Preoperative Care- EXAM 4 Flashcards
What is it
3 phrases of surgical procedure
Preop
Intra
Postop
Preop
Patient is identified to have surgery, surgical site is prepared
Surgeon is responsible to assess patient and get consent!!! Nurse only witnessess and can paraphrase what was said
Lab tests are done, Allergies are collected, medication admin occurs:
NSAID’s, Blood thinners, and OTC meds are stopped
Postop
Recovery phase
Begins when the patient leaves surgical suite
Ends when patient meets all discharge needs:
Patient is able to void, Airway and circulation are perfect, Vitals are all stable and all and any teachings are done and understood
Intra
Surgery is done and procedure within operating room and procedure room is done
Anesthesia is given, prep is done, draping and then surgical procedure
Preparation for the post op phase
Circulating nurse
Ensure sterile field isn’t broken
Counts instruments
Mouthpiece for the patient
Verify everything before surgery
Universal Protocol
Ensures safety!
Procedure verification process
Time-outs
Handoff report
antimetics
zofran
For nausea and vomitting
Nonopoioid
Tramadol
Tylenol
Anxlolytics
For anxiety, Calms them down, go to sleep, sedation
opioids
Morphine,
General anesthesia
Antibacterial
Used as prevention
Saline, Antibacterial soap, prophylactic
Types of surgical procedure
Open and Laparoscopy
‘ectomy’ removal of organ
‘oscopy’ part of the body is being viewed
Patients with high BMI during preop
At risk for poor wound healing, surgical site infections!
Over BMI 30
High alert medications
Beta-blockers: affect blood pressure
Coumadin: places the patient at risk
Teachings to be done postop
How to use spiromator, ambulation, infections that can occur, follow up visits, home care plans, medication regimen, coughing and deep breathing, diet
Post Wound managment
Surgeon is in charge of first dressing change
Nurse only reinforces dressing if necessary!
Once they leave, we are in charge of giving bathing instructions and suture/staples care
What patient info would you expect after a patient is handed off to you from surgery
Name, age, Who the surgeon is, what surgery they had
Indication for surgery, Medical history, Current medication, Allergies, Vitals, Blood loss, urine output, unexpected surgical events or anasthesia reactions
What assessments should be performed in postop
ABCNGS
Airway check,
Breathing: quality, breath sounds, what oxygen they take, contionius pulse ox
Circulation: ECG, pulses, capillary refil, skin color and temp
Neurological checks: Orient, LOC, sensory and motor, pupil size and reaction
GI/GA: I&O, Bowel sounds, Nausea
Surgical site!!! Dressing, Pain, Lab tests if needed
What complications are at risk for following a subtotal gasterectomy
Airway obstruction
Hypoxemia
Aspiration
Bronchospasm
Hypoventilation
Neuromuscular assessment
Includes
LOC, Orientation, Sensory and motor status and pupil size and reaction
