Pre-Operative Flashcards
- AppendECTOMY
- ElectroLYSIS
- HerniORRHAPHY
- EndOSCOPY
- ColOSTOMY
- TracheOTOMY
- MammoPLASTY
- excision/removal
- destruction of
- repair/suture of
- looking into
- creation of opening
- cut/incision of
- repair/reconstruction of
What is a nurse’s role in a med surg unit?
Preoperative?
Intraoperative?
Postoperative?
Assessment/Teaching/Surveillance and Intervention
- Teaching & Assessment
- Surveillance- Vision opened to everything but using own knowledge to look for something specific
- Postoperative- Surveillance & Teaching aimed at preventing complications and facilitating recovery and discharge
What are the most common psychological factors?
anxiety
fear
hope
What should be looked at during a PSYCHOSOCIAL assessment of a preoperative patient?
Situational Changes Concerns with the Unknown Concerns with Body Image Past Experience Knowledge Deficit
What is the key priority in Preoperative Nursing?
How do you achieve this?
- Patient Safety
- Always use the nursing process and gather data (Subjective and Objective)
What are some preoperative subjects you need to know in a nursing interview?
- History
- Allergies
- Meds
- Nutrition
- Herbs
What should you do if a patient is on herbs?
D/C (discontinue) all herbs 2-3 weeks before surgery, Consult HCP for specific instructions
Herbs and Their Effects w/ Anesthesia
- Echinacea
- Ephedra
- Garlic
- Ginkgo
- Ginseng
- Kava
- St. John’s wort
- Valerian
- Echinacea- liver damage if you have liver disease
- Ephedra - hypertension and tachycardia
- Garlic - Prolonged bleeding during or after surger
- Ginkgo- Prolonged bleeding during or after surgery
- Ginseng- Hypertension and Tachycardia
- Kava- Liver damage and interactions with other medicine
- St. John’s wort- Excess Sedation
- Valerian- Excess sedation and Irregular Heart Rhythms
What complications can occur with a patient who takes a diuretic and a beta blocker to control blood pressure and with a low potassium level?
Dysrhythmias
What do you do if you determine that the patient has an URI (upper respiratory infection) and why?
What are the risks of someone going into surgery with a URI?
- Inform the doctor and Reschedule surgery and Reassess
- Lungs are at risk if you are in surgery due to General Anesthesia
- Increased risk of laryngospasm or bronchospasm
- Decreased SaO2
What risks are increased with someone with COPD going into surgery?
What should the nurse do?
- Atelectasis and Hypoxemia
- Teach breathing techniques and lung exercises
What should the nurse do about smokers about to go into surgery?
Try to get them to quit 6 weeks prior
What risks does a patient with a history of urinary or renal diseases about to go into surgery have?
What should the nurse do?
Increased potential for
- Fluid & Electrolyte Imbalances
- Coagulopathies
- Increased risk for infection- kidneys
- Increased wound healing- kidneys
- Watch voiding carefully
If a patient is on a diuretic such as Lasix, what occurs in their body?
What medication should they watch out for then and why?
- Pees out K+ resulting in hypokalemia
- Digoxin because digoxin toxicity will more likely occur if the person has hypokalemia
What is more likely to happen with a patient with valve replacement?
More likely to have blood clots
What does a patient with a history with valve replacement need before surgery and why?
What else do you need to do?
- Antibiotic Prophylaxis
because they are at risk for endocarditis - Let the surgeon know
If a patient has a certain food allergy such as eggs, avocados, bananas, chestnuts, potatoes, and peaches, what else an that indicate?
What do you need to do for these patients?
- Patients with certain food allergies are likely to have latex allergies
- Use special non-latex materials during surgical procedures
What are some important things that the patient needs to do when recovering from surgery?
- Spirometry
- Coughing
- Ambulation
What does the nurse need to do in terms of paperwork before the surgery?
Get the patient’s informed consent in very legal, plain language while witnessing the patient’s signature.
- Make sure the patient is informed
What are the exceptions where you don’t have to get the patient’s signature?
- Minor (Get Parent’s Signature)
- Incompetent (Get Guardian’s Signature)
- Emergency (Document Surgery)
If the patient is not informed or does not consent voluntarily, what should you do in terms of getting their signature?
Don’t have them sign and notify the surgeon and do this before pre-op drugs are given
What are the elements of Valid Informed Consent that can be considered as adequate disclosure?
- Diagnosis
- Nature and Purpose of Proposed Treatment
- Risks and Consequences
- Probability of Successful Outcome
- Availability, benefits, and risks of alternative treatments
- Prognosis if treatment is not instituted
