Safety Flashcards
Why was the Surgical Safety Care improvement initiated?
to reduce surgical complications
What does the Surgical Safety Checklist aim to improve?
wrong-site surgery, patient falls, hospital-acquired pressure injuries, and vascular/catheter associated infections
Why was TeamSTEPPS designed?
to facilitate communication between health care providers to enhance patient safety and quality of care
What are CUS words?
express concern
What are check backs?
restate what a person said to verify understanding
What are call outs?
shout out important information for everyone to hear
What is the two-challenge rule?
state a concern twice as needed; if ignored, follow chain of command
What is urgent surgery?
may be life-threatening if treatment is delayed more than 24-48hrs
What does ambulatory status mean?
returns home same day of surgery
What are the 5 responsibilities of the nurse preop?
- Pay attention to patient’s stress levels
- Interpret last lab tests before surgery
- Understand risks of surgery
- Assessment
- Patient Interview
What are the 5 steps to a safer surgery?
- briefing
- sign-in
- timeout
- sign-out
- debriefing
What are a patient’s top 5 fears before surgery?
- death
- pain
- anesthesia
- mutilation
- disruption of life
What 2 things associated with cardiovascular function should a nurse be aware of before surgery?
- EKG
- Blood thinners
What 3 things associated with the respiratory function should a nurse be aware of before surgery?
- smoker/vaper
- asthma
- COPD
What should the nurse be aware of concerning the urinary function before surgery?
frequency
What should the nurse be aware of concerning the musculoskeletal system before surgery?
bone demineralization
Why do old people pee a lot at night?
Laying down allows for more perfusion in body
What two things are considered before surgery on an obese person?
- BMI
- measurement of neck
What are 3 complications of surgery on an obese person?
- wound dehiscence and infection
- slows recovery
- adipose tissue absorbs and stores anesthesia
When are prophylactics used for surgery?
if it has a high risk of infection
What are benzodiazepines?
sedative; amnesia
What is the perioperative nurse’s role?
to prepare room
patient advocate
one last check
What is the circulating nurse’s role?
not scrubbed in
recorder and documentation
What is the scrub nurse’s role?
second set of hands
What is the LPN/surgical technician’s role?
hands instruments
What are two additional responsibilities of the nurse before surgery?
- prepping site
- positioning patient
What is general anesthesia used for?
quick onset
long periods of time
What is an example of an IV induction agent used for general anesthesia?
versed
How are inhalation agents excreted by a patient?
rapid ventilation
What are 3 examples of local anesthesia?
EMLA cream
lidocaine
novacaine
What is MAC?
monitored anesthesia care
(maintains own airway)
What is a regional nerve block?
agent injected into or around specific nerve or group of nerves
How long does a regional nerve block last?
24-48hrs
What is the difference between spinal anesthesia and an epidural block?
in spinal anesthesia the agent enters the CSF
Spinal anesthesia is injected into what space?
subarachnoid
What 4 things should a nurse be aware of while using spinal anesthesia?
- Spinal headache
- vitals q15min (BP & HR)
- administration of benadryl
- O2 on during injection
What is the position the patient should be in before spinal or epidural anesthesia is injected?
knee to chest
What is malignant hyperthermia?
inherited trait of hypermetabolism of skeletal muscle resulting in altered control of intracellular calcium
How is malignant hyperthermia triggered?
exposure to certain drugs used for anesthesia
What are the 4 manifestations of malignant hyperthermia?
- tachycardia
- tachypnea
- hypercarbia
- ventricular arrhythmias
What are 3 common respiratory complications post-op?
- atelectasis
- pneumonia
- airway obstruction
What are 4 common circulatory complications post-op?
- hypovolemic shock
- fluid overload
- DVT
- pulmonary embolus
What 4 medications can be administered for DVT prevention?
- heparin
- Coumadin
- LMW heparin
- Xarelto
How are heparin and LMW heparin administered?
subcutaneously
How are Coumadin and Xarelto administered?
orally
What is dehiscence?
surgical incision opens
What is evisceration?
after incision opens organs protrude out
If the patient has a temp >100 when could it mean infection?
after 48hrs
What score on the Aldrete Scoring System indicates readiness for transfer or discharge to the next phase of recovery?
9 or 10
How often do you check lungs during the first 24hrs following surgery?
4hrs
How often do you check LOC during the first 24hrs following surgery?
4-8hrs
How to appropriately instruct the patient on how to use spirometer?
seal lips tightly around the mouthpiece, inhale spontaneously, and hold breath for 3-5 seconds
What 3 things do you ask about pain?
type
location
intensity
How often do you monitor BP and respirations after administering pain medication?
every 15-30min
