Pre & Post-op

Question 1

Definition of Surgery

Answer 1

Art and science of treating diseases, injuries, and deformities by operation and instrumentation

Question 2

What are the perioperative Nursing stages

Answer 2

1. Preoperative care
2. Intraoperative care
3. Post-anesthetic care
4. Post-operative care

Question 3

Preoperative care

Answer 3

Preparing client for sx

Question 4

Intraoperative care

Answer 4

Care during sx

Question 5

Post-anesthetic care

Answer 5

Recovery room or PACU

Question 6

Post-operative care

Answer 6

on floor care or home setting

Question 7

PACU

Answer 7

Post anesthesia care unit

Question 8

What are the preoperative care steps

Answer 8

• client interview
• nursing assessment
• pre-op teaching
• legal preparation
• pre-op checklist

Question 9

What does a nursing assessment involve

Answer 9

• Nursing history (previous experience with sx and anesthesia)
• physical examination (allergies, meds, age, nutrition, past medical history, systems, lab work)
• Risk Factors ( meds, physical/mental impairments, mobility limitations, smoking, ETOH, street drugs, occupation, VS, WT

Question 10

ETOH

Answer 10

ethanol (alcohol)

Question 11

VS

Answer 11

vital signs

Question 12

WT

Answer 12

weight

Question 13

What needs to consist during a Pre-op teaching period

Answer 13

• food and fluid restrictions (pre and post-op)
• medications if any, permitted (determined by physician)
• any need for surgical site prep
• written instructions (post-op exercises)
• post-op expectations (ie. pain management, tubes, ambulation)

Question 14

What are the 2 Nurse’s roles with consent

Answer 14

1. Legal

2. Ethical

Question 15

What do Nurse’s need to do with a Legal consent

Answer 15

act as a witness to verify that the person who signed the consent is the client or the legal guardian

Question 16

What do Nurse’s need to do with Ethical consent

Answer 16

as the client’s advocate, ensure that the client understands the information and that the form has been signed and witnessed before the client receives preoperative medication

Question 17

What are the Intraoperative care steps

Answer 17

• operative room
• surgery performed
• psychosocial assessment
• physical assessment
• chart review
• admission to holding area or OR (OR nurse will admit the patient after going through all of these)

Question 18

What are the Post-operative care steps

Answer 18

• Get report from OR nurse
• Assessments
• Systems (lungs, cardiac)
• VS, ABC’s
• pain
• hypothermia (temp)
• color
• nausea vomiting
• incision site, drainage, collecting devices
• lines (IV,NG, catheter, drains, 02)
• documentation
• post-op exercises
• elastic stockings
• post-op wash
• discharge planning (starts at admission)

Question 19

What is the postanesthesia discharge criteria

Answer 19

• client needs to be awake (or baseline)
• VS stable
• no excess bleeding or drainage
• no respiratory depression
• oxygen saturation is over 90%
• pain is controlled
• report has been given

Question 20

When should you document your findings and patients assessment

Answer 20

• every 15 minutes until stable
• then every 30 minutes X 2
• Then every hour X 4
• then every 4-8 hours as condition warrants

Question 21

Post-op exercises

Deep Diaphragmatic breathing

Answer 21

• assist client to comfortable sitting or standing position
• apply pt’s hand below rib cage and inhale
• feel hands separate from each other
• do not use shoulders or chest to inhale
• do this 3 times (slow breaths)
• repeat breathing exercises 3-5 times

Question 22

Post-op exercises

Controlled coughing

Answer 22

• explain the importance of an upright position
• two slow, deep breaths, inhaling through the nose and out through the mouth
• do this 3 times, on the third breath, count to 3 and cough 2-3 times
• apply pillow over incision line and place hands over the pillow
• instruct client to examine characteristics or sputum

Question 23

Post-op exercises

Turning and ambulating

Answer 23

• lay supine
• bend knees, press heal against mattress and lift buttock
• place left hand on pillow around incision for stability
• use right hand to pull with hand rails to turn
• turn every 2 hours while awake

Question 24

Post-op exercises

Incentive spirometer

Answer 24

• slow deep breaths
• inhale slowly
• constant flow
• try for the same result as pre-op time

Question 25

Post-op exercises

Leg exercises

Answer 25

• supine position and demonstrate passive ROM
• rotate each ankle
• dorsiflexion and plantar flexion of both feet 5 times
• flex and extend knees 5 times
• raise each leg straight up from bed, keeping legs straight 5 times
• practice exercise every 2 hours

Question 26

Ambulatory surgery discharge criteria

Answer 26

• All PACU discharge criteria met
• no IV narcotics for last 30 mins
• minimal nausea and vomiting
• pain controlled
• voided
• able to ambulate if age-appropriate
• responsible adult present to accompany client
• discharge instructions given and understood