surgical client Flashcards
steps for perioperative assessments
- Confirm client name and diagnosis is correct in chart
- Two identifiers
- A complete health hx
- Medical and surgical
- Allergies
- Current medications/supplements
- Alcohol and tobacco use (exam)
- Spiritual/cultural beliefs
- Physical Assessment – head-to-toe
- Ensure informed consent is obtained
- Labs/diagnostics
- Client teaching is done
preoperative assessment - informed consent
- Ensure the client understands and agrees to have a treatment or procedure
- Ensure they understand risks and benefits
- Ensure their understanding of what the treatment or procedure is, who will perform the treatment or procedure, the purpose, and
expected outcome. - You must witness the physician who will be doing the procedure obtain consent from the patient before signing your own name as
the RN
risk factors for complications - age (exam)
- Age – older adults at higher risk
- Post-op delirium
- Post-op cognitive dysfunction (POCD)
risk factors for complications - obesity
- Establishing airway
- Maintain sedation
- Blood clots post-op
risk factors for complications - smoking
- Infections
indications of complications
Nausea and Vomiting
* Deep Venous Thromboembolism
(DVT)
* Pulmonary Embolism
* Hypovolemia
* Atelectasis
* Wound Infection
* Ileus
* Oliguria
* Wound Dehiscence vs
Evisceration (see next slide)
dehiscence versus evisceration defined
dehiscence refers to the reopening of a surgical wound, while evisceration is a more severe complication where internal organs protrude through the dehisced wound
client teaching for dehiscence and evisceration should include what
- Client teaching should include the need for splinting surgical incisions to decrease pain and prevent dehiscence
the circulating nurse for surgery does what?
Coordinates the care of the client before, during, and after the surgical procedure
Verifies consent forms
Assists the anesthesiologist as needed while anesthesia is initiated
Responsible for client safety, positioning and monitoring
Facilitates the time out
Maintains sterility, provides supplies, and equipment to the sterile team
Labels any specimens
Assists scrub tech in counting of the sponges, instruments, and sharps used in the surgery
scrub nurse
ensures utensils used during surgery are sterile and ready for use
may hand the equipment or tools to the surgeon
local anesthesia
Prevents conduction of pain impulses by
affecting both the motor and sensory nerves at the surgical site.
regional anesthesia
Causes a temporary loss of feeling in an
area of the body
general anesthesia
The use of drugs or inhalants to depress the
central nervous system.
moderate or conscious sedation
Permits the client to remain relaxed and calm so they can follow commands without pain or
anxiety.
immediate post op care priorities (exam)
- Airway
- Breathing
- Circulation
- Ventilation
- Vital signs- oxygen saturation
- Level of consciousness (LOC)
- Physical assessment completed asap when
receiving a patient from surgery
post-op: controlled analgesia
- The Patient Control Analgesia Pump (PCA) = computerized pump with a syringe of pain
medication connected to an IV line. - Patient can self-administer pain medication
safety considerations for the surgical client
Fall Risks
Aspiration precautions
Impaired Cognition
the three perioperative phases
preoperative
intraoperative
postoperative
preoperative
initial phase of care; before surgery
- both physical and psychological preparations
intraoperative
middle phase; during surgery
- time from patient to bed in the OR to the transfer to the recovery or post anesthesia care unit (PACU)
postoperative
final phase; immediately after surgery
- this period can be brief, lasting only a few hours, or include rehabilitation and recuperation
