Surgical Nursing Flashcards
Primary prevention
Knowledge screenings and family hx
Secondary prevention
Minimize disability and increase quality of life
Terterary prevention
Treatment of illness
Women are
Under treated and under diagnosed
Preoperative phase
Hx of Surgeries Medical problems Medications Family Surgery Indicators for surgery Make sure everyone on the team knows this information
23 hour surgery
Ambulatory surgery Monitored care Low cost Ex. Tonsillectomy Cardiac catheterization
Same day admission
Work up done prior to surgery
Ex. Total hip
Coronary artery bypass graft
In patient hospital based surgery
Patients that need stabilization sent to OR from Inpatient bed ER Lab Or ICU
Elective surgery
Improves quality of life Scheduled at pt convinence Time is not a factor Decreased mortality/morbidity Runs same risks
Semi elective surgery
Increased time sensitive
May or may not be within 24 hours
Decreased mortality and morbidity
Ex. Cholecystisis = cholecystectomy
Urgent surgery
Required with in 24 hours
Prevention of complications
Emergency surgery
Done with in 24 hours preferably with in two hours
Delay causes major injustice
Goal is to stablize
Increased risk for mortality and morbidity
Increased risk for bleeding, MI, renal failure
Salvage surgery
When CPR is in progress in the or or on the way to the or Required for survival Ex. Ruptured aneurism Perforated ulcer Penetrating trauma
ATM
Assessment
Treatment
Intervention
High BUN
dehydration
Low BUN
hypervoluema
High BUN
dehydration
Creatnine
indicates kidney function
PT/PTT/INR
Indicates coagulation
Do all teaching
pre op
NPO status before surgery is to
reduce risk of aspiration
Benzodiazepines
Decrease anxiety
ex. Midazolam (versed)
H2 antagonists
inhibit production of gastric acid- prevent aspiration
ex. ranitidine (zantac), famotidine (pepcid)
Anticholinergics
prevents vomiting
antiemetics
prevents vomiting
opiods
pain management
antibiotic prophylaxis
used according to risk for infection
antithrombolitics
prevents thrombus formation
two biggest preventions after surgery
DVT and atelectesis
General anesthesia objectives
produce CNS depression and complete loss of sensation, consciousness, pain perception, and memory
General inhalation agents
gas plus oxygen induces rapid loss of consciousness / alter CNS Suprane Ultane Forane Nitrous oxide
Intravenous anesthetics
Rapid-acting opioid-anaglesic anesthetics
Rapid-acting opioid-anaglesic anesthetics
Alfenta
Remifentanil
Sufentarill
Intravenous anesthetics
Nonanaglesic hypnotics
etomidate (amidate)
reversal agents
reverse negative effect of an agent
types of reversal agents
narcotic antagonists (naloxone) Benzodizepine antagonist (romazicon) neuromuscular blocking antagonists
regional anesthesia objectives
block pain impulses via local anesthetic
local anesthesia objectives
topically, infiltration
injection, target specific nerve or nerve bundles
regionally (epidural or intrathecal/spinal)
AORN
Circulating nurse, safety of the patient
lithothomy position
legs up knees bend
Major systems to monitor (respiratory)
rate, rhythm, breath sounds, pulse ox, artificial, O2 delivery
Major systems to monitor (cardiovascular)
HR, rhythm, B/P and pulse
major systems to monitor (neurological)
CNS/LOC, ability to follow commands, movement of extremities
major systems to monitor (renal)
I&O, IV lines, catheters, drains
other things to monitor after surgery
dressings, drains, comfort, thermoregulation
DAT
Diet as tolerated
Dehiscence
surgical wound reopens
Evisceration
organs leaving the body cavity
types of drains
jackson pratt
hemovac
penrose
T-tube
SGOT
liver function test
LDH
Indicator of tissue damage
ALK phosphate
tests for bone and liver conditions
SGPT or ALT
indicates liver status
Considerations for bariatrics
slowed healing
decreased mobility
decreased cardiovascular health
Considerations for the elderly
confusion
slowed metabolic processing of the medication
decreased strength
decreased mobility
considerations for pediatrics
NKDA lowed immune system poor judgement communication seperation anxiety
check ____ before they are aloud to get up
Hemoglobin
some doctors say it has to be above 9
