pre peri post op

Question 1

types of surgery: classification by purpose

Answer 1

diagnostic, ablative, constructive, reconstructive, transplantation, palliative and cosmetic

Question 2

types of surgery: classification by degree of urgency

Answer 2

elective, urgent, emergency

Question 3

types of surgery: degree of risk

Answer 3

Minor and major

Question 4

preoperative period begin when

Answer 4

patient is scheduled for surgery and ends at the time of transfer to the surgical suite

it make start days or weeks before admission

Question 5

during preoperative period you are responsible for

Answer 5

education and teaching

anxiety management

medication/pain management

teaching about drains

teaching about dressings

Question 6

pre operative assessment

Answer 6

obtain history

conduct physical exam

draw and review results of labs

verify consent is signed

provide education to prevent post op complications: tcdp, is, scds

what to expect in the surgical suite and recovery

Question 7

preop medications

Answer 7

follow surgeons orders on when to stop certain medications like

blood thinners

anticoagulants

aspirin

nsaids

vitamin E

herbs

Question 8

pre-op testing

Answer 8

CBC

BMP

PT = 11-13

INR= ~1

aPTT = 22-35

type and screen

EKG

chest x-ray

pregnancy test

Question 9

pre operative teaching

Answer 9

explain what tests may be done

dietary restriction- npo requirements

what families should expect

Question 10

pre op assessing

Answer 10

ability to take care of self upon discharge

home safety- entrances, stairs, railings, showers

discharge need

Question 11

pre op teaching to prevent post operative compliation include

Answer 11

preventing deep vein thrombosis

preventing surgical site infection

preventing raspatory complication

Question 12

components the enhanced recovery after surgery (ERAS) protocol: preoperative

Answer 12

nutrition

habilitation

education and counseling

smoking and alcohol cessation

cardiopulmonary assessment

venous thrombo-prophylaxis

preoperative fasting and carbs rich loading

Question 13

components the enhanced recovery after surgery (ERAS) protocol: intaoprative

Answer 13

surgical approach

anesthesia management

perioprative flid management

prevention of hypothermia

Question 14

components the enhanced recovery after surgery (ERAS) protocol: postoperative

Answer 14

early mobilization

early removal of drains

early enteral feeding

perioperative pain control

postoperative nausea and vomiting

post operative glycemic control

Question 15

member of the surgical team are

Answer 15

surgeon

PA/APRN

surgical/ scrub nurse and circulating nurse- they monitor patient sterile field iv vs output- urine blood and count what goes in and out sponges and equipment included

anesthesiologist or nurse anesthetist

scrub tech- create sterile field, preparing equipment,counting( sponges, sharps, etc)

Question 16

surgical patients risks

Answer 16

anesthesia complications

patient unable to speak and protect themselves

risk for having incorrect procedure done

risk for infection

Question 17

esnuring patient safty

Answer 17

consent and doctor explain the risk and benefits of surgery

presonal belongings get sent home or lock up somewhere

the chart is checked to be certain the correct site is listed

the site is marked by the surgon and rechecked by two nurses

Question 18

types of anesthsia

Answer 18

general

regional

local anesthisa

moderate sedation

Question 19

general anesthesia may require and may cause

Answer 19

advance airway

produces CNS depression, amnesia, and unconsciousness with loss of muscle tone and reflexes

Question 20

intra-oprative period begins when

Answer 20

patient enter OR and ends when he leave

Question 21

intra-operative period important points

Answer 21

check equipment prior to surgery to ensure that equipment is functioning properly

lock bed and surgical table

anesthesia: continouisly check vital on monitor

position patient as required

sterility: prevent infection by maintaining sterile technique

Question 22

intraoperative nursing diagnoses

Answer 22

risk for wrong site procedure

risk for injury

risk for imbalanced body temperature: hypo or hyperthermia

risk for fluid volume deficit

Question 23

post op period you must check

Answer 23

did patent regain consciousness

is airway patent

is patient oriented

are vs stable

can patient move extermities

is dressing dry and intact

Question 24

postoperative nursing diagnoses

Answer 24

impaired skin integrity
impaired gas exchange
risk for infection

risk for aspiration
risk for imbalance fluids and electrolytes
risk for deep vein therombosis

Question 25

report or to pacu

Answer 25

surgical procedure and length

medication and last time pain med was given

IV fluids

blood loss

drains

urine/ catherter

incision/dressing/packing

concerns

unusual position that may affect patent

unsusual events in surgery

questions

Question 26

general immediate post op assessment

Answer 26

level of cosciousness

airway

tempreture VS, pulse

pain

surgical site

overall skin intergrity

iv lines and other drains or tubes

nause/ patient comfort

I&O’s

MD orders

Question 27

general post op nursing care

Answer 27

maintain: opioids, non opioids, PCA pump

close monitoring of VS: watch for S&S hemorrhage- low BP with increased pulse rate

must urinate within a certain time period after surgery or after catheter is removed

TCDB, IS, SCDs, early ambulation

Question 28

post operative nursing care

Answer 28

nutrition

asess for nausea and obtain order for antemetics and administer prn

education and teaching

encorage to perform IS, TCDB, foot wiggles, early ambulation

prepare for dicharge if applicable

family involvement