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MedSurg > Unit Exam 2 > Flashcards

Unit Exam 2 Flashcards

1
Q

The care of a client or patient before surgical operation

A

Preoperative Phase

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2
Q

The care of a client or patient during surgical operation

A

Intraoperative Phase

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3
Q

The care of a client or patient after surgical operation

A

Postoperative Phase

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4
Q

Impairment to the flow of vital fluids (Blood, Urine, CSF, Bile)

A

Obstruction

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5
Q

What are the types of pathologic process requiring surgery

A

Obstruction
Perforation
Erosion
Tumors

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6
Q

Rupture of an organ

A

Perforation

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7
Q

Wearing off of a surface or membrane

A

Erosion

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8
Q

Abnormal new growths

A

Tumors

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9
Q

Type of pathologic process requiring surgery:

Hydrocephalus

A

Obstruction

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10
Q

Type of pathologic process requiring surgery:

Burn

A

Erosion

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11
Q

Type of pathologic process requiring surgery:

Prostatic Hyperplasia 

A

Tumor

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12
Q

Type of pathologic process requiring surgery:

Cholelitihiasis

A

Obstruction

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13
Q

Lithiasis means

A

Stones

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14
Q

Type of pathologic process requiring surgery:

Intusussesception

A

Obstruction

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15
Q

Type of pathologic process requiring surgery:

Ruptured Aneurysm

A

Perforation

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16
Q

Classification of surgeries according to purpose

A

Diagnostic
Curative
Reparative
Reconstructive
Palliative

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17
Q

To determine the presence and extent of a disease condition

A

Diagnostic

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18
Q

To treat the disease condition

A

Curative

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19
Q

Removal of an organ suffix

A

-ectomy

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20
Q

To repair damage organs

A

Reparative

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21
Q

Repair of congenitally defective organ suffix

A

-oorhapy
-pexy

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22
Q

To restore or change appearance

A

Reconstructive

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23
Q

To relieve distressing signs and symptoms, not necessarily to cure the disease

A

Palliative

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24
Q

Identify the type of pathologic process requiring surgery:

Tonsilectomy

A

Curative

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25
Q

Identify the type of pathologic process requiring surgery:

Pap smear

A

Diagnostic

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26
Q

Identify the type of pathologic process requiring surgery:

Osteoplasty

A

Reconstructive

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27
Q

Identify the type of pathologic process requiring surgery:

Perineorrhapy
Trachelorrapy

A

Reparative

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28
Q

Identify the type of pathologic process requiring surgery:

Colostomy Creation

A

Palliative

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29
Q

Classification of surgery according to urgency

A

Emergent
Urgent
Required
Elective
Optional

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30
Q

Patient requires immediate attention

A

Emergent

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31
Q

Patient requires prompt attention

A

Urgent

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32
Q

Patient needs to have surgery

A

Required

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33
Q

Patient should have surgery

A

Elective

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34
Q

Decision rest with patient

A

Optional

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35
Q

Without delay

A

Emergent

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36
Q

Examples of emergent

A

Severe bleeding
Bladder or intestinal obstruction
Fractured skull
Gun shot or stab wounds
Extensive burns

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37
Q

Can be delayed within 24 to 30 hours

A

Urgent

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38
Q

Examples of urgent

A

Acute gallbladder infection (ayaw sa pakan on ug karne)
Kidney or ureteral stones

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39
Q

Plan with in a few weeks or month

A

Required

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40
Q

Examples of required

A

Prostatic Hyperplasia without obstruction
Thyroid disorders
Cataract

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41
Q

Failure to have surgery not catastrophic 

A

Elective

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42
Q

Examples of elective

A

Repair of scars
Simple hernia
Vaginal repair

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43
Q

Personal preference

A

Optional

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44
Q

Example of optional

A

Cosmetic surgery

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45
Q

The start and end of the preoperative phase

A

Start: Decision to proceed with surgical operation

End: Transfer pf patient onto the Operating Table

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46
Q

Sa asa man mahitabo ang tanan teaching

A

preoperative phase

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47
Q

Assessing and correcting physiologic and psychologic problems that may increase surgical risk

giving the person and significant others complete learning/ teaching guidelines regarding surgery

instructing and demonstrating exercises that will benefit the person during post op period

planning for discharge in any projected changes in lifestyle due to surgery

A

Goals of the nurse

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48
Q

The process in which patients are given important information, including possible risk and benefits about medical procedure, treatment, gebetic testing or a clinical

A

Informed Consent

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49
Q

-Any invasive procedure where scalpel , scissors , suitor and electrocoagulation may be used
- procedures requiring sedation or anaesthesia
- procedures involving radiation
- non surgical procedure that carries more than slight risk to patient

A

Circumstances requiring consent

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50
Q

Who can sign the consent ?

A

-patient who is legally aged and mentally capable
- if minor or incompetent , a responsible family member, power of attorney, or legal guardian
- emancipated minor - married minor

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51
Q

In an EMERGENCY situation

A

No consent is necessary as long as every effort must be made to contact the patient’s family

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52
Q

Must obtain the consent and explain the procedure

A

Surgeon

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53
Q

Acts as a witness and making sure patient willingly signs it

A

Nurse

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54
Q

Signs of abuse

A

Bruises of different healing stage
broken bones
changes in eating habits

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55
Q

What should you do if you notice that there are signs of abuse

A

Nurses should be the one to report to authorities of patients who are victims of abuse

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56
Q

Normal RBC

A

4.5-6

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57
Q

Hemoglobin levels

A

Male: 14-18
Female: 12-16

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58
Q

Hematocrit

A

Male: 42-54
Female: 36-48

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59
Q

Basic assessments laboratory exam

A

Complete blood count
Blood cross matching
Serum electrolyte
Pt, PTT
Fasting blood glucose
BUN/Creatinine
ALT/AST
Urinalysis

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60
Q

Are important to the oxygen carrying capacity

A

RBC, Hemoglobin, Hematocrit

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61
Q

Are indicator of immune function

A

WBC

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62
Q

To determine in case blood transfusion is required during or after surgery

A

Blood Cross Matching

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63
Q

Universal donor

A

Type O

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64
Q

Universal recipient

A

Type A and B

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65
Q

To evaluate fluid and electrolyte status

A

Serum electrolyte

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66
Q

Measure time required for clotting to occur

A

Pt, PTT

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67
Q

Normal BUN

A

10-20

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68
Q

Normal Creatinine

A

0.6-10.2

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69
Q

Maximum hours for NPO

A

Maximum of 12 hours

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70
Q

What should you use in case of emergency in the drug and alcohol assessment

A

local , regional , or spinal anaesthesia

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71
Q

How many hours should you instruct the patient to stop smoking prior to surgery

A

At least 24 hours

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72
Q

Why should you postpone surgery if with respiratory infection

A

Because adequate ventilation may be compromised

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73
Q

How many days should the blood thinners stop before surgery

A

Stop for 3 days to orevent bleeding

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74
Q

Why should the hepato-renal conditions must be improved

A

Because liver and kidney metabolizes and excretes anesthesia

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75
Q

What should you do prior tk transporting the patient to the operating room

A

-Have the patient void
Insert urinary catheter as prescribed (to monitor elimination status)

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76
Q

Increases risk for surgical wound infection

A

Hyperglycemia

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77
Q

May develop intra op or post op due to patient is under NPO prior to surgery

A

Hypoglycemia

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78
Q

Risk for Thyrotoxicosis

A

Hyperthyroidism

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79
Q

Risk for respiratory failure

A

Hypothyroidism

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80
Q

Corticosteroids is anti-inflammatory and must be reported to the

A

Anesthesiologist

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81
Q

It is a same day surgery

A

Ambulatory Intervention

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82
Q

They are the people who frequently do not report symptoms because they accept much symptoms as part of the aging process

A

Elderly people

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83
Q

Individuals who are hearing impaired may need a translator or some alternative communication system preoperatively

A

Disabled patients

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84
Q

Patients needs must be identified as a factor in the preoperative evaluation and clearly communicated to personnel

A

Disabled patients

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85
Q

Nurse Laica is caring for a client admitted with a diagnosis of to consider bowel obstruction. The attending physician proposed a colon resection as management of the said complaint. Nurse Laica knows that the preoperative phase of surgery begins with

A

The decision to proceed with surgical intervention

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86
Q

Which of the following surgery classified as emergent

A

Fractured skull

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87
Q

Nurse sarah knows that deep breathing is an important preoperative teaching area. Which one of the following would be included in her teaching for the preoperative patient?

A

Take a deep breath and hold for 5 seconds, repeat 15 times, twice daily

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88
Q

Nurse Ava Sharpe is providing preoperative teaching to patient sara lance about coughing exercise. Which of the following statements is the correct way for patients are at two splint incisions when she cough

A

Put palms together and interlaced the finger snugly and place hands across incision

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89
Q

Christian, a staff nurse in a medical surgical ward for Fr. Urios General Hospital, is assigned to take care for a client for surgical operation. After Dr. Laica Libres explains the procedure to the patient they are going to proceed with signing the informed consent. Nurse Christian understands that the responsibilities of the nurse regarding informed consent is

A

To witness a patient’s signature

90
Q

A client is scheduled for surgery in the morning. Preoperative orders have been written. Which of the following is the most important to do before surgery?

A

Have all consent forms signed

91
Q

Nurse Mick Rory is preparing the preoperative client for surgery. The following statements indicate the client is knowledgeable about his impending surgery except

A

“I will skip the dose of my aspirin maintenance on the day of my surgery to prevent bleeding”

92
Q

Nurse Anastasia Steele knows that the primary reason or purpose of maintaining patient on NPO status prior to surgery is to

A

Prevent aspiration pneumonia

93
Q

The nurse will provide preoperative teaching on deep breathing , coughing , and turning exercises. When is the best time to provide the preoperative teachings?

A

Before administration of preoperative medications

94
Q

Which of the following factors ensures that validity of informed consent except

A

If the patient is unable to right , the nurse the consent for the patient

95
Q

Which of the following drugs is administered to minimize gastric secretions preoperatively?

A

Atropine Sulfate

96
Q

Atropine Sulfate

A

Sympathetic

97
Q

Diazepam (Valium)

A

Parasympathetic

98
Q

Fentanyl Citrate

A

Parasympathetic

99
Q

Sevoraine

A

Parasympathetic

100
Q

Which of the following is experienced by the patient on general anesthesia

A

Patient is unconscious

101
Q

The patient undergone spinal anaesthesia for appendectomy. To prevent development of spinal headache, nurse dina natuto place the patient in which of the following positions?

A

Fkat kn bed

102
Q

Nurse Pafall is admitting patient to the operating room, which of the following nursing actions should be given highest priority

A

Checking patient’s identification and correct operative consent

103
Q

Nurse Paasa is caring for a patient in the recovery room. Her patient is post exploratory laparotomy. Which of the following findings does Nurse Paasa needs to report to the physician

A

The patient’s urine output has been 30 ml/hr for the past 2 hours

104
Q

Normal urine output

A

30 ml/hr

105
Q

Nurse Cong is taking care of Patient Viy in the recovery room. Upon assessing the wound, Nurse Cong notes that the wound of Patient Viy has opened and abdominal organs were protruding. Which of the following is the most immediate nursing action?

A

Cover the wound with sterile gauze soaked in normal saline solution

106
Q

Which of the following are not members of the sterile team in the operating room except

A

Surgeon

107
Q

Nurse Isabel knows that the best position for kidney surgery is

A

Lateral

108
Q

Patient Murphy has been admitted to the operating room for hemorrhoidectomy, Nurse Claire places Patient Murphy to which position during the operation

A

Jack-Knife

109
Q

Nurse Marie is assigned at the emergency department. A client has been rushed by the bystanders due to multiple injuries including head trauma secondary to motor vehicle or accident. The patient has been ordered for emergency craniectomy to evacuate the clothes that formed intracranially. However, the patient’s family was not known. Based on the principles of informed consent, what should Nurse Marie do?

A

Wheel the patient to OR without a signed informed consent

110
Q

PCA pump

A

Patient-controlled analgesia pump

111
Q

Non-invasive pain relief techniques

A

Relaxation
Distraction
Guided imagery

112
Q

Are not commonly prescribed unless the patient is undergoing abdominal or pelvic surgery

A

Enemas

113
Q

Transfer the patient to the holding area/presurgical suite ________ minutes before anesthetic agent is administered

A

30-60

114
Q

A preoperative client expresses anxiety to the nurse about upcoming surgery. Which response by the nurse is most likely to stimulate further discussion between the client and the nurse

A

“can you share with me what you’ve been told about your surgery?”

115
Q

The nurse is developing a plan of care for clients schedules for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery?

A

Have the client void immediately before going into surgery

116
Q

The nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week. The client has a history of arthritis and has been taking acetylsalicylic acid. The nurse determines that the client needs additional teaching if the client makes which statement

A

“I need to continue to take the aspirin until the day of my surgery”

117
Q

Start and end of the intraoperative phase

A

Start: transfer of patient onto the operating table

End: admission to the Post Anesthetic Care Unit

118
Q

PACU

A

Post Anesthetic Care Unit

119
Q

The surgical team

A

Surgeon
anesthesiologist
scrub nurse
circulating nurse

120
Q

-Performs the surgical procedure
-Heads the surgical team
-Has the ultimate responsibility for performing the surgery in an effective and safe manner

A

Surgeon

121
Q

-Assess the patient before surgery, select anaesthesia, and administers it
-Intubate patients as necessary
-Assesses and manages condition throughout the procedure

A

Anesthesiologist

122
Q

-Performs surgical hand scrub
-Setting up the sterile tables
-Preparing sutures, ligatures, and special equipment
-Assisting the surgeon and surgical assistant during the procedure by anticipating the instruments and supplies that will be required

A

Scrub nurse

123
Q

Who counts all sponges , instruments , and needles to be sure they are accounted for and not retained as a foreign body in the patient

A

Scrub nurse together with circulating nurse

124
Q

Main Responsibilities include:
-Verifying consent
-Coordinating the team
-Ensuring cleanliness
- proper temperature and humidity
- lighting and safe function of equipment and availability of supplies and materials

A

Circulating nurse

125
Q

Monitors aseptic practices to avoid breaks in technique where coordinating the movement of related personal as well as implementing fire safety precautions

A

Circulating nurse

126
Q

Ensures that the second verification of the surgical procedure and site takes place is documented

conduct time out phase

A

Circulating nurse

127
Q

Three zones in the surgical area

A

Unrestricted zone
Semi-restricted zone
Restricted zone

128
Q

-Area in the operating room that interferes with other departments
-Street clothes are allowed
-Ex. Patient reception area and holding area

A

Unrestricted zone

129
Q

-Area in the operating room where scrub attire is required
-Ex. Areas where surgical instruments are processed

A

Semi-restricted zone

130
Q

-Scrub clothes, shoe cover, caps, and masks are worn
-Includes operating room and sterile core area

A

Restricted zone

131
Q

The surgical attire

A

Scrub suit
Head cover
Shoes and shoe cover
Surgical mask
Eyewear/face shield
Laser eye wear
Gloves


132
Q

-Should cover the hair completely
-Worn in semi restricted area
-Never comb your hair when wearing a scrub suit
-Disposable caps are preferred
-Bald head also causes contamination by shedding squamous cells


A

Head cover

133
Q

-Worn in semi restricted area
-Should be comfortable and puncture resistant
-are worn during procedures with expected spells/splashes of blood or body fluids

A

Shoes and shoe cover

134
Q

-High infiltration mask decreases the risks of post wound infection
-Worn inside they restricted area at all times
-Should cover nose and mouth completely


A

Surgical mask

135
Q

Protects the eyes from splashing of blood and body fluids or from debris when bone drilling is performed

A

Eyewear/face shield

136
Q

Protects the eyes from the intense light created by laser surgery

A

Laser Eye wear

137
Q

Donned for clean procedures

A

Non-sterile gloves

138
Q

Donned For sterile procedures

A

Sterile gloves

139
Q

An area of the patient’s skin larger than that requiring exposure during the surgery is meticulously cleansed, and antiseptic solution is applied

A

Skin preparation

140
Q

Instrument decontamination process

A

Cleaning
Boiling
Pasteurization
Chemical disinfection
Sterilization

141
Q

Removal of foreign material from the instrument by a combination of mechanical means (Scrubbing) and chemical means (detergents)

A

Cleaning

142
Q

Uses 100C Boiling water to destroy most pathogens except pores

A

Boiling

143
Q

Exposure to hot water with temperature of 60 to 80°C for 30 minutes

A

Pasteurization

144
Q

Items are soaked in a disinfectant
Used for heat labile Instruments that cannot be boiled or sterilized

A

Chemical disinfection

145
Q

Process in which all pathogens are destroyed including spores



A

Sterilization

146
Q

Types of sterilization

A

Chemical sterilization
Autoclaving
dry heat sterilization

147
Q

A state of narcosis (Save your central nervous system depression produced by pharmacologic agents), Analgesia, relaxation, and loss of reflex

A

Anesthesia

148
Q

Types of anesthesia

A

General and local anesthesia

149
Q

A reversible consisting of complete loss of consciousness that provides analgesia, muscle relaxation, and sedation

A

General anesthesia

150
Q

Tulog si patient

A

General anesthesia

151
Q

General anesthesia of route of administration:

Ex.
Barbiturates
Benzodiazepines
Non-barbiturate hypnotics
Dissociative agents
Opioid agents

A

Intravenous

152
Q

General anesthesia route of administration:

Inhaled anesthetics include volatile liquid agents and gases

A

Inhalation

153
Q

Anesthetic agents produce anesthesia when their vapors are inhaled

Ex. Halothane (Fluothane)
Enflurane (Ethrane)
Isoflurane (Forane)
Sevoflurane (Ultrane)

A

Volatile Liquid Agents

154
Q

Ubos ang ginhawa sa mga naka parasympathetic agent or general anesthesia so kailangan ang pasyente butangan ug?

A

ET tube

155
Q

Ace inhibitor suffix

A

-pril

156
Q

Beta blockers suffix

A

-olol

157
Q

Calcium channel blockers suffix

A

-difene

158
Q

Angiotensin receptor blocker suffix

A

-sartans

159
Q

Agents are administered by inhalation and are always combined with oxygen

Ex. Nitrous Oxide 

A

Gas anesthetic agents

160
Q

What are the stages of general anesthesia

A

-Stage 1 Beginning anesthesia/Induction
-Stage 2 Excitement/Delerium
-Stage 3 Surgical Anesthesia
-Stage 4 Medullary Depression/Danger

161
Q

Feeling of detachment
Drowsy/dizziness
Hallucination occurs
Ringing, roaring or buzzing in the ears
Keep quiet because exaggerated noises are heard by the patient

A

Stage 1 Beginning Anesthesia/Induction

162
Q

Pupils are dilated, pulse rate are rapid, and may have irregular respiration
Because of uncontrolled movement of the patient, restraints are necessary

A

Stage 2 Excitement/Delirium

163
Q

Patient is unconscious and lies quietly
Pupils are small but reactive to light
Respirations are regular, the pulse are normal
Skin is pink or slightly flushed

A

Stage 3 Surgical Anesthesia

164
Q

Too much anesthesia has been administered
Shallow respiration, weak and thread pulse
Widely dilated pupils
Death may occur
If this stage develops, discontinue anesthesiologist and initiate respiratory and circulatory support

A

Stage 4 Medullary Depression/Danger

165
Q

Anesthetic agents are injected around nerves so that the region supplied by these nerves are anesthetized

A

Regional Anesthesia

166
Q

Mata si patient

Unless hatagan siyag pampatulog

A

Regional Anesthesia

167
Q

Regional anesthesia route of administration:

Achieved by injecting a local anesthetic agent into the epidural space That surrounds the dura mater of the spinal cord

A

Epidural anesthesia

168
Q

Advantage: absence of headache
Disadvantage: greater technical challenge of introducing the anesthetic agents into the epidural rather than the subarachnoid space

A

Epidural Anesthesia

169
Q

Expensive conduction under the block that is produced when a local anesthetic agent is introduced into the subarachnoid space at the lumbar level (L4 L5)

Produces anesthesia Of the lower extremities, Perineum, and lower abdomen

A

Spinal anesthesia

170
Q

Previously known as “conscious sedation”

Form of anesthesia involves the IV administration of sedative or analgesic medications to reduce patient’s anxiety and to control pain during diagnostic or therapeutic procedures

A

Moderate sedation

171
Q

Previously known as “monitored sedation”

Administered by an anesthesiologist who must be prepared and qualified to convert to general anesthesia if necessary

A

Monitored anesthesia care (MAC)

172
Q

Injection of a solution containing the anesthetic agent into the tissues at the planned incision site

A

Local anesthesia

173
Q

Patient is flat on the back
Both arms are position at the side of the table
Used for procedures of anterior surface of the body such as abdominal operation.

A

SUPINE POSITION

174
Q

Used for surgery on the lower abdomen and pelvis to obtain good exposure by displacing the intestines into the upper abdomen.

A

TRENDELENBURG’S POSITION

175
Q

Used for thyroidectomy, laparoscopic cholecystectomy to displace the stomach contents into lower abdomen.

A

REVERSE TRENDELENBURG

176
Q

Used for shoulder, dental, nasopharyngeal, facial, and breast reconstruction.

A

FOWLER’S POSITION

177
Q

Used for perineal, vaginal, urologic, and rectal procedure.

A

LITHOTOMY POSITION

178
Q

Used for perineal, vaginal, urologic, and rectal procedure.

A

PRONE POSITION

179
Q

Hips are positioned over the center break of the operating table.

Done for rectal procedures

A

JACK-KNIFE POSITION

180
Q

Used for renal surgery

A

LATERAL POSITION

181
Q

POTENTIAL INTRA OP COMPLICATIONS

A

NAUSEA AND VOMITING
RESPIRATORY COMPLICATIONS
HYPOTHERMIA
MALIGNANT HYPERTHERMIA

182
Q

Administer antiemetics preoperatively or intraoperatively as ordered to counteract possible aspiration.
Turn patient’s head to side or lower the head of bed to prevent aspiration.
Suction saliva and vomitus.

A

NAUSEA AND VOMITING

183
Q

May lead to brain damage if not recognized.
Monitor oxygen saturation all through-out operation.
Administer oxygen as ordered.
Check peripheral perfusion frequently.

A

RESPIRATORY COMPLICATIONS

184
Q

Patient’s temperature may fall during anesthesia.
May occur as a result of a low temperature in the OR, infusions of cold fluids, inhalation of cold gases, open body wounds, and decreased muscle activity.
Give warm IV and irrigating fluids as ordered.
Wet gowns and drapes must be removed promptly.

A

HYPOTHERMIA

185
Q

Increase temperature
Identify meds that causes increase temperature, then stop the infusion.
Give antipyretics as ordered.

A

MALIGNANT HYPERTHERMIA

186
Q

Surgical asepsis is a requirement in the restricted zone of the operating suite. What personal protective equipment should the nurse wear at all times in the restricted zone of the operating room?

A. Reusable shoe covers
B. Mask covering the nose and mouth
C. Goggles
D. Gloves

A

B. Mask covering the nose and mouth

187
Q

You are a circulating nurse. Which task are you solely responsible for?

A. Monitoring the patient and documents
B. Estimating the patient’s blood loss
C. Setting up the sterile tables
D. Keeping track of drains and sponges

A

A. Monitoring the patient and documents

188
Q

As an OR nurse, you have an increased awareness regarding asepsis. You know that a basic guideline for maintaining surgical asepsis is what?

A. Sterile surfaces or articles may touch other sterile surfaces.
B. Sterile supplies can be used on another patient if the packages are intact.
C. The outer lip of a sterile solution is considered sterile.
D. The scrub nurse may pour a sterile solution from a nonsterile bottle.

A

A. Sterile surfaces or articles may touch other sterile surfaces.

189
Q

Start and end of the Postoperative phase

A

Start: Admission of patient to the PACU

End: Follow-up evaluation in the clinical setting or at home

190
Q

-Also called “Recovery Room”
-Located adjacent to the operating room suit.

A

POST ANESTHETIC CARE UNIT

191
Q

PHASES OF POST ANESTHETIC CARE:

Care of surgical patients immediately after surgery and for the patient whose condition warrants close monitoring and intensive care is provided.

A

PHASE 1

192
Q

PHASES OF POST ANESTHETIC CARE:

-Patient is prepared for discharge.
-Also known as step-down unit.
-Patient may remain in phase II unit for as long as 4-6 hours.

A

PHASE 2

193
Q

Who is responsible for transporting patient from operating room to the post anesthetic care unit?

A. Anesthesiologist
B. Surgeon
C. Scrub Nurse
D. Circulating Nurse

A

A. Anesthesiologist

194
Q

During transport, the anesthesia provider remains at the

A

head of the stretcher to maintain the airway

195
Q

Pinaka uwahi mawala nga senses if mag anesthesia ka

A

Ears/Hearing

196
Q

c (with) stimuli)

A

Hallucination

197
Q

s (without) stimuli

A

Delusion

198
Q

PHIC

A

Phlebitis Hot Infiltration Cold

199
Q

PISO

A

Potassium In Sodium Out

200
Q

NURSING MANAGEMENT IN THE PACU

A

-ASSESSING THE PATIENT
-MAINTAINING PATENT AIRWAY
-MAINTAINING CARDIOVASCULAR ACTIVITY
-RELIEVING PAIN AND ANXIETY
-PREVENTING RESPIRATORY COMPLICATIONS
-PREVENTING DEEP VEIN THROMBOSIS
-PREVENTING WOUND INFECTION

201
Q

ASSESSING THE PATIENT

A

-Assess patient’s airway, respiratory function, cardiovascular function, skin color, level of consciousness, and the ability to respond commands.
-Check the surgical site for drainage or hemorrhage and make sure that all drainage tubes and monitoring lines are connected and functioning.
-Monitoring vital signs every 15 minutes
-Administer postoperative analgesics
-In patient with spinal anesthesia, maintain flat on bed position for 6 hours to prevent spinal headache.

202
Q

MAINTAINING CARDIOVASCULAR ACTIVITY

A

Assess for HYPOTENSION.
Assess for SHOCK
Assess for HEMORRHAGE

203
Q

It can result from blood loss, hypoventilation, position changes, pooling of the blood extremities, or side effects of medication and anesthetics.

A

Assess for HYPOTENSION

204
Q

one of the most serious postoperative complications. WOF: HypoTachyTachy
> Give IV fluids and oxygen as ordered

A

Assess for SHOCK

205
Q

Copious escape of blood from blood vessels.
Signs: - Hypotachytachy
Disorentation
Restlessness
Oliguria
Cold and pale skin
Frequent swallowing (for throat surgery)

A

Assess for HEMORRHAGE

206
Q

Management for shock/hemorrhage

A

-Transfuse blood or blood products
-Determine the cause of bleeding
-Inspect surgical site and incision for bleeding
-Place patient in shock position

207
Q

RELIEVING PAIN AND ANXIETY

A

Monitor the patient’s psychological status, manage pain, and provides psychological support to relieve the patient fears and concerns.

Opioid analgesics are administered mostly in the IV to provide immediate pain relief.

208
Q

Patient is at risk for respiratory complications due to

A

depressive effects of opioids medications, decreased lung expansion secondary to pain, and decreased mobility.

209
Q

Alveolar collapse; incomplete expansion of lungs.

-Signs and symptoms:
Decreased breath sound
Crackles upon auscultation
Cough

A

ATELECTASIS

210
Q

Signs and symptoms:
Fever and chills
Tachycardia
Tachypnea

A

PNEUMONIA

211
Q

Accumulation of fluid in the lungs due to a weakened cardiovascular system.

A

PULMONARY CONGESTION

212
Q

Isa ka sign na nag bleeding ang patient due to thyroidectomy or tonsillectomy kay?

A

Frequent swallowing

213
Q

to promote veinous return

A

Shock position

214
Q

Nursing management to prevent respiratory complications

A

Encourage the patient to turn frequently, take deep breaths, cough, and use the incentive spirometer at least every 2 hours.

Careful splinting of abdominal or thoracic incisions sites help the patient to overcome the fear that the exertion of coughing might open the incisions.

Administer oxygen as ordered.

Coughing is contraindicated in patient with surgical operations in the head due to risk for increase intracranial pressure.

215
Q

Signs and symptoms:
Homan’s Sign – Calf pain upon dorsiflexion
Painful swelling of the entire leg
Slight fever, chills, perspiration

A

PREVENTING DEEP VEIN THROMBOSIS

216
Q

Nursing Interventionfor deep vein thrombosis:

A
  1. Hydrate patient adequately to prevent hemoconcentration.
  2. Encourage leg exercises and ambulate patient as soon as permitted by the surgeon.
  3. Avoid restricting devices such as tight straps that can constrict and impair circulation.
  4. Avoid rubbing or massaging calves and thighs.
  5. Instruct to avoid standing or sitting in one place for prolonged periods and crossing legs when seated.
  6. Assess distal peripheral pulses, capillary refill, and sensation of lower extremities.
  7. Initiate anticoagulation therapy as ordered.
217
Q

Signs and symptoms:
Redness, excessive swelling, tenderness, warmth.
Red streaks in the skin near the wound.
Pus and foul smelling wound.
Tender, enlarged lymph nodes closest to the wound.
Fever and chills

A

PREVENTING WOUND INFECTION

218
Q

Nursing Intervention for wound infection:

A
  1. Keep wound dressing intact
  2. Used strict sterile technique when dressings are changed.
  3. Ensure all drains are working properly.
  4. Wound irrigation may be done as ordered.
  5. Administer antibiotics as ordered.
  6. Assess for wound dehiscence and evisceration
219
Q

anticoagulation drugs for shock

A

Warfarin -maintenance, PO
Heparin- IV (check PTT)

220
Q

total or partial disruption in wound edges
ni ukab

A

wound dehiscence

221
Q

protrusion of viscera through an abnormal wound opening
ni buka ug naay ni gawas organ

A

wound evisceration

222
Q

unsay buhaton if naay wound dehiscence ug wound evisceration?

A

cover with sterile gauze soaked in normal saline solution

MedSurg (5 decks)

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