The surgical client, end of life and grief, leadership and professionalism Flashcards
what is the role for the preoperative nurse
to make sure there is an informed consent, go over the complete knowledge of the client such as age, name, medical records, date, time, diagnosis, and chief complaint,
also in charge of preoperative education,
how does preoperative education affect the client
permits the client to have a better understanding of the surgery, feel empowered, experience less pain, and be less anxious, education is also directed to decreasing the hospital stay and recovery period
what is the role for the intraoperative nurse
coordinates the care of the client before, during, and after the surgical procedure, responsible for verifying consent form, provides emotional support and assists the anesthesiologist as needed, responsible for client safety, positioning, and monitoring as well as enforcing policies and procedures during surgery, including the time out, with the scrub tech confirms and counts equipment used,
role of the post op nurse
assess the patient for any complications, goal is to ensure proper healing and rule out any complications, a head to toe assessment of the body systems, pain management, vital signs, LOC
prior to surgery what must the client do
shower and prepare the skin with the use of an antiseptic wash to minimize the number of microbes present on the skin
once client is in surgical field how do you prep the surgical site
if needed hair will be removed, cleanse the surgical site with an antiseptic solution, preparation begins with scrubbing the surgical site in a circular motion, starting at the center and moving outward to the area away from the site, at the outer edge the sponge is considered contaminated and must be disgarded,
when does the circulating nurse initiate the time out for the team
after skin preparation is performed
what is a minor degree of urgency
surgical alteration to body is minimal, low risk of life
what is major degree of urgency
reconstruction of alteration of a body part, complicated and prolonged procedure
what is elective degree of urgency
preformed to improve their quality of life
what is urgent degree of urgency
preformed when the client’s health condition is not immediately life threatening, but if not preformed, can result in death or serious complications, performed within 24 hours
what is emergent degree of urgency
procedure that is unanticipated and is preformed immediately to reserve life of the client
how does age affect risk for surgery
older people tend to have more post op delirium and increased time for wound healing
what kind of medication can affect risk for surgery
aspirin
how does health affect risk for surgery
obese means more problems because could have DM, heart disease, GERD, and sleep apnea,
smokers could have more time for healing and getting infections
what is the biggest thing to monitor with anesthesia
vital signs, especially heart rate and respiratory rate
what is local anesthesia
prevents conduction or pain impulses by affecting both the motor and sensory nerves at a surgical site
what is regional anesthesia
causes a temporary loss of feeling in an area of the body
what is general anesthesia
use of drug and/or inhalant to depress the CNS
what is moderate or conscious sedation
allows client to remain relaxed and calm so they can follow commands without pain or anxiety
when is the time out completed
at the beginning of the procedure , before starting an additional procedure, and at the end of the procedure
what is a time out
when all members of the surgical team must verify and agree that it is right client, right surgical site, right procedure
what are the different parts of the preop assessment/checklist
name of client and medical record, a complete client history, informed consent, client teaching is complete, verify allergies , advise to stop smoking before surgery especially chest or abdominal surgery, pregnancy test,
post op interventions to prevent complications
main concern is airway and resp rate and head to toe assessment , and position the client correctly
potential post op complications
infection, confusion, dvt, allergic reactions, bleeding, eviscerations, and falls
what is the importance of maintaining a sterile field
to prevent infection and contamination
what are the 5 stages of grief, describe them
denial = client refuses to believe truth
anger = client is trying to adjust to the loss and is severe emotional distress
bargaining = an exchange for something better, usually with a higher power
depression = reality sets in
acceptance = still feels loss but knows its all going to be all right
different types of grief
normal also known as uncomplicated grief = caused by the loss of someone, through death or ending of a relationship
anticipatory = grief that is experienced before the expected loss of someone
prolonged grief disorder = also known as complicated grief, lasts more than 6 months, and can affect how the person functions
disenfranchised = grief related to a relationship that does not coincide with what is considered by society to be a recognized or justified loss
what are the 5 ways nursing care and communication for the dying client
name ; id what the client just stated or emotion expressed
understand ; demonstrate understanding by recognizing the client’s feelings and providing an opportunity to discuss
respect; voice your respect
support; inform you are available
explore; ask open ended questions to extend convo
what is post mortem care
physical care preformed after death to prepare a body for viewing, autopsy, or release
what are the steps for post mortem care
washing the body, accounting for the client’s possessions, removing invasive devices, place id tags on two areas, document date and time the name of anyone notified, location of belongings, and where body is being moved
what is the difference between hospice and palliative care
palliative care is provided while the client is still engaging in curative treatment methods
what is an advanced directive and what is it purpose
it is a legal document that directs end of life issues
living will = a directive document for medical treatment per client’s wishes
health care proxy = a durable power of attorney that appoints someone to make medical decisions when client are no longer able
what is the nurses role in organ donation
a nurse is not allowed to begin a dialogue about organ or tissue donation with the client or family member
the nurses role is to assist families who are dealing with this challenging decision
what is the difference between professionalism and unprofessionalism
professionalism is the actions, beliefs, attitudes, that reflect the core values of the profession. It is a commitment to to self and the profession to practice with integrity and honesty
unprofessionalism is the oppostite
different stages from novice to expert
novice = beginner with little or no experience
advanced beginner = demonstrates basic skills but continues to need the support or guidance of a mentor
competent = individual can plan, make decisions, and preform job responsibilities and edfficiencies
proficient = demonstrates advanced decision making skills
expert = role model has deep knowledge and teaches others
differences between transactional , transformational, laissez faire, bureaucratic , and situational leaders
transactional = establish standards, highlight obligations, use reward or punishment
transformational = establish a common mission and vision, encourage to heighten their level of performance, challange the best in people
laissez faire = hands off leaders, work independently, little control
bureaucratic = by the book leader, pays great attention to detail, follows procedures
situational = move from one leader style to another based off situation,
what is shared governance and its importance
its a shard decision structure that gives nurses control over their own practice
promotes collaboration, autonomy, professional development, accon
what is shared governance and its importance
its a shard decision structure that gives nurses control over their own practice
promotes collaboration, autonomy, professional development, accountability, and empowerment of nurses
