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2.2 - ABSN NUR 334 Fluid & Electrolytes & Periop > Preoperative Nursing > Flashcards

Preoperative Nursing Flashcards

1
Q

What is the focus of the preoperative phase?

A 
-Nursing and anesthesia 
  provider assessment
-Planning of care
-Interventions to 
 prepare for surgical 
 procedure
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2
Q

Reasons why patients have surgery

A
  • Diagnosis
  • Cure
  • Palliation
  • Prevention
  • Exploration
  • Cosmetic improvement
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3
Q

What are the different types of surgery?

A

Ambulatory
Same day admit
Inpatient

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4
Q

What is an ambulatory surgery?

A

comes in, has surgery and goes home on the same day

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5
Q

What is a same day admit surgery?

A

comes in for surgery, post-op admit

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6
Q

What is an inpatient surgery?

A

admitted to
hospital, has surgery,
stays post-op

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7
Q

How urgent is an elective surgery? What are the risks?

A 
•Improve quality of life 
 (physically or psychologically)
• Cataract removal; breast 
  reduction
• Time is not of the essence in 
   scheduling
•General risks include:
• Bleeding
• Infection
• Anesthetic exposure
• Relatively low 
  mortality/morbidity risk
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8
Q

How urgent is a semi-elective surgery? What are some examples?

A 
• More time-sensitive than 
  elective
• Although not required 
   within 24 hours, 
   scheduling should be 
   considered a    priority
• Cholecystectomy for 
   gallstone removal
• Uterine artery ablation  for 
   postmenopausal bleeding 
  from fibroids
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9
Q

What is an urgent surgery? Give examples?

A

Surgery is required within 24 hours of diagnosis; done to prevent unnecessary
complications that can occur with waiting
• Hip fracture repair
• Appendectomy

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10
Q

What is an emergency surgery?

A 
Cannot be delayed and must occur within 24 hours; ideally, scheduled within 2 
hrs.
• Any delay may promote 
  critical injury or systemic 
  deterioration; required as a   
  result of an urgent medical 
  condition
• Stabilize a GI bleed
• Subdural hematoma
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11
Q

When is the patient interview/History taken?

A

•Occurs in advance or on
day of surgery

Check documented information prior to interview to avoid annoying
repetition

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12
Q

What is the purpose of an interview/history?

A 
• Obtain health information
• Determine expectations
• Provide and clarify 
  information on procedure
• Assess emotional state 
  and readiness
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13
Q

10 Essential parts to a patient interview/history

A
  1. patient understanding of surgery
  2. surgical history
  3. patient and family health history
  4. review ALL meds
  5. review allergies
  6. review drug use
  7. tobacco use
  8. date of Last menstrual
    period for females
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14
Q

What are risks for latex allergies?

A

Food allergies (kiwi, bananas, avocados, chestnuts)
Allergy to poinsettia plant
Daily exposure to latex
Hx reactions to latex (balloons, condoms)
Hx allergies or asthma

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15
Q

How do you end a patient interview/history?

A

“Is there anything else
you would like to share
with me or think I should
know?”

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16
Q

What is a review of systems?

A

An inventory of body systems obtained through a series of questions seeking to identify signs and/or
symptoms that confirm the presence vs absence of
any disease

17
Q

ROS assessing for pulmonary problems

A 
Atelectasis
Infection
Prolonged mechanical 
      ventilation
Respiratory failure
Bronchospasm
Exacerbation of underlying chronic lung 
disease
18
Q

ROS assessing for cardiac problems

A

Due to increase myocardial oxygen demands

19
Q

ROS assessing for neurological problems

A

Hearing, vision, cognition (baseline?)

20
Q

ROS assessing for GU problems

A

Renal function; pregnancy

21
Q

ROS assessing for hepatic problems

A

Clotting, metabolism issues

22
Q

ROS assessing for integumentary problems

A

Rashes, pressure ulcers

23
Q

ROS assessing for musculoskeletal problems

A

Mobility restrictions (intra- and postop)

24
Q

ROS assessing for endocrine problems

A

Diabetes, thyroid problems

25
Q

ROS assessing for immune system problems

A

Steroid therapy

26
Q

ROS assessing for fluid electrolyte problems

A

N/V/D; narrow margin of fluid safety with older

patients

27
Q

ROS assessing for nutritional problems

A

Obesity vs. malnourishment

28
Q

Objective data that must be in the chart before surgery?

A

Physical Exam:
The Joint Commission requires all patients
admitted to the OR have both a history &
physical exam (“H&P”) in their chart

Diagnostic Studies:
• Per provider order, patient-dependent
• Make sure results are in chart

29
Q

What information will we share with the patient to prepare them for the experience of surgery?

A

Sensory information
• Noise, lights, temperature
• Procedural information
• What it will look like to get ready for surgery
• Process information (about general flow of surgery)

30
Q

How will you care for the patients family during surgery?

A

Explain the rules for caregivers and show them where they can wait

31
Q

Who is responsible for getting informed consent?

A

the surgeon

32
Q

Legally what information must the surgeon disclose about the surgery?

A 
- Diagnosis
• Purpose of surgery
• Risks of surgery 
• Alternative treatments and 
  risk
• Risks of not treating
• Who will be conducting 
   procedure
• Short- and long-term costs:
• Short term: pain, length of 
  stay, recovery time
• Long term: loss of function, restriction of activity
33
Q

What is the nurses role in informed consent?

A
  1. Witness the patient’s
    signature
  2. Act as patient advocate
34
Q

In a true medical emergency can consent be overridden?

A

yes

35
Q

If a patient is a minor, unconscious, or is

mentally incompetent to sign consent can someone sign it for them?

A

yes, by a legally appointed

representative or responsible family member.

36
Q

Can emancipated minors sign their own consent?

A

yes

2.2 - ABSN NUR 334 Fluid & Electrolytes & Periop (11 decks)

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