Unit 1: Perioperative Care Flashcards

1
Q

What information from a patient’s health history could be risk factors for complications?

A

Smoking, alcohol, heart disease, respiratory disease, kidney disease, age, malnutrition, obesity, and previous reactions to anesthsia (malignant HTN).

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2
Q

When does d/c planning begin?

A

Begins at admission, provider will write in progress notes expected date of discharge. Does the patient have family to help or should they go to rehab, home with homehealth.

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3
Q

What preop instructions are important to review with the patient before surgery?

A

NPO status, skin prep, what meds needed the morning of surgery
-Insulin, BP meds, did the pt stop taking NSAIDs weeks before surgery or stop anticoagulants.

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4
Q

Discuss consent.

A

MD explains procedure, nurse witness, 2 nurses witness, 2 nurses witness if blind, speaks another language, phone consnet, or cannot write and sign with an x.

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5
Q

What post op complications will we try to prevent?

A

Hemorrhage- assess VS, dressing for drainge, drains.
DVT- SCDs, TED hose, ambulation, enoxaprian injections, ROM exercises.
Fluid Volume Excess/ Deficit- Monitor I/Os, vs for changes reflecting fluid status, kidney functions.
Pneumonia- IS, TCDB q 2 hours, fluids, ambulation.
Constipation- fluids, fiber, ambulation.
Paralytic ileus- listen to BS, passing gas? look for increased distention, vomit, no BS. Put down NG tube, make NPO.
dehiscence/ evisceration – look for increased drainage, risk factor
– diabetic, obesity, steroids, malnutrition.
infection – proper dressing changes, assess for odor, purulent drainage, redness, swelling, pain, fever, increased WBC.

-impaired skin integrity: turn, reposition, assess bony prominences, nutrition

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6
Q

What preop drugs can be given?

A

PPI – reduce stomach acid.
Midazolam – for anxiety.
Morphine – pain.
Anticholinergics – dry up secretions.
Antibiotic – given 1 hour before surgery.

Don’t allow patient to get out of bed after these meds, safety to prevent falls.

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7
Q

List in order the assessments you would make as the PACU nurse.

A

-ABC
-Pain
-Surgical area
-I/Os, drains
-LOC
-GI

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8
Q

Your patient is 5 days post op. They are complaining of a lot of drainage from their incision site. What could be the problem? What do you do?

A

Dehiscence – cover and call MD

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9
Q

What considerations do we need to think about when an elderly patient is recovering from surgery?

A

More confusion, longer to recover from anesthesia – airway problems.

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10
Q

FYI INFORMATION:
When answering NCLEX questions about priorities, especially which patient to see first, think of this acronym:

A

S - stable / unstable
P - potential / real
E – expected / unexpected
C – chronic / acute

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