Week One Modules Flashcards
what is the flow of surgery?
pre-op, surgery, and post-op
true/false: higher priority patients bump those of lower priority
for example:
whose surgery will be performed first?
an unstable crash-craniotomy patient or a patient who has a scheduled surgery for a femur fracture repair?
true
unstable crash-craniotomy patient
NPO = ______
why is it required that patients be NPO the night before a surgical procedure?
nothing by mouth
b/c anesthesia is known to make patients nauseous which increases their risk for choking and aspiration
what tasks are delegated to the nurse the morning of surgery?
full set of vital signs, perform a head to toe assessment, and report any abnormal VS to the surgeon immediately
when does the IV fluid order for the patient begin?
begins at midnight after the patient has become NPO
what is the pre-op checklist and what does it consist of?
entering the last set of VS, entering the time of the last food & drink, checking the patient ID band, flushing the peripheral IV line, and making sure the consent form is signed by patient
During pre-op checklist it is also the nurse’s job to do what?
prepare the patient psychologically by asking questions like “how are you feeling about your surgery tomorrow?”, or “do you have any questions about your surgery?”
what are the three requirements of informed consent?
adequate disclosure by the surgeon, demonstration of clear understanding by the patient (through teachback), and voluntary consent
an informed consent is a ________ between both the _____ and the ____
decision making process; patient; surgeon
what is the RN’s role in obtaining informed consent?
to determine whether the patient has a clear understanding of what will happen during surgery
what is an example question the RN can ask the patient to assess their knowledge and understanding of the surgical procedure?
“tell me what you know about what they’re going to do during your surgery”
what are the FOUR main points the RN should touch on during the pre-op teaching?
sensory information (five senses), procedural information (specific information about what will happen), process information (info about the general flow of surgery), and what to expect post-operatively
pre-op teaching:
limit the use of _______
begin teaching at a ___ literacy level
_____ give too much information at once
remember, ____ will affect the patient’s ability to learn and retain new information
medical terminology, low, don’t, anxiety
intra-operative nursing care:
_____: prepares the OR and interacts with the patient before surgery
_____: assists the surgeon directly and is actively involved in the surgery
circulating nurse; scrub nurse
which OR nurse serves as the “patient protector” during surgery?
circulating nurse
what kinds of information are we looking for when we receive report from the PACU nurse post-surgery?
EBL, fluids/blood pt. received, the types of medications pt. received, and the timing of the last pain medication
when the patient arrives back on the acute floor post surgery what does the RN need to do?
take VS, perform a head to toe, assess the surgical site, review post-op orders, and assess for nausea/vomiting
what are the two neurological post-op complications that can occur?
fever and pain
____ is common within the first ___ hours after surgery
fever; 24
what are some nursing interventions when it comes to treating fever post-op?
administer NSAIDS such as acetaminophen
should ibuprofen be prescribed to patients who are post-op for orthopedic surgeries?
no, because it impedes bone growth and repair
what are some common narcotics that are prescribed for post-op pain related to surgery?
morphine, dilaudid, and fentanyl
is fentanyl a medication that is often prescribed for pain?
no, not often because of its short life meaning it doesn’t last long in the body
what is a pca machine?
patient controlled analgesia
benefits of PCA machines:
allow the patient to _____ earlier
more likely to have ____ hospital stays
_____ pulmonary complications
_____ satisfaction with post-op pain control
ambulate; shorter; fewer; better
PCA machines also help patients to avoid what?
the peaks and valleys of having to wait for their nurse to administer their pain medication
what does a PCA order look like?
the order would indicate the type of narcotic, the dose, the dosing interval, and the lockout interval
interpret this pca prescription
(1: 6: 10)
morphine 1mg/mL
dose: 1 mg
time interval: every 6 minutes
lockout interval: 10 mg
the patient can receive 1 mg every 6 minutes up to 10 mg total in one hour
what is the lockout interval that is recommended by the American Pain Society?
one hour
with the pca, there should be no basal infusion because it increases the risk of what?
increases the risk of oversedation
you must have ___ RNs check the pca pump when setting it up for the first time
the RN must check the pca pump settings every ___ hours
2; 4
documenting sedation level
if the patient is at a level three sedation, this means what?
if the patient is at a level four sedation, this means what?
pt. is frequently drowsy, and drifts off to sleep; pt. is somnolent with minimal response to sensation
if the patient is at level three sedation what kind of nursing intervention is required?
decrease the dosage of the pca
