PreOp Flashcards
1
Q
PreOperative
A
- Before surgery
- Begins when pt is scheduled for surgery & ends at time of transfer to surgical site
2
Q
Number 1 Priority PreOp
A
Patient safety
3
Q
Cardiovascular System Age-Related Changes as Surgical Risk Factors
A
- Dcrd cardiac output
- Dcrd peripheral circulation
- Incrd BP
-
Interventions:
> determine normal lvls, note when pt tires
> monitor VS, peripheral pulses, & cap refill
4
Q
Respiratory System Age-Related Changes as Surgical Risk Factors
A
- Reduces vital capacity
- Loss of lung elasticity
- Dcrd oxygenation of blood
-
Interventions:
> teach cough & deep-breath
> monitor resps & breathing effect
5
Q
Musculoskeletal System Age-Related Changes as Surgical Risk Factors
A
- Inrd incidence of deformities r/t osteoporosis or arthritis
-
Interventions:
> assess pt’s mobility
> teach turning & positioning
> encourage ambulation
> place on fall precautions
6
Q
Neurologic System Age-Related Changes as Surgical Risk Factors
A
- Sensory deficits
- Slower reaction time
- Dcrd ability to adjust to changes in surroundings
-
Interventions:
> orient pt to surroundings
> allow extra time for teaching pt
> provide for pt’s safety
7
Q
Renal/Urinary System Age-Related Changes as Surgical Risk Factors
A
- Dcrd blood flow to kidneys
- Reduced ability to excrete waste
- Decline in GFR
- Nocturia common
-
Interventions:
> monitor I&Os
> assess overall hydration
> monitor electrolyte status
> assist frequently w/ toileting needs, especially @ night
8
Q
Skin Age-Related Changes as Surgical Risk Factors
A
- Dry w/ less subcutaneous fat makes skin at greater risk for damage
- Slower skin healing incrs risk for infection
-
Interventions:
> assess pt’s skin b4 surgery for lesions, bruises, & areas of dcrd circulation
> pad bony prominences
> use pressure-avoiding/reducing overlays
> avoid applying tape to skin
> change position at least q2
9
Q
PreOp Assessments
A
- Complete VS & report abn findings
- Focus on problem areas
- S/S of infection
- Report:
> change in mental status
> vomiting
> rash
> recent admin of anticoags
> hx of malignant hyperthermia w/ anesthesia
10
Q
Factors tht Contraindicate Surgery
A
- Incrd prothrombin time (PT)
- Incrd international normalized ratio (INR)
- Incrd activated partial thromboplastin time (aPTT)
11
Q
Psychosocial Assessment
A
- Lvl of anxiety
- Coping ability
- Support systems
12
Q
Laboratory Assessment
A
- Can depend on age, medical hx, & type of anesthesia + surgery planned
> UA, blood type & screen
> CBC or H/H
> clotting studies (PT, INR, aPTT, platelet count)
> electrolyte lvls
> serum creatinine & BUN
> pregnancy test
> ABG’s (pts w/ chronic pulm probms)
13
Q
Other Assessments
A
- Imaging: CXR, CT, MRI
- Diagnostic: ECG
14
Q
Informed Consent
A
- Surgeon is responsible for informing & having consent form signed BEFORE sedation & surgery
- Nurse is responsible for being a witness to signature, NOT tht pt is informed
15
Q
Interventions
A
- Advance directives
- NPO status
- Admining scheduled drugs
- Intestinal prep
- Skin prep
- Prep for tubes, drains, & vascular access
- PostOp interventions to prevent resp comps
- Teach cardiovascular comps
- Minimize anxiety
- Pain management
