Quiz 2 Flashcards
Prevention of Infection - surgery
- Educating the patient and family about prevention
- providing pt antiseptic skin cleanser before surgery
- clipping, not shaving
- follow standard preop antibiotic protocols
- maintain normothermia in operating room and 4 hr after
- changing the operating room glove and tray at closing of fascia
- changing the incisional dressing at 48 hours and postop shower
- choose right antibiotic
- start preop antibiotic w/in 60 min of incision
- stop antibiotic 24 hr postop
vancomycin infusion
- infused in 2-hr time frame
- one hour before tourniquet inflation and incision
Emergent surgery level
life threatening, immediate life, limb or eyesight
may have a few hours to prepare
urgent surgery level
usually something that needs to be dealt within the next 24 hours
elective surgery level
you may “elect” when to have the surgery
-not that it isn’t necessary, just that it can wait for more opportune time
optional surgery level
cosmetic surgeries, optional preventative measures, bariatric?
preoperative consent
- gives legal consent for surgery
- can be given by pt or pt rep
- informed consent is duty of physician
- no sedation when signing
- voluntary
- can withdraw any time
- nurse clarifies facts, dispels myths
- nurse may sign as witness to consent if confident pt understands
preop instructions
- NPO 6-8 hr before op; asperation
- Consult phycision to ok meds
- no anticoagulants
- alcohol/substance withdrawel?
- bowel prep, enema or laxitive; bacteria
- set pain goal and educate pt (IV, PO, nerve block?)
- IV access, 18g min, may need 1+ lines
Skin prep for operations
- shower using antiseptic solution
- Do not shave, clip instead or electric razor if necessary
Risk factors for surgery
- emotional responses/previous experience
- age; very young or old at higher risk
- hydration/nutrition level, healing more diff.
- smoking and alcohol, decrease tol. to anesthesia, withdrawal, risk for pneumonia
- diseases,
complictions of local or regional anesthesia
- anaphylaxis
- incorrect delivery technique
- systemic absorption, overdosage
- assess for CNS stimulation, CNS and cardiac depression,
- restlessness or excitement
- headache
- incoherent speech
- nausea and vomiting
- tremors or seizures
- metallic taste
- increased pulse, respirations or BP
Complications from general anesthesia
- malignant hyperthermia
- overdose
- hypoventilation
- peripheral nerve damage - due to positioning
- hypothermia
- complications of intubation
- pressure ulcers
postop complication prevention
- early ambulation
- compression devices first 48-72 hrs
- reduce DVT and pulmonary embolism
