Week 2 (Post-op Teaching) & Week 3 (Surgical Asepsis) Flashcards
What are three post-operative exercises that you should encourage your patients to do?
- Deep breathing and coughing
- Change positions
- Leg exercises
- Ankle pumps
- Ankle circling
- Knee bending
Why is it important to encourage deep breathing and coughing?
- helps prevent pneumonia
- helps remove secretions from the lungs
- helps to expand the lungs after surgery
How often should deep breathing and coughing be encouraged?
5 - 10 times an hour during immobilization
What are the benefits of performing leg exercises post-operatively?
- helps prevent circulatory problems (thrombophlebitis)
- facilitates venous return to the heart
- helps prevent pressure ulcers and respiratory problems
How often should you encourage patients to change position?
Every 2 hours
What are three reasons for hypotension in a postoperative patient?
- Decreased blood volume (blood loss)
- Fluid loss (dehydration)
- Peripheral pooling
What is a common complication related to analgesia (morphine or hydromorphone)?
Decreased respiratory rate (or hypotension)
What are three major complication that can develop if a patient refuses to ambulate?
- DVT
- PE
- Pneumonia
Your patient is feeling lightheaded. What should you do? What should you assess?
Have the patient sit down (if standing) or lay down - gets more blood to the head
- assess BP (and vital signs)
What is the surgical experience composed of?
- Pre-operative
- Intra-operative
- Post-operative
What is the immediate recovery phase?
When the patient is in the recovery room or PACU
What is the convalescent phase?
Post-operative care
- extends from time patient is discharged from PACU until discharge from surgery ward
What are your priority assessments in the convalescent phase?
- ABC
- LOC
- VS
- Pain
- Dressings, tubes, drains
- H2T assessments
What should you know about your patient prior to completing a H2T assessment (6)?
- Diagnosis
- Surgical procedure (and common complications)
- Restrictions of procedure (immobility)
- Pmhx
- Type of analgesia used during surgery
- Medications patient is on
What are the common post-operative complications?
Hemmorrhage, atelectasis, shock, low urine output (oliguria), fever, wound dehiscence, DVT, PE, infection, paralytic ileus, hypo/hypervolemia, UTI, urinary retention, confusion, pruritis (itchy skin), dry mouth, N/V, electrolyte imbalance
What are some common cardiovascular complications that could occur after surgery (7)?
- Hypotension
- Hypertension
- Dysrhythmias
- Syncope (loss of consciousness; fainting)
- Fluid overload (pulmonary)
- Peripheral edema
- Fluid and electrolyte imbalance
What are some common respiratory complications that could occur after surgery (4)?
- Respiratory depression
- Atelectasis
- Pneumonia
- Aspiration pneumonia
What are some common GI system complications that could occur after surgery (6)?
- Paralytic ileus
- N/V
- Delayed return of bowel function
- Mechanical obstruction
- Peritonitis (inflammation)
- Anastamotic leakage
What are some common GU system complications that could occur after surgery (3)?
- UTI (urinary tract infection)
- Oliguria (low urine output)
- Urinary retention
What places older adults at risk when undergoing surgery?
- Age related changes
- Delirium (common!)
- Depression
- Osteoporosis
- F/E imbalances
- Malnutrition
- Constipation
- Falls
True or False:
All objects used in the sterile field must remain sterile
TRUE!
True or False:
Once an object is sterile, it does not expire.
FALSE!
- Sterile articles can be stored for only a prescribed time
- After that, they are considered unsterile
True or False:
Sterile objects become unsterile when touched by unsterile objects
TRUE!
True or False:
Sterile items that are in vision and at the waist line are considered sterile
FALSE
- Need to be in sight AND ABOVE the waist
What happens if you turn your back to your sterile field?
It becomes unsterile
True or False:
Sterile objects can become unsterile by prolonged exposure to airborne microorganisms
TRUE
When holding foreceps, are the tips above the handles or the handles above the tips?
Tips below the handles
- if they become wet and you hold the tips ABOVE the handles, the fluid runs down to the contaminated handles
- once you go to use them again, this contamination will run into your sterile field
How much of the border of a sterile field is considered unsterile?
1 inch (2.5 cm) border all the way around the sterile field
True or False:
Skin can be sterilized
False
- skin is unsterile, therefore, use sterile gloves or sterile forceps to handle sterile items
What is the absence of microorganisms called?
Sterility
When organisms are present on a tissue or a surface, what is it called?
Contamination
What is the name for the process in which microorganisms are transmitted from one patient to another?
Cross contamination
What is the name for the process in which moisture soaks through the drapes, whether sterile or unsterile?
Strike through
True or False:
All items used within a sterile field must be sterile
True
True or False:
The edges of a sterile normal saline (sterile salt water) container is still considered sterile once it has been opened
False
True or False:
Tables are considered sterile 1 inch below table level
False
True or False:
Items of doubtful sterility are considered unsterile
True
True or False:
Contamination occurs when sterile barriers are permeated
True
True or False:
Sterile gowns are considered sterile in the front, shoulders, and at table level
True
True or False:
Unsterile objects may come into contact with sterile items in the sterile field
False
True or False:
Sterile items may only contact sterile items
True
True or False:
If a sterile items is dropped on the floor, it is OK to pick it up, open it and use it
False
True or False:
Once sterile gloves are applied, the hands should remain together in front of the body and above the waist level
True
What is the difference between medical and surgical asepsis?
Medical: maintains cleanliness, reduce and prevent the spread of microorganisms, clean technique
Surgical: eliminate all microorgansisms from an area, used for procedures which invade an area/body cavity that is normally microorganism free
What are some example of surgeries that require surgical asepsis?
- sterile dressing changes
- tracheotomy care
- suctioning
- any invasive procedure (catheter, IV insertion, IV removal, dressings)
- any surgical procedure
What is the number 1 reason for accidental exposure?
Needle stick injury
Define antiseptic
Any substance that inhibits the growth and reproduction of microorganisms
Define nosocomial infection
Hospital acquired infection
Define disinfection
Process of killing microorganisms
Define Bacteriostatic
Biological or chemical agent that stops bacteria from reproducing,
- not necessarily killing them
