UNRS 212 Perioperative

Question 1

Preoperative phase

Answer 1

before surgery; patient is in the pre-op area

Question 2

Intraoperative phase

Answer 2

during surgery, patient is in the operating room

Question 3

Postoperative phase

Answer 3

after surgery, nursing care delivered in the post-anesthesia care unit (PACU); prior to transfer to the inpatient unit or discharge home

Question 4

Inpatient

Answer 4

patient who is admitted to a hospital. The patient may be admitted the day before or, more often, the day of surgery (often termed same-day admission [SDA]), or the patient may already be an inpatient when surgery is needed

Question 5

Outpatient or ambulatory

Answer 5

patient who goes to the surgical area the day of the surgery and returns home on the same day (same day surgery)

Question 6

Elective surgery

Answer 6

planned for correction of a nonacute problem (e.g. cataract removal, hernia repair, total joint replacement)

Question 7

Urgent surgery

Answer 7

requires prompt intervention, may be life threatening if treatment is delayed more than 24 to 48 hour (intestinal obstruction, kidney or ureteral stones, acute cholecystitis)

Question 8

Emergency surgery

Answer 8

requires immediate intervention because of life threatening consequences (e.g. gunshot or stab wound, ruptured abdominal aortic aneurysm, appendectomy)

Question 9

Minor procedure

Answer 9

without significant risk; often done with local anesthesia (e.g. incision and damage, implantation of a venous access device)

Question 10

Major procedure

Answer 10

of greater risk; usually longer and more extensive than a minor procedure (e.g. mitral valve replacement, pancreas transplant)

Question 11

Simple

Answer 11

only the most overtly affected areas involved in the surgery (e.g. simple/partial mastectomy)

Question 12

Radical

Answer 12

extensive surgery beyond the area obviously involved; is directed at finding a root cause (e.g. radical prostatectomy, radical hysterectomy)

Question 13

Minimally invasive surgery (MIS)

Answer 13

surgery performed in a body cavity or body are through one or more endoscopes; can correct problems, remove organs, take tissue for biopsy, reroute blood vessels and drainage systems is a fast growing type of surgery (e.g., laparoscopic cholecystectomy)

Question 14

Diagnostic surgery

Answer 14

performed to determine the origin and cause of a disorder or the cell type for cancer (e.g. breast biopsy, exploratory laparotomy)

Question 15

Curative surgery

Answer 15

performed to resolve a health problem by repairing or removing the cause of problem (e.g. cholecystectomy, appendectomy, hysterectomy)

Question 16

Restorative surgery

Answer 16

performed to improve a patient’s functional ability (e.g. total knee replacement)

Question 17

Palliative surgery

Answer 17

performed to relieve symptoms of a disease process, but does not cure (e.g. tumor debulking, colostomy)

Question 18

Cosmetic surgery

Answer 18

performed primarily to alter or enhance personal appearance (e.g. rhinoplasty for cosmetic reason)

Question 19

What are the common lab and diagnostics required for pre-op clearance?

Answer 19

1. Urinalysis
2. Blood type and screen
3. CBC or hemoglobin level and hematocrit
4. Clotting studies (PT, INR, aPTT)
5. Electrolyte levels
6. Serum creatinine level
7. Pregnancy test
8. Chest x-ray
9. ECG

Question 20

What is a preoperative Checklist?

Answer 20

A checklist that promotes safety by ensuring nothing is omitted

Question 21

Surgeon

Answer 21

physical who does the surgical procedure. Primarily responsible for the preoperative medical history and physical assessment, ordering pre op tests, obtaining informed consent

Question 22

Anesthesia care provider (ACP)

Answer 22

person responsible for administering anesthetic agents during the procedure and managing vital life functions (breathing, blood pressure) during the perioperative period. May be an anesthesiologist or nurse anesthetist (CRNA)

Question 23

Surgeon’s assistant

Answer 23

usually holds the retractors to expose surgical areas and helps with hemostasis and suturing. May be another physician, a registered nurse first assistant (RNFA), physician assistant (PA), or surgical resident or fellow

Question 24

Scrub nurse

Answer 24

prepares and manages the sterile field and instrumentation

Question 25

Circulating nurse

Answer 25

stays in the unsterile field area of the operating room, records/documents intraoperative care, coordinates all intraoperative activities with team members and other departments, prepares and labels intraoperative specimens, gives hand-off report to PACU nurse

Question 26

Unrestricted (3 areas of Surgical Department)

Answer 26

where people in street clothes interact with those in scrub attire. These areas typically include the point of entry for patients (pre op holding area), staff locker rooms, and nurses station

Question 27

Semi Restricted (3 areas of Surgical Department)

Answer 27

only authorized staff in clean surgical attire (scrubs laundered in an accredited laundry facility, long sleeved jacket, shoes dedicated for surgery use or shoe covers, surgical head cover, and mask that covers all facial hair

Question 28

Restricted (3 areas of Surgical Department)

Answer 28

found within the semi restricted zone. Surgical suite (OR) where the invasive procedure takes place. In addition to clean surgical attire, masks must be worn and traffic minimized wherever sterile supplies are open

Question 29

General anesthesia

Answer 29

loss of consciousness, sensation, and skeletal muscle relaxation. Required advanced airway management (i.e., intubation with mechanical ventilation). Administered by ACP

Question 30

Monitored anesthesia care (MAC)

Answer 30

patient less responsive and may need some airway management. Examples include procedures such as endoscopy or colonoscopy

Question 31

Regional anesthesia

Answer 31

loss of sensation to the region of the body without loss of consciousness. Includes epidural anesthesia

Question 32

Moderate sedation

Answer 32

used for procedures done outside of the OR (reduction of fracture in ER). Patient remains awake and breathes independently. Does not require an anesthesiologist