Test 1 Flashcards
What is included in the interdisciplinary team in the OR?
Patient, Anesthesiologist/Nurse Anesthetist, Circulating Nurse (RN), Surgical Tech, Surgeon, First Assist, and Vendors.
What are the most used PeriOp diagnostic tests?
prothrombin time, partial thromboplastin time, bleeding time, hematocrit, hemoglobin, red blood cells, platelets, sodium, potassium, pH, pCO2, HCO3, human chorionic gonadotropin, total protein, blood glucose. chest xray, and ECG.
What are comment meds in the OR?
antiemetic, analgesics, anxiolytics, antibiotics, and anesthetics.
PreOp Nursing diagnoses
anticipatory grieving, anxiety, and knowledge deficit.
What is an antiemetic?
anti-nausea
What is an analgesic?
pain relieving meds
What is an anxiolytics?
anti-anxiety
What are the three perioperative phases?
preoperative phase, intraoperative phase, and postoperative phase.
What is the preoperative phase?
Begins immediately when a client is notified of the need for surgery. educate the patient about the upcoming procedure, assess the client’s health history, and a current physical status. client also must give informed consent prior to the surgery. you will also oversee and assist with preparation of the surgical site.
What is the intraoperative phase?
intraoperative nursing includes all aspects of a surgical or invasive procedure, within the operating or procedure room. constant monitoring of the surgical environment and the client to ensure client safety.
What is the postoperative phase?
begins with admission to a post-surgical recovery area and concludes upon the clients transfer to a hospital unit or discharge home.
What is the nurses role in the preoperative phase?
preparing the client, informing the client about the nature and anticipated length of the procedure, including expectations related to recovery time. patient teaching on how to prepare for the surgery, as well as what to know for discharge. gathers important data regarding he client’s health history and current physical status. client medication review. verify surgeon has discussed the procedure and obtained signature on informed consent.
What is the nurses role in the intraoperative phase?
the nurse acts to promote the physiological health of the client by guarding against infection and preventing potential complications, including but not limited to complications during positioning of the client, SSIs, and hypothermia. the nurse is the protector of the client. monitors vitals and blood loss. in charge of positioning the patient and padding to prevent injury and protect the skin. calling a call blue. blood transfusions.
What is the nurses role in the postoperative phase?
the nurse is in charge of maintaining airway patency, oxygen saturation, and ventilation. monitoring cardiovascular status, protective reflexes, skin assessment, fluid status, taking care of operative site, monitoring for pain, nausea, vomiting. patient safety. postoperative meds. wound management and line and drain management.
What does preoperative documentation include?
history & physical, social assessment, nutritional assessment, systems assessment, pain assessment, medication review, medication administered in the preoperative setting, and perioperative care plan.
What is -ectomy?
indicates the removal of
What is -oscopy?
indicates a body part or organ being viewed
What is reconstructive surgery?
performed to restore lost or reduced appearance or function.
What is diagnostic procedures?
conducted to determine or confirm a diagnosis.
What is elective surgery?
procedure that is the recommended treatment for a condition that is not life threatening.
What is emergency surgery?
performed when a condition creates the risk of loss of life and limb.
What is palliative surgery?
may be performed to alleviate pain or symptoms associated with a disease.
What is transplant surgery?
replaces malfunctioning organs or other structures.
What are the two types of surgical procedures?
open and laparoscopic
Complications of longer surgical procedures
increased risk of complications. lengthened recovery time. greater risk of hypothermia. greater risk for blood loss.
What are the types of anesthesia?
local and general
What is included in intraoperative documentation?
complete hand-off, pre- and postop diagnoses, informed consent, anesthesia type and ASA level, team members, times, surgical prep, position of client, position of aids used, foley inserted, surgery counts, time-outs, equipment used, specimens collected, tubes or drains placed, dressing placed, total fluid I&O, medications used, and additional notes.
How are wounds classified?
Class I- clean
Class II- clean, contaminated
Class III- contaminated
Class IV- dirty, infected
What is the purpose of wound classification?
determined at the beginning and end of a surgical procedure. predicts risk of surgical site infection and potential intraoperative complications.
What are the types of blood transfusions?
autologous and allogenic
What is an autologous blood transfusion?
when the client donates their own blood
What is an allogenic blood transfusion?
when the client receives blood from the community.
What are potential intraoperative complications?
hypovolemia, hypervolemia, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, increased intracranial pressure, hypothermia, hyperthermia, and malignant hyperthermia.
What findings postop should be reported to the surgeon?
prolonged unresponsiveness, change in LOC, oxygen saturation <93, respiratory rate <10, tachycardia, hypertension or hypotension, weak or absent peripheral pulses, urine output <30 mL/hr, and more than expected amount of bleeding at incision site.
What is pain?
an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
How does one describe pain?
location, intensity, quality, and duration.
What are types of pain stimuli?
biological-viruses, bacteria
mechanical-fractures, shearing forces
thermal- extreme heat or extreme cold
electrical- electrical shock or electrical burn
chemical-cleaning supplies, tobacco smoke, acids/bases, radiation
Types of pain
acute and chronic
Types of acute pain
somatic pain, visceral pain, and referred pain
Types of chronic pain
chronic recurrent pain, chronic intractable benign pain, and chronic progressive pain
What are characteristics of acute pain?
sudden onset, identifiable tissue injury, duration <6 months, initiates automatic fight or flight.
What are characteristics of chronic pain?
prolonged pain >6 months, not always a known cause. adaptation of autonomic responses decreased over time.
Additional types of pain
breakthrough, central, phantom, psychogenic.
What is the WHO three step approach to pain management?
Step 1- mild pain = nonopioid analgesic (with/without coanalgesic)
Step 2- mild to moderate pain = weak opioid, combination of opioid and nonopioid (with/without coanalgesic)
Step 3- moderate to severe pain = strong opioid administered around the clock. titrated until pain is relieved.
example of nonopioid analgesics/NSAIDs
Tylenol, advil, motrin, Naprosyn, aleve, toradol, Celebrex, bayer, etc.
example of weak or partial opioid analgesics
codeine, Vicodin, etc
example of mixed opioid analgesics
Tylenol no 3, nubain, talwin, etc
example of strong opioid analgesics
dilaudid, Demerol, OxyContin, etc
example of coanalgesics
gabapentin, prednisone, lidocaine, etc
side effects of opioids
respiratory depression, sedation, nausea/vomiting, constipation, pruritus, and sexual dysfunction
What are coanalgesics?
have analgesic properties. potentiate effects of pain medications. reduce pain medication side effects, and effective at reducing neuropathic pain.
What are some nonpharmacologic therapies for pain?
repositioning, acupuncture, guided imagery, social support, and dietary and herbal remedies
What is fibromyalgia?
a chronic syndrome characterized by widespread musculoskeletal pain, stiffness, fatigue, sleep disturbances, and difficulty concentrating.
What are risk factors of fibromyalgia?
middle-aged females, ages 20-50. family history of fibromyalgia. having a psychiatric disorder such as ADHD or depression. having a medical disorder such as IBS or RA.
What are the pharmacologic therapy for fibromyalgia?
Cymbalta, savella, and lyrica.
What are nonpharmacologic therapy for fibromyalgia?
aerobic exercise and strength training.
ways to prevent fibromyalgia?
no known way to prevent. maintain healthy lifestyle. prompt diagnosis and treatment of symptoms.