Wk 3 Perioperative Nursing/Preop Flashcards
When does a patient go into the intraoperative phase?
When they enter the OR and go to the PACU
6 reasons a patient might have surgery
Diagnosis Cure Palliation Prevention Exploration Cosmetic Improvement
What is ambulatory surgery?
Patient comes in, has surgery, and goes home same day
What is a same-day admit surgery?
Patient has surgery, is admitted for post-op
What is inpatient-admitted surgery?
Patient admitted to hospital first, then has surgery, and stays admitted
What are 3 risks with elective surgery?
Bleeding
Infection
Anesthetic exposure
What is a semi elective surgery?
Scheduling should be considered a priority but it doesn’t have to be within the next 24 hours
What are 2 examples of a semi-elective surgery?
Cholecystectomy for gallstone removal
Uterine artery ablation for postmenopausal bleeding from fibroids
What is an urgent surgery?
Must be done within 24 hours to prevent further complications
What is emergency surgery?
Should be within 24 hours, preferably less than 2 to prevent further deterioration
What are 2 examples of an emergency surgery?
GI bleed
Subdural hematoma
What are 7 things you should ask a patient before they are having surgery?
Do they understand the surgery? Previous surgeries/sedations? Family health history? Current medications/illegal drug use Allergies Pregnancy Tobacco use
What are some allergies you should ask a patient about before they have surgery? (6)
latex Poinsettia plant anaphylaxis during surgery food allergies season allergies asthma
What are 4 foods that have the same substances as latex that you should ask you patient if they are allergic to?
Kiwis
Bananas
Avocados
Chestnuts
What is a good habit to end your pre-op interview with?
Is there anything I should know or that you would like to tell me?
What is a review of symptoms?
Inventory of body systems obtained through a series of questions seeking to identify signs/symptoms of disease
What are 6 pulmonary risks that you should assess for, for a patient undergoing surgery
Atelectasis Infection Prolonged mechanical ventilation Respiratory failure Bronchospasm Exacerbation of underlying lung disease
What are two examples of someone at risk for prolonged mechanical ventillation?
Smoker
COPD
If a patient has cardiac problems, we don’t want to do anything that will…
Increase myocardial oxygen demand
What are neurological problems to assess for?
Hearing
Vision
Cognition (what is their baseline?)
What are two GU problems to assess for?
Renal function
Pregnancy
What are two hepatic problems to assess for?
Clotting
Metabolism issues
Why is metabolism issues an important problem to assess for concerning the hepatic systmem?
If they don’t metabolize medications correctly it will affect how much of a medication they get
What are two integument problems to assess for?
Rashes
Pressure ulcers
Any sign of skin breakdown
What is a musculoskeletal problem to assess for?
Activity restrictions
What are two endocrine problems to assess for?
Diabetes
Thyroid problems
What is an immune problem to assess for?
Steroid use
Why are steroids a problem for anesthesia?
Increases BS
Delays wound healing
Impaired skin integrity
What are fluid and electrolyte problems to assess for?
N/V/D
Narrow margin of fluid safety with older patients
What are some nutritional issues to assess for?
Obesity
Malnutrition
What is something that must be in the patient’s chart before they go into the OR, as required by the Joint Commission?
history & physical
What will you teach your patient before surgery?
Noise, lights, temperature, pre op area
What it will look like to get ready for surgery
What will you teach your patient’s caregivers before surgery?
Preop area, caregiver rules
what to do during surgery
Whose responsibility is it to obtain informed consent before a surgical procedure?
The surgeon
What should be on the informed consent document? (7 things)
Dx Purpose of surgery Risks Alternative treatments Risks of not treating Who is conducting the procedure Short and long term costs
What is considered part of the short term costs of surgery? (3 things)
Pain
Length of stay
Recovery time
What is considered part of the long term costs of surgery? (3 things)
Loss of function
Activity restriction
Scarring
Signing an informed consent is a voluntary process, meaning the patient must demonstrate __ __
significant comprehension
Who should discuss with the patient the issues of informed consent to the patient?
the surgeon
What is the role of the nurse concerning informed consent?
Witness the patient’s signature
Act as a patient advocate
What are scenarios that written permission may be given to a legal representative of responsible family member? (3 things)
Patient is a minor
Patient is unconscious
Patient is mentally incompetent
What is a scenario where you wouldn’t need consent for surgery?
A true medical emergency
What is the pre-op fasting recommendation for clear liquids?
at least 2 hours
What is the preop recommendation for breast milk?
at least 4 hours
What is the preop recommendation for non-human milk, and a light meal?
at least 6 hours
What is the preop recommendation for a regular meal?
at least 8 or more hours
Preoperative intake recommendations are specific to…
the procedure
What will you need to do as the nurse for a patient who is preoperative?
Fill out the perop check list
