Surgical Techniques - Preoperative Routine, Post-Anesthesia Care, and Related Nursing Procedures 1-B Flashcards
nothing by mouth
NPO
liberated or uncontrolled
emancipated
a recording of the x-ray visualization of the internal anatomy of the heart and blood vessels after the intravenous injection of radiopaque contrast medium
angiogram
to develop or grow in intensity at a rate that constitutes an emergency
emergent
designated room or area where patients wait prior to being admitted to the operating room
preoperative holding area
the scientific study of poisons, their detection, their effects, and the method of treatment for conditions they produce
toxicology
an endovascular procedure that re-opens narrowed blood vessels and restores forward blood flow
angioplasty
level of force blood exerted against an artery wall or the wall of any vessel as the heart beats at the height of the pulse wave
blood pressure
a radiograph of the ureter and renal pelvis after the injection of radiopaque contrast medium
pyelogram
an x-ray of detailed tissue structure cross-sections or slices that are used to construct a 3-dimensional image
computerized axial tomography (CT)
medical imaging that uses nuclear magnetic resonance as its source of energy
magnetic resonance imaging (MRI)
the surgical removal of tonsils and adenoids
T&A (tonsillectomy and adenoidectomy)
a graphic recording of the electrical activity of the muscle of the heart to detect abnormalities
electrocardiogram
postoperative care unit
PACU
All oral intake is discontinued as ordered for at least _____ to _____ hours prior to surgery.
6 to 8
Ideally, the surgeon and ________ should visit the patient prior to surgery.
anesthesiologist
Preoperative visits by the surgeon or assistant help lessen the patient’s fear and anxiety by allowing the patient to _____ ______.
ask questions
False nails or _____ should be removed to allow the observation of the nail beds during surgery.
polish
Special preparations such as preoperative douches or _____ are performed as ordered by the surgeon or physician.
enemas
A shower with _______ solution should be performed by the patient the night before or the morning of the surgical procedure.
antimicrobial
Preoperative enemas are used in procedures involving the gastro-intestinal and _____ areas.
vaginal/gynecological
The preoperative douche cleanses the _____ area.
vaginal
_____ _____ is performed immediately before surgery, since there is less time for inflammation and _____, should the skin be compromised.
Hair removal
infection
Preoperative medication helps reduce secretion of saliva and gastric juices and prevents _____.
nausea
Explains the risks and benefits of the procedures.
informed surgical consent
authorizes the use of an experimental drug, chemical agent, or medial device on the patient
investigative/research device consent
authorizes the attending physician and staff to render standard treatment or miscellaneous procedures
general medical consent
authorizes the facility to administer blood and blood products if needed before, during, or after the surgical procedure
blood transfusion consent
authorizes proper disposal of an amputated extremity
specimen/limb disposal consent
authorizes a voluntary reproductive procedure
sterilization consent
Crosscheck information on the patient chart, ensuring that patient name, procedure, surgeon, and _____ match.
site
Assess patient’s physical and _____ status; signs of distress can affect the course of surgery.
emotional
To establish a baseline, take and document the _____ _____ on the patient chart.
vital signs
Ensure the patient has _____ or _____ before putting on a hospital gown.
bathed or showered
Remove all patient jewelry, body piercings, wigs, and _____ devices and label for safekeeping and patient safety.
prosthetics
Ensure that the patient is in a _____ hospital gown.
clean
If ordered by the physician, apply special (anti-embolic) stockings or elastic bandages to the _____ extremities to prevent blood clots.
lower
Ensure the patient has ____ prior to surgery, recording the time on the preoperative checklist.
voided
Place bed in its _____ position with the side rails _____ after patient has received pre-op medications.
lowest
highest
All _____ should accompany the patient to the operating room.
records
used for pediatric patients under 5 years of age
cribs
used for patients who require supervision of their movement
beds or ward beds
same-day surgery permit patients to walk to the OR
ambulation
primarily used for out-patients
wheelchairs
most common means for transporting patients
stretchers (gurneys)
used to ease apprehensive young child when transporting to OR
wagon
used for newborn and premature infants
isolettes
Identify the patient verbally, by _____, and on chart, letting the patient know why you are there.
wristband
Cover patient and apply safety strap over blanket _____ inches above the knees.
2
Allow for _____ _____ or assist the patient onto the stretcher.
self transfer
Secure side rails in _____ position.
highest
Review the chart for _____.
completeness
Push stretcher from _____ _____, facing patient in direction of travel, avoiding abrupt movements such as sharp turns or sudden stops or bumping into things.
head end
When approaching inclining and declining ramps with doors, explain what is happening, then stop movement of stretcher at least _____ feet from start of incline or decline, open door, secure it and proceed with firm control of stretcher on ramps at all times.
2
Walk _____ and in full control.
slowly
Give special attention to _____, drains, IVs, etc.
catheters
Check the _____ of the patient.
identity
Request patient to verbally state name, date of birth, _____, procedure side and site, and surgeon.
allergies
Verify that the _____ has marked the appropriate surgical site to ensure the correct site and side.
surgeon
Surgical site marking may be waived in a life-threatening emergency at the discretion of the surgeon, but a _____ _____ should be conducted unless there is more risk than benefit for the patient.
time out
Review patient’s chart for the presence of history and physical, surgeon’s orders, signed surgical consent, any required laboratory reports, and any _______ or interventions.
dx tests
Document known allergies on chart and with an ____ _____.
arm band
Report any abnormalities or discrepancies to the surgeon and/or _____ provider immediately.
anesthesia
Check the _____ checklist and review with the patient to ensure accuracy.
pre-op
Observe and assess the patient’s _____ level.
anxiety
Check vital signs, including blood pressure, temperature, pulse and _____.
respirations
Identify any oral consumption prior to surgery and _____ of consumption by asking the patient.
time
Convey warmth, respect, and concern for the patient by keeping the patient covered and unexposed, ensuring patient _____.
dignity
Distinguish between normal and abnormal heart sounds.
systole
normal
Distinguish between normal and abnormal heart sounds.
murmurs
abnormal
Distinguish between normal and abnormal heart sounds.
reduplication
abnormal
Distinguish between normal and abnormal heart sounds.
diastole
normal
Pulse beat is the throbbing caused by the regular contraction and expansion of an _____ _____.
artery wall
Normal pulse rates vary according to _____ and _____.
sex and age
A heart rate (pulse) greater than ______ beats per minute is a common indicator of tachycardia.
100
An indicator of _____ is a heart rate (pulse) below 60 beats per minute in an adult.
bradycardia
pulse rate in women
72-80 bpm
pulse rate in infants
110-13- bpm
pulse rate in children over 7
75-90 bpm
recorded pulse pressure
systolic minus diastolic
pulse rate in men
60-70 bpm
pulse rate in neonates
140 bpm
ordinary, quiet respirations made without obvious effort
eupnea
painful, difficult, and labored breathing
dyspnea
increased rate and/or depth of respirations
hypernea
cessation of breathing or lack of breathing
apnea
breathing possible only when person sits or stands in an erect position
orthopnea
lack of oxygen or absence of oxygen
hypoxia
decreased amount of oxygen reaching the body cells
anoxia
any stoppage of respirations caused by strangulation, aspiration of foreign object, or drowning
suffocation
increased CO2 and decreased O2 in the body as a result of some interference with respiration
asphyxia
bubbling or rattling sounds caused by mucus in the air passages as in bronchitis or pneumonia
rales
alternating cycles of hypernea and apnea, often seen in critically ill or unconscious patients
Cheyne-Stokes
All institutional policies, procedures and guidelines should be followed when documenting care and _____ of the patient from PACU.
discharge
Written postoperative orders pertaining to the immediate care of the patient in the PACU and follow-up instructions will be completed by the _____.
surgeon
Most patients will remain in the PACU for approximately one hour or until _____ _____ are stable and they have satisfactorily recovered from the effects of anesthesia.
vital signs
The PACU staff is trained to recognize complications and anticipate postoperative difficulties by carefully monitoring patients until they meet _____ criteria.
transfer
The patient’s condition is scored using a _______ scoring system and the anesthesia provider or surgeon will determine if the patient is stable enough to be transferred from the PACU.
post-op
A post-anesthesia evaluation must be completed no later than _____ hours after surgery or a procedure requiring anesthesia services.
48
The post-anesthesia evaluation must occur in either the PACU/ICU or in another designated _____ location.
recovery
