Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NRSG 302 > Week 2- Perioperative Care and Assessment > Flashcards

Week 2- Perioperative Care and Assessment Flashcards

1
Q

3 components of periop

A

preop
intra op
post op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Seriousness classification of surgery
- major
- minor

A
  • involves extensive reconstruction or alteration in body parts, poses great risk to wellbeing
  • involves minimal alteration in body parts; often designed to correct deformities; involves minimal risks compared with major procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

examples of major surgeries

A

CABG
colon resection
removal of larynx
resection of lung lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

example of minor surgery

A

cataract extraction
facial plastic surgery
tooth extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 types of urgency surgeries

A

elective
urgent
emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

elective surgery

A
  • usually is optional
  • may not be necessary for health

ex: bunionectomy, facial plastic surgery, breast reconstruction, removal of wart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

urgent surgery

A
  • is necessary for patient health
  • may prevent additional problems from developing (tissue destruction or impaired organ function) not necessarily emergency

ex; excision of cancerous tumour, removal of gallbladder for stones, vascular repair for obstructed artery (CABG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

emergency

A

must be done immediately to save a persons life or preserve function of body part

ex: repair of perforated appendix, repair of traumatic amputation, control of internal hemorrhaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

diagnostic purpose of surgery

A

surgical exploration that allows physician to confirm diagnosis may involve removal of tissue for further diagnostic testing

ex: exploratory laparotomy (incision into peritoneal cavity to inspect abdominal organs)
breast biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ablative surgery

A

excision or removal of diseased body part
amputation, removal of appendix, cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

palliative surgery

A

relieves or reduces intensity of disease symptoms will not cure

ex: colostomy, debridement of necrotic tissue, removal of brain tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

reconstructive or restorative surgery

A

restores function or appearance to traumatized or malfunctioning tissues

ex: internal fixation of fractures, scar revision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

procurement for transplant

A

Removal of organs, tissues, or both from a person pronounced dead for purpose of transplantation into another person.

Sometimes there are living donors such as one person donating a kidney to another.

ex: kidney, heart or liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

purpose of constructive

A

Restores function lost or reduced as a result of congenital anomalies

repair of cleft palate, closure of atrial septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cosmetic surgery purpose

A

performed to improve personal appearance

ex: rhinoplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

purpose of pre op assessment

A

more than HTT
baseline information
want them to be safe
might be specific based on surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Older adult considerations

4

A

Are more likely to experience perioperative complications than younger adults because they
- more likely to have chronic illness
- have lower % of body water- so more likely to experience fluid and electrolyte disturbances
- Tend to have reduced liver and kidney function – so they metabolize and excrete drugs slower, increasing the risks for toxic effect
- May be poorly nourished – which can impair healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

review _____ with patients to confirm accuracy

A

BPMH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

always check

A

surgical PPOs and written pre op orders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

meds to check pre op day of procedure

A
  1. Glucocorticoid (e.g. prednisone, dexamethasone)
  2. Anti-Diabetics - patient is NPO so watch for hypoglycemia and check pre-operative orders. The MRP may have changed orders for the day of surgery and the patient may not require insulin or oral hypoglycemics
  3. Cardiac medications- Check orders
    Betablockers – typically given but check orders
    ACE inhibitors and ARBs have been associated with hypotension during surgery & can impair renal function -check
    Diuretics may lead to postoperative hypovolemia and hypotension -check
  4. Blood thinners – Usually held - Heparin, Warfarin, LMWH (Should they be stopped a certain amount of time prior to surgery?); ASA(? dosage dependent) & NSAIDS & Plavix are sometimes held because of bleeding properties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

herbs and supplements that cause complications

A

Echinacea
Feverfew
Garlic
Ginger
Gingko biloba
Ginseng
Goldenseal
Licorice
Saw palmetto
St John’s wort
Valerian
Vitamin E
Kava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

surgical checklist

A

confirm, identification ,allergies, informed consent, laterality, blood products, NPO status
has pt voided/catheter
skin prep (no makeup, nail polish)
pre op meds with a sip of water
check OR slate
Removal of jewelry and personal items (give to family if possible). Glasses/hearing aides - can take to OR with them, but need to be removed prior to surgery
Patient history (on back side of form) and past anesthetic reactions e.g. Malignant Hyperthermia (MH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

patient teaching to _____
examples

A

prepare then for post op

Review pain management
Activity to prevent atelectasis
Deep breathing and coughing exercises
Post op diet
Wound care
Common complications to watch for
Discharge – how long is the stay? Will they need help post-op?

24
Q

who must sign consent form

25
RN must ask the patient if they have received
enough information and understand the reason for surgery
26
3 key elements for consent to be valid
1. Must be voluntary 2. Must have mental capacity to consent (or written permission by legally appointed representative) 3. Must be properly informed
27
consent - must - cannot - when is is not required
relate to the treatment be obtained through misrepresentation or fraud life or limb true emergency may not require consent. check policy
28
common pre op meds | 7
1. Medications that reduce stomach acid : - H2 Receptor blockers (e.g. Ranitidine), Proton pump inhibitors (e.g. Pantoprazole) 2. Medications that reduce oral/respiratory secretions & dilates bronchi - Anticholinergics (e.g. Atropine) 3. Sedatives - Benzodiazepines (e.g. Lorazepam/Ativan) 4. Prophylactic Antibiotics (e.g. 2g Cefazolin IV 30min before incision/on call to OR) 5. Pain medications (e.g. Tylenol PO given 60-90 min preop) 6. Anti-emetics (e,g. Metoclopramide/Dimenhydrinate) 7. Bronchodilators (e.g. Salbutamol)
29
pt will go from or to
PAR or PACU
30
when can pt be transferred to the floor
- maintain airway - stable VS - conscious and oriented - pain and nausea are managed - patient is stable
31
PACU will call
and give report to primary surgical ward nurse
32
transfer from PAR to WARD - have all - check - have bed - PAR nurse will
- equipment ready at bedside: IV pole, vital machine, slider board, other patient specific equipment (e.g. OSAM, blanket warmer - safety equipment is working correctly and board has all items - at appropriate height for transfer and covers pulled back - will give report on surgery, anesthetic, and head to toe assessment on patient (report for floor patients will generally be over the phone, critical care/monitored patients will be in person with PAR nurse) - will review how surgery went, dr orders and last analgesic/antiemetic given
33
post op primary assessment
1. visually assess the pt and say hello: - answer - color - breathing - obvious concerns - tubes and drains 2. get help to transfer pt to bed 3. full primary survey= ABGs (including VS and pain) 4. ABCDEFG
34
Airway
1. Is patient is able to maintain an open airway? 2. Patient should have an intact gag reflex (so can protect airway against aspiration)
35
How will you know that the patient has a patent airway?
- talking to you - listen to lungs - sats - proper positioning
36
breathing
1. is pt breathing easily - RR - accessory muscles - depth - speak in full sentences - position normal
37
breathing assessment ask pt - - -
any SOB difficulty breathing if on o2 attach it and set to right rate
38
circulation assessment - check - check - check - ask
- pulse (radial and apical), o2 sats, BP - bleeding is under control - check IV site is patent and IV is infusing as ordered (rate/solution) - ask pt if they have any chest pain or palpitations
39
do not remove any dressings as this
opens them up to potential infection. If dressing are saturating, add more gauze on top. Ideally wounds stay covered for 24-48 hours
40
Disability/discomfort
is patient alert - only respond to verbal? - only respond to pain? - no response? is patient orientedx3 assess pt pain - scale - opqrstuv
41
environment - check on pt - everythign else
Wounds/dressings are dry and intact Drains/tubes are in situ and functioning Braces/splints are in situ Other ordered treatments are taken care of Safety Equipment has been checked and is working correctly (should be done BEFORE patient arrives!!!) Bed brakes are on Bed rails are up, as appropriate Bed is in lowest position Patient has the call bell (and knows how to use it)
42
full set of vital signs/freedom of risk
- Check vital signs if not already completed or need to be done at timed increments - Remember to include temperature (do we have parameters for Temp and interventions e.g. blanket warmers or blood cultures) - Check heart rate, BP, are there parameters to maintain and orders to implement interventions? - Check O2 sats: Apply supplemental oxygen if < 92% on room air or increase oxygen rate if < 92% unless ordered otherwise. - Resp. rate for 60 seconds, is it regular?
43
check chart for important information | 4
What type of anesthesia did the patient have? What drugs did the patient receive in PAR? When is next timed dose due? How much blood/fluid did the patient lose/receive? What were the patient’s vital signs in PAR? What interventions did they perform?
44
Dr orders are transcribed in
kardex
45
all orders prior to surgery are
are CANCELLED and only post-op orders now stand
46
all med orders prior to surgery are
CANCELLED and all need to be reordered
47
if pt has an epidural or PCA all supplemental _____, _____, _____ must
sedative, anticoagulants, pain meds must be okayed by anesthesia regardless if ordered by MRP post op
48
resp, CVS, abdominal assessment
air entry clear s1 and s2 no extra sounds abdomen flat, soft, non tender, Bowel sounds present
49
visually inspect the body
Visualize every site where there is a dressing, drain, or tube Roll patient to the side to visualize the patient’s back
50
when pt voids post op it needs to be ________ needs to be addressed quickly
needs to be assessed and documented. Urinary retention/distended bladder needs to be addressed quickly
51
how to prioritize
Immediately life or limb threatening problems NEXT serious but not immediately life-threatening problems NEXT prevention of future complications or problems LASTLY routine, non-urgent care/tasks
52
first assess sedond third fourth
- immediate life or limb threatening issues - serious, but not immediately life/limb threatening - prevention of future complications - routine, non urgent
53
maslows hierarchy of needs
physiological safety love/belonging esteem self actualization
54
What strategies would you use to ensure adequate breathing and respirations in a post-op patient? (7)
- positioning with pillows - pain management - DB & C - incentive spirometer - supplemental O2 - mobilization - independence
55
Where would you look to find documentation of medications given in the OR and PAR?
the OR record (red tab) PAR record

NRSG 302 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions