placenta and enters the breast milk. May experience drowsiness. CAT D

Question 10

How is Ranitidine used pre op

Answer 10

Ranitidine: H2 antagonist. pump inhibitor. Inhibits the secretion of histamines which in turn decreases the secretion of hydrochloric acid. Reduce risk of aspiration of stomach contents during incubation

Question 11

What is Sodium Citrate

Answer 11

Sodium Citrate: Antacid. Increases the production of bicarbonate which in turn increases the pH therefore minimizes the acidity of stomach gastric juices. Helps to promote healing for stomach and esophageal ulcers.