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► Med Misc 49 > unit V > Flashcards

unit V Flashcards

This flashcard deck was created using Flashcardlet's card creator

1
Q

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

A

Preoperative

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2
Q

Administration of anesthesia through completion of surgery

A

Intra-operative

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3
Q

Post anesthesia care unit until recovery is complete

A

Post operative

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4
Q

Peri operative nursing is a planned process based on?

A 
The nursing process
Assess
Planning
Implement
Evaluate
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5
Q

Standardized policies and procedures are important for?

A

Pt safety
Easier to teach pt
Help maintain quality of practice
Continuity of care for total surgical experience

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6
Q

Pt admitted & surgery performed in the hospital surgical suite

A

Inpatient

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7
Q

Approximately 80% of surgeries are now?

A

Outpatient aka

Ambulatory surgery

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8
Q

What are some advantages of out patient surgery?

A

Less costly

Inpatient beds for very I’ll

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9
Q

Disadvantages of outpatient

A

Responsible for own pre op preparation

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10
Q

Name some criteria for out patient surgery

A

Age
General health
Pt willingness
Insurance requirements

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11
Q

Simple surgery that presents little risk to life

Performed in dr office

A

Minor surgery

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12
Q

Involves extensive reconstructive or alteration in body part

A

Major surgery

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13
Q

Performed to determine cause of symptoms or verify diagnosis

A

Diagnostic or exploratory surgery

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14
Q

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

A

Curative surgery

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15
Q

Removal of diseased part

A

Ablative

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16
Q

Strengthen a weakend area

A

Restorative surgery

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17
Q

Repair malformations or improve function/appearance

A

Constructive or reconstructive surgery

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18
Q

Relieves symptoms without curing disease

A

Palliative

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19
Q

Replace an organ

A

Transplant

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20
Q

Surgery performed due to major trauma or hemorrhage of internal organs, done to save life or body part

A

Emergency: unplanned

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21
Q

Requires surgical intervention within 24-48 hrs

A

Urgent: unplanned

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22
Q

Indicated for health problems but not necessary immediately to preserve life or function
Ex. Knee replacement

A

Required: planned

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23
Q

Scheduled weeks or months in advance, if delayed there are no adverse effects

A

Elective: planned

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24
Q

Removal of an organ or gland

A

Ectomy

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25
Q

Suturing or stitching

A

Orrhaphy

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26
Q

Providing an opening

A

Ostomy

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27
Q

Otomy

A

Cutting into

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28
Q

Scopy

A

Looking into

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29
Q

What must the pt sign before surgery?

A

Informed consent form

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30
Q

The consent form protects who?

A

Pt, hospital, staff & surgeon

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31
Q

Who has to fully explain the procedure including risks & benefits

A

The physician

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32
Q

How long is an informed consent good for?

A

60 days

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33
Q

What is the first thing you assess?

A

Anxiety level

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34
Q

What are the three phases in the perioperative period

A

Per operative
Intra operative
Post operative

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35
Q

Good nutrition is essential for ?

A

Wound healing & infection

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36
Q

What is the purpose of nursing associations?

A

Gain new knowledge and improve nursing care

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37
Q

Free standing surgical unit

A

Not connected to the hospital in any way

Independently owned and operated

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38
Q

Simple surgery that presents little risk of life

A

Minor surgery

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39
Q

Involves extensive reconstruction or alteration of body part

A

Major surgery

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40
Q

Name the factors that affect risk

A 
Age
General health
Nutrition 
Medications 
Mental status
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41
Q

When can treatment be given with out consent

A

Immediate life threat to life or health, condition cannot be delayed

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42
Q

What decrease level of anxiety?

A

Information, understanding of what’s going on

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43
Q

Why do we do pre op teaching?

A

Reduces anxiety
Requires less anesthesia & analgesia
Lowers infection rates
Lowers pulse & b/p

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44
Q

What information ate you giving to the pt during pre op teaching

A 
Purpose of surgery
Tests need to be done
Pre op routines
Schedules
What to expect after surgery
Post op therapies
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45
Q

How will you know that the pt understands your teachings?

A

Return demonstration

Verbalized

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46
Q

What is a collection of subjective & objective data that provides baseline information

A

Physiological preparation

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47
Q

Why is physiological preparation used

A

Identify & correct any risks factors
Est. baseline data for comparison
Plan pre op care
Select anesthesia

48
Q

Baseline data includes

A 
General health/previous surgeries
Allergies
Rx/smoking/ETOH
Prothesis
Mobility limitations
Body size
LOC
Height weight
49
Q

During the physical assessment what are you looking for in the Respiratory system?

A 
Hx of resp allergies
Asthma
COPD
smoking hx
Lung sounds
Breathing exercises
50
Q

During the physical assessment what are you looking for in the cardiovascular system

A 
Angina
MI
HTN
Peripheral vascular disease (DVT)
VS (all pulses, heart rate & rhythm)
51
Q

If you have a pt with abnormal potassium what could this cause?

A

Cardiac arrhythmia

52
Q

During the physical assessment what are you looking for in the renal system

A

Decrease function increases toxicity
Check I&O
May need electrolyte replacement prior to surgery

53
Q

What lab values are used to check for renal function

A

BUN
Creatin
(Check kidney function)

54
Q

During the physical assessment what are you looking for in the endocrine system

A

Diabetic risks
Delayed wound healing
Lab tests-ketones in urine

55
Q

During the physical assessment what are you looking for in the hepatic system

A

(liver)
Metabolizes Rx
PRIMARY concern for anesthesia

56
Q

During the physical assessment what are you looking for in the neurological system

A

Orientation
Alertness
Hx of seizures, epilepsy

57
Q

During the physical assessment what are you looking for in the musculoskeletal system

A

Positioning

Airway management

58
Q

During the physical assessment what are you looking for in the immune system

A

Hx of HIV
Autoimmune disease
Chemotherapy (risk for infection)
Steroids (lowers immune system)

59
Q

What is important in determing pt outcomes during & after surgery

A

Surgical risk factors

60
Q

The degree of surgical risk depends on

A

Physical & mental condition
Extent of pre existing disease
Severity of required operation

61
Q

Why is at the greatest surgical risk

A

Very young

Very old

62
Q

Protein is an essential component for?

A

The building & repair of tissues and to fight infection

63
Q

Why is obesity a high risk

A

Excessive amt of fat
Longer anesthesia time
High risk intra op complications

64
Q

What side effects can radiation have

A

Decrease of collagen

Delayed wound healing

65
Q

What is the overall goal of pre op period

A

Ensure pt is mentally & physically prepared for surgery

66
Q

What is your expected outcome of the surgery

A

Decrease complications & length of stay in hospital

67
Q

During the physical preparation the evening prior why do you want to prep the bowel

A

Decompress the bowel, so not to obstruct access to the organs, prevents incontinence or contamination

68
Q

During the physical preparation the evening prior, what does skin preparation do

A

Decreases the # of microorganisms at the surgical site.

69
Q

During the physical preparation the evening prior, what does sleep & rest provide?

A

Manage stress

Reduce anxiety

70
Q

During the physical preparation the evening prior, why are pt’s NPO after MN?

A

Nothing by mouth after midnight

Reduces possibility of vomiting & aspiration during anesthesia

71
Q

During the physical preparation of the day of surgery you can not enter the OR without?

A

History & physical & OR checklist

72
Q

Name purposes of pre op Rx.

A 
Relieves anxiety
Provides analgesia 
Prevents N & V
Prevents post op infections
Decreases anesthetic requirements 
Prevents gag reflex
Decreases respiratory & GI secretions
73
Q

Pre op rx’s are ordered by?

A

Anesthesiologist or surgeon

74
Q

Antibiotics and anti emetics are given when?

A

30-60 minutes prior to surgery

75
Q

When are anticholinergics & benzodiazepines given

A

Given just prior to OR

76
Q

Once pre op Rx’s are given what must happen

A

Pt must remain in bed with side rails up, call bell in reach

77
Q

Normal WBC count

A

4,000-10,000

4-10

78
Q

The whit blood cells are made up of what 5 components

A 
Neutrophils
Lymphocytes
Monocytes
Basophils 
Eosinophils
79
Q

What do whit blood cells do?

A

Fight infection

80
Q

Basophils & eosinophils do what?

A

Activate allergy response

81
Q

Monocytes do what?

A

Eat bacteria (long lasting)

82
Q

Neutrophils & lymphocytes do what?

A

Fight infection

Last short time 6 hrs

83
Q

Neutrophils

A

Eat, clean up bacteria

84
Q

Lymphocytes

A

Fight chronic or bacteria infections

85
Q

Normal RBC count

A

Male 4.7-6.1

Female 4.2-5.4

86
Q

What do hemoglobin do?

A

Carry oxygen

87
Q

Normal hemoglobin levels

A

Male 14-18

Female 12-16

88
Q

If your WBC count is low, what kind of disease could it be?

A

Chronic

89
Q

If your WBC count is high, it can be a sign of ?

A

Acute infection

90
Q

Hematocrit

A

Percentage of total blood volume made up by RBCs

91
Q

What is the normal hematocrit %

A

Male 42-52%

Female 37-47%

92
Q

Platelets

A

Essential for blood clotting

93
Q

Normal platelet count

A

150,000-400,000

94
Q

If your RBC count is low what could be the cause

A

Blood loss

Not making enough blood

95
Q

Sodium (Na+)

A

Normal 135-145

Balance between dietary intake and renal excretion

96
Q

If you have an imbalance of electrolytes what could happen?

A

Cardiac problems

97
Q

Potassium (K+)

A

Normal 3.5-5.0

Imbalance can cause cardiac arrhythmia or cardiac arrest

98
Q

Carbon dioxide (CO2)

A

Normal 23-30

Assists with Ph balance

99
Q

Chloride (Cl)

A

Normal 98-106 mEq

Acid base balance

100
Q

Calcium (Ca+)

A

Normal 7.6-10.4 mg/dl

101
Q

BUN

A

Blood urea nitrogen
Normal 10-20
Monitors kidney function

102
Q

Increase of BUN could indicate?

A

Dehydration

103
Q

Creatin

A

Normal 0.5-1.1

Monitors kidney function

104
Q

What labs monitor kidney function

A

Creatinine & BUN

105
Q

Urinalysis is used to identify ?

A

UTI, renal function, diabetes

106
Q

If pt is at high risk for blood loss what lab is ordered?

A

Type & cross match

107
Q

ABG

A

Arterial blood gases
Oxygenated blood
Drawn by respiratory

108
Q

FBS

A

70-100

109
Q

PTT, PT/INR, bleeding time

A

Clotting factors

Done for surgery or if on blood thinners

110
Q

Albumin/protein

A

Measure of nutrition

111
Q

ALT

A

Normal 4-36

Monitors liver function

112
Q

CXR

A

Chest x ray

Examine condition of heart & lungs

113
Q

EKG

A

Measures hearts electrical activity

Over age of 40 & heart Hx

114
Q

PFT

A

Pulmonary function test

115
Q

A planned anatomical alteration of the body

A

Surgery

► Med Misc 49 (29 decks)

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