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M.H.R School Of Nursing > Unit 5 Pre-op > Flashcards

Unit 5 Pre-op Flashcards

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1
Q

Phases of Surgery

A
  • Preoperative
  • Intra-operative
  • Post-operative
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2
Q

Preoperative

A

time decision is made to have surgery until transported to the OR

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3
Q

Intra-operative

A

administration of anesthesia through completion of surgery

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4
Q

Post-operative

A

Post-anesthesia care unit until recovery is complete

Can be years!

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5
Q

Surgery

A

planned anatomical alteration of the human organism designed to arrest, alleviate, or eradicate some pathological process

anatomical alteration of the body

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6
Q

Palliation/ Palliative

A

Does NOT cure; Alleviates symptoms
relieves symptoms without curing disease

Think Hospice

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7
Q

Perioperative period

A

(encompasses 3 phases)—around the surgery

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8
Q

Perioperative Nurse

A

allows nurse to function in variety of roles within the surgical process–> CONTINUITY OF CARE

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9
Q

Inpatient

A

patient admitted and surgery performed in the hospital surgical suite

must stay in hospital at least over night

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10
Q

Ambulatory Surgery

A

Outpatient

~70-90% of surgeries are not outpatient

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11
Q

Free Standing

A

not affiliated w/ hospital; independently owned & operated

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12
Q

Hospital affiliated facility

A
  • Sep. department (for all 3 phases)

* Located w/in hosp complex or satellite office

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13
Q

Minor Surgery

A

simple surgery that presents little risk to life (may not be minor to patient!)

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14
Q

Major Surgery

A

involves extensive reconstruction or alteration in body part

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15
Q

Diagnostic/Exploratory

A

to determine cause of symptoms or verify diagnosis

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16
Q

Curvative

A

removal of diseased part, repair damaged or malformed area, removal of early stage tumors

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17
Q

Ablative

A

removal of diseased part ** total !!!

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18
Q

Restorative

A

strengthen a weakened area

bone pinning, herniorrophy (suture repair of hernia), mitral, valve replacement

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19
Q

Constructive/reconstructive

A

repair malformations or improve function/appearance.

Plastic, cleft palate, plastic surgery, breast reconstruction

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20
Q

-ECTOMY

A

removal of an organ or gland

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21
Q

-lysis

A

destructive

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22
Q

-orrhaphy

A

suturing or stitching

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23
Q

-ostomy

A

providing an opening

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24
Q

-otomy

A

cutting into

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25
Q

-plasty

A

formation or plastic repair

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26
Q

-scopy

A

looking into

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27
Q

Emergency Surgery

A

unplanned – preformed immediately to save life***
- to save life or body part

Performed due to major trauma or hemorrhage of internal organs.

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28
Q

Informed Consent

A
  • Prior to any non-emergency surgery
  • Must Have: clear understanding of the surgery, risks, and benefits w/ clear judgment –no impairments *
  • Surgery cannot legally be performed until patient understands and signs consent
  • protects: patient, hospital, staff, & surgeon
  • valid for 60 days
  • must be witnessed
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29
Q

Urgent Surgery

A

Unplanned. Requires surgical intervention within 24-48 hrs

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30
Q

Required Surgery

A

Planned; Required

Indicated for health problems but not immediate

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31
Q

full explanation of the procedure in terms the patient can understand prior to signing is performed by

A

the physician

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32
Q

Elective

A
  • planned; desired

- Scheduled weeks or months in advance

33
Q

AORN

A

Asc. Of Operating Room Nurses

Purpose: gain new knowledge and improve nursing care in the OR; Develop standards of practice for the OR

34
Q

Subjective Data

A

Pt level of understanding/perceptions

35
Q

Subjective Data Assessments

A
  • Site/ type of surgery/ reason for surgery
  • extent of hospitalization, limitations
  • pre-op/ post-op routines/ tests required
  • surgical experiences/ specific concerns about present surgery
  • religion or cultural beliefs
  • family/significant other source of support
36
Q

WBC

A

Total White Blood Cell Count
Fight Infection
4,000-10,000 (4-10 on lab print out)

37
Q

Neutrophils

A

2nd line of defense

38
Q

Lymphocytes

A

1st line of defense

39
Q

Potassium

A

Major Cation within cells
3.5-5.0
**Minor Changes have significant consequences
Abnormal Ranges increase risk of cardia arrhythmia
• Excreted by the kidneys

40
Q

Sodium (Na+)

A

maj determinant of extracellular osmolality

Norm: 136-145

41
Q

Carbon Dioxide

A
  • Norm: 23-30 mEq

* pH status of pt and other electrolytes

42
Q

Cl-

A
  • 98-106 MeQ
  • → indication of acid-base balance
  • Maintain electrical neutrality with Na+
43
Q

Ca+

A

7.6-10.4 mg/dl

parathyroid funx, ca+ metabolism, monitor renal funx

44
Q

Collection of subjective & objective data provides

A 
baseline information (DAY 2)
•	identify & correct any risk factors
•	establish baseline data for comparison 
•	plan & institute pre-op care
•	select anesthesia
45
Q

Pre-op physical assessment includes

A
  • physical assessment
  • pre-surgical test results
  • identification of surgical risk factors
46
Q

Baseline Data Includes

A
  • General health/previous surgeries
  • Allergic responses
  • Medications/smoking/ETOH
  • prosthesis: dentures, glasses, etc
  • disabilities/impairments
  • mobility limitations
  • body size & structure
  • level of consciousness
  • mental status/ coping/support
  • pregnant
  • Body surface area
47
Q

smoking history –>

A

↓ ciliary action to remove secretions

irritating to tracheobronchial passages →lyringo spasms

48
Q

Hepatic

A

detoxifies drugs - primary concern for anesthesia

49
Q

malnutrition

A

state of impaired functional ability of essential nutrients & calories within cells

50
Q

obesity

A

excessive accumulation of fat ↑surgical risk
• Adipose tissue is avascular
• More adipose tissue, more technical difficulty
– longer anesthesia time
– higher risk of intraop complications

51
Q

adrenocortical stress response

A

results in sodium & water retention/ potassium loss

52
Q

Radiation Therapy

A
  • Side effects that may affect surgery/healing
  • -thin skin layers
  • -breaks down collagen for less healing potential
  • -scars tissue-fibrotic & changes vascularity
  • Ideally, wait 4-6 weeks after radiation to do surgery.
53
Q

Overall goal of pre-op period

A

to ensure patient is mentally & physically prepared for surgery

54
Q

Purposes of Pre-op Medication

A

Prevents N/V, autonomic reflex response, post-op infections – antibiotics

Decreases anesthetic requirements,respiratory & GI secretions –> prevents aspiration; anticholorgenic

Relieves apprehension & anxiety –>Promotes sedation & amnesia –>Facilitates induction of anesthesia

55
Q

Pre-op Medications:

A

• ordered by anesthesiologist or surgeon

56
Q

Antibiotics & anti-emetics:

A

given 30-60 minutes prior to surgery

57
Q

Once pre-op meds are given:

A
  • patient to remain in bed with side rails up, call bell in reach
  • DOCUMENT: explained to patient need to remain in bed
58
Q

What to expect when love one comes out of surgery

A
  • Not awake
  • Say incoherent things
  • Pale
  • Special Equipment
  • Frequent Vital Signs
59
Q

BUN

A
  • 10-20

* Monitors Kidney Function

60
Q

• Creatine

A
  • 0.5-11

* Monitors Kidney Fun

61
Q

Urinalysis

A

• UTI, renal function, diabetes

62
Q

• Type & Cross Match

A

• High risk for blood loss, sufficient blood for pt during surgery

63
Q

ABG’s

A

arterial blood gases

64
Q

• Pregnancy Test

A

Female pt of childbearing age

65
Q

• Clotting Factor

A
  • PTT – Prothrombin Time

* PT/INR- Pro Time/ International Ratio – normally between 1&2

66
Q

• Bleeding Time

A

how long… done on “wheel”

67
Q

FBS

A
  • Fasting Blood Sugar

* Thick blood → decrease flow → increase clot

68
Q

Albumin/Protein

A

important for osmotic press. w/ in vascular space

• Measure of Nutrition

69
Q

• ALT

A

(alanine aminotransferase)

70
Q

(alanine aminotransferase)

A

Norm: 4-6

Liver enzyme → indicates any damage to liver

71
Q

EKG

A

measures heart electrical activity
• Rate, Rhythm & other factors
• ID Pre-existing cardiac problems
• Pt >40 years/ or hist of heart disease

72
Q

PFT

A

pulmonary function

73
Q

Anticholinergics & benzodiazepines:

A

given just prior to OR

74
Q

Hematocrit

A

% of total red blood volume made up of RBC
• M: 42-52%
• F: 37-47%

75
Q

Platelets

A

essential to blood clotting

• 150,000-400,000

76
Q

Bowel Prep

A

empty bowel of fecal material ‘
Collapse or “decompress” bowel so not obstruct access to organs or be nicked during surgery; prevents incontinence & contamination of surgical; prevents post-op constipation r/t decreased peristalsis; prevents uncomfortable straining first dew days post-op → dangerous for rectal, prostate & eye surgery; PERISTALSIS DOES NOT RETURN FOR 24 HOURS

77
Q

Objective Data: clues to anxiety level

A
  • speech patterns -rept themes
  • degree of interactions with others
  • physical-pulse/ respirations,hand movements, perspiration, activity level, frequent voiding
  • change in sleep patterns
78
Q

biggest fear

A

will not wake up

79
Q

a stressor, a potential or actual threat to body integrity; Always a major experience for pt

A

surgery

M.H.R School Of Nursing (32 decks)

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