Preoperative / Postoperative Care Flashcards
What does preoperative nursing include?
Obtaining consent, health history, head-to-toe assessment,
Where might you see a pt preoperatively?
OR, Obstetrics, Cath Lab, Outpatient, Radiology
What patient health history would you like to know preoperatively?
any history of malignant hyperthermia, any blood conditions, past surgeries, respiratory issues, allergies, family history, medications
Preoperative assessment: what should you check for?
(Head to Toe): neurological (psychological status), cardiovascular, respiratory, skin, GI, GU, Liver
Labs & Diagnostics: what do you expect to see?
CBC, ABG (if necessary), EKG, CMP, LFT (liver function test), PLT, PT/PTT/INR, HCG, Type & Screen ( for their blood type), MRI, CT scan
Preoperative Teaching; What do you talk to the pt about?
Expectations, Signs and Symptoms, Discharge instructions, surgery flow, surgeon/anesthesia, pain, breathing, mobility, vital signs
What is informed consent?
talks about the procedure, pros/cons, possible complications
- permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits
What are the components of consent?
disclosure, understanding, voluntariness, and capacity
Who consents the patient?
surgeon and anesthesia
What is the nurse’s role? (6)
Patient education, know baseline, know risks, what is wrong the with patient, patient consent, assess
Postoperative Care: What do you do?
Vital signs (every 15min), Pain and Arousal assessment, ABC, all assessments you do in preop, notify family, look for nausea/vomiting, postop medication, discharge instructions/transfer to nursing unit
Postoperative Complications: Neurological (4)
memory loss, confusion, waking up crazy (emergence delirium), stroke
Postoperative Complications: Respiratory (4)
hypoxia, pneumonia, atelectasis, aspiration
Postoperative Complications: Cardiovascular (8)
anesthesia puts pt at risk for blood clots, DVT, Dysrhythmias, HTN, Hypotension, Embolism, Fluid imbalance, Hyperkalemia
Postoperative Complications: GI (4)
nausea/vomiting, diarrhea, constipation, ileus
Postoperative Complications: GU
Urinary retention, low urine output
Postoperative Complications: Surgical Incision (4)
Infection, dehiscence, evisceration, bleeding
Risk Factors of Fractures (4)
- bone density
- trauma
- age
- conditions
Clinical manifestations of Fractures (6)
- impaired mobility
- circulatory issues
- edema/swelling
- deformity
- ecchymosis/contusion
- crepitation
Nursing management for Fractures
- mobility assistance
- monitor pain (pain medication / alternative pain management)
- pin care (for external fixators)
- peripheral pulses
- neurovascular checks
- maintain alignment
Complications of Fractures
- compartment syndrome
- decreased perfusion
- loss of pulses
- edema/swelling
- infections
- prolonged bedrest (risk for blood clots)
- renal calculi
- constipation
- skin breakdown
- neurovascular changes
What is Compartment Syndrome?
- swelling, increased pressure
- restricts blood flow
- damage to muscle, blood vessels, and nerves
What are the early symptoms of Compartment Syndrome?
Pain, Pressure, Paraesthesia
What are the late symptoms of Compartment Syndrome?
Pallor, Paralysis, Pulselessness
