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NURSING PRACTICE III > TEST 1 > Flashcards

TEST 1 Flashcards

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1
Q

DEFINITION: art and science of treating diseases, injuries, and deformities by operation and instrumentation

A

SURGERY

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2
Q

4 CATEGORIES OF Perioperative Nursing

A
  1. preoperative care
  2. intraoperative care
  3. post-anesthetic care
  4. post-operative care
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3
Q

5 PARTS OF Preoperative Care

A

1) Client interview
2) Nursing assessment
3) Pre-op teaching
4) Legal preparation
5) Pre-op checklist

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4
Q

THIS PART OF THE PREOPERATIVE NURSING ASSESSMENT INCLUDES:

  • Previous experiences with Sx (surgery) and anesthesia
  • Allergies, meds, age, nutrition
  • Past medical history
A

Nursing history

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5
Q

THIS PART OF THE PREOPERATIVE NURSING ASSESSMENT INCLUDES:

  • Assessment of mobility (side weaknesses)
  • Systems
  • Head to Toe
  • Lab work/test results
A

Physical examination

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6
Q

LIST 7 PREOPERATIVE RISK FACTORS

A
  1. Meds
  2. Physical/mental impairments
  3. Mobility limitations (side weaknesses)
  4. Smoking, ETOH (ethanol/alcohol) use, street drugs (risk of withdrawal symptoms)
  5. Occupation
  6. Poor nutritional status (obesity-related healing complications such as dehiscence)
  7. Infection, nausea, fever
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7
Q

PRE-OP TEACHING: NUTRITION

3 items

A
  1. NPO (Most surgeries require NPO after midnight)
  2. POST-OP DIET (Increase diet slowly)
  3. POST-OP NAUSEA (common—there are medications to help with this)
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8
Q

PRE-OP TEACHING: AMBULATION

4 items

A
  1. AMBULATE EARLY (important to prevent clots)
  2. IMMOBILIZERS (May have immbolizers, have to use assistive devices)
  3. LEG EXERCISES
  4. TED SOCKS
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9
Q

PRE-OP TEACHING: BREATHING

3 items

A
  1. Perform deep breathing and coughing exercises
  2. Splinting
  3. Incentive spirometer
  4. IMPORTANT TO PREVENT COLLAPSED LUNG & PNEUMONIA
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10
Q

PRE-OP TEACHING: GROOMING

5 ITEMS

A
  1. Take a bath or shower morning of surgery
  2. Remove nail polish, artificial fingernails, hair clips, and jewellery before surgery
  3. Dentures and eyeglasses will be removed and stored during surgery
  4. Remove prosthetics
  5. No contact lenses permitted
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11
Q

PRE-OP TEACHING: MEDICATION

2 ITEMS

A
  1. Take preoperative medication as ordered
  2. Stop taking prescribed medications, OTC medications, and herbal remedies as suggested by the physician, anaesthesiologist, or surgeon
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12
Q

PRE-OP TEACHING: PAIN CONTROL

2 ITEMS

A
  1. Ask for pain medication as needed

2. Types of pain control (epidural, PCA)

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13
Q

9 IMPORTANT THINGS ON AN INFORMED CONSENT

A
  1. Name of procedure/surgery
  2. Description of procedure/surgery
  3. Person performing the procedure/surgery
  4. Benefits of procedure/surgery
  5. Potential risks and adverse effects of procedure/surgery
  6. Approximate length of time for procedure/surgery
  7. Approximate length of time needed for recovery
  8. Alternative treatments
  9. Consequences of refusing treatment
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14
Q

INFORMED CONSENT - LEGAL OR ETHICAL NURSING ROLE?

act as a witness to verify that the person who signed the consent is the client so named or the client’s legal guardian

A

LEGAL

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15
Q

INFORMED CONSENT - LEGAL OR ETHICAL NURSING ROLE?

act as the client’s advocate, ensures that the client understands the information and that the form has been signed and witnessed before the client receives preoperative medication

A

ETHICAL

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16
Q

Post-operative Care (after surgery) begins ________________ after surgery and continues until the client is discharged

A

immediately

17
Q

PACU

A

post anesthesia care unit

18
Q

RR

A

recovery room

19
Q

patient stays in PACU until ________________

A

stable

20
Q

From PACU – client can be discharged to ______, _____________ _________, or ___________________ _________ _________.

A

ICU
IN-PATIENT UNIT
AMBULATORY CARE UNIT

21
Q

7 CRITERIA FOR PACU discharge:

A
  1. Client awake (or baseline)
  2. Vital signs stable
  3. No excess bleeding or drainage
  4. No respiratory depression
  5. Oxygen saturation > above 90%
  6. Pain controlled
  7. Report given to receiving recipient (nurse from other units)
22
Q

FIRST STEP IN POST-OPERATIVE CARE

A

Get report (how much blood was lost, fluids received, pain meds, etc.)

23
Q

5th vital sign?

A

pain

24
Q

5 post-op exercises

A
  1. deep breathing
  2. controlled coughing
  3. incentive spirometer
  4. leg rom
  5. repositioning
25
Q

8 Ambulatory surgery discharge criteria

A
  1. All PACU discharge criteria met
  2. No IV narcotics for last 30 minutes
  3. Minimal nausea and vomiting
  4. Pain controlled
  5. Voided (if appropriate to surgical procedure/orders)
  6. Able to ambulate if age-appropriate and not contraindicated
  7. Responsible adult present to accompany client (not to drive home - sedatives can be in the body for up to 24 hours post-op)
  8. Discharge instructions given and understood
26
Q

WHICH POST-OP EXERCISE?

prevents respiratory complications (collapsed lung/atelectasis & pneumonia)

A

DB&C

27
Q

WHICH POST-OP EXERCISE?

option for deep breathing, provides measurable visual feedback

A

INCENTIVE SPIROMETER

28
Q

WHICH POST-OP EXERCISE? removes secretions from lungs

A

CONTROLLED COUGHING

29
Q

IMPORTANT CONSIDERATION FOR CONTROLLED COUGHING?

A

SPLINT ABDOMINAL INCISIONS

30
Q

WHICH POST-OP EXERCISE? important for patient comfort and reduce risks related to immobility

A

REPOSITIONING/TURNING

31
Q

WHICH POST-OP EXERCISE? reduce risk of clots

A

LEG EXERCISES

NURSING PRACTICE III (1 decks)

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