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P&A II midterm > Peri-op nursing > Flashcards

Peri-op nursing Flashcards

1
Q

What is an elective surgery?

A

A surgery with no immediate emergency, so it can be scheduled

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2
Q

What is an urgent surgery?

A

A surgery needed soon

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3
Q

What is an emergency surgery?

A

A surgery needed immediately

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4
Q

What is a diagnostic surgery?

A

For testing; biopsy

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5
Q

What is an ablative surgery?

A

Surgery taking care of a diseased part

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6
Q

What is a palliative surgery?

A

A surgery to improve the quality of life

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7
Q

Why is the assessment important in periop nursing?

A

It’s used to ID patient’s norms to recognize, prevent, and minimize postop complications of surgery

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8
Q

Why is nutrition a risk factor for surgery?

A

Need a balanced diet for healing
No eating for ~8 hrs beforehand
Need to have conversation pre-op on post-op diet

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9
Q

Why is obesity a risk factor for surgery?

A 
Medication needed
Potential increased blood loss
Mobilization
Post-op complications
Breathing
Healing slower
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10
Q

Why is sleep apnea a risk factor for surgery?

A

At risk for cardiac disease

Important for knowing if you get intubated

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11
Q

What is the nursing implication for the CV system during surgery?

A

Vital signs, fluid balance; leg exercises (for DVT)

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12
Q

What is the surgery risk for the pulmonary system?

A

Cough and deep breathe, ambulate

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13
Q

What is the surgery risk for the renal system?

A

Baseline urinary output/ response to meds

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14
Q

What is the surgery risk for the neuro system?

A

Orient; Inspect for signs of pressure (ulcers)

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15
Q

What is the surgery risk for the metabolic system?

A

Monitor labs

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16
Q

What age tends to have lower urine output?

A

Elderly pts

Can have a problem with incontinence

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17
Q

What is the rule for older patients and medication?

A

Start low, go slow

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18
Q

What types of medications need to be considered preop?

A 
Anticoagulants
Insulin
NSAIDS
OTC
Supplements/herbs
Rec drugs
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19
Q

Why might Heparin be given in the hospital?

A

Anticoagulant with a short half life

20
Q

What can be used to counteract Coumadin?

A

Vitamin K

21
Q

Is insulin given in the hospital even if the pt isn’t eating?

A

Yes

22
Q

What diagnostic tests should be done?

A

CBC, serum electrolytes, coagulation, serum creatinine & BUN

23
Q

What is autologous blood donation?

A

Taking blood from the pt preop and giving them back their own blood postop

24
Q

Which surgeries have the biggest blood loss?

A

Orthopedic surgeries

25
Q

When should postop care be taught?

A

Preop

26
Q

In which pts is delayed surgical recovery seen?

A

Diabetic pts

27
Q

When should intervention be provided for pain?

A

During discomfort because it’s easier to slow the progression

28
Q

Who gets informed consent?

A

Physicians. Nurses can witness it

29
Q

What is included in preop teaching?

A

Reasons for preop instructions and exercises
Time of surgery
Postop unit and location of family during surgery and recovery
Anticipated postop monitoring and therapies
Surgical procedures and postop treatment
Postop activity resumption
Pt verbalizes pain relief measures
Pt expressing feelings
Sensations related to surgery and anesthesia
Instructions on preop orders
Invasive procedures (IV, NG, catheters)
Turn, cough & deep breathe/splinting/positioning
Lower extremity exercises/DVT prevention
Early ambulation
Pain management

30
Q

What is included in the preop check list?

A 
Patient’s name band
Consents obtained
Allergies
Vital signs
Hygiene/Skin prep
Personal belongings
IV access; blood availability 
Marking OR site
Bowel/bladder prep  (document  time)
Preop med (safety - complete necessary activities before meds)
Transport
Family
31
Q

When are prophylactic antibiotics used?

A

For anaerobic organisms

32
Q

Are razors used for hair removal?

A

No

33
Q

What is a circulating nurse?

A

Nurse that evaluates the patient’s ongoing clinical status

Continuously monitor vital signs and intake and output

34
Q

What is general anesthesia?

A

Loss of sensation/consciousness

Risks associated

35
Q

What is regional anesthesia?

A

Loss of sensation in one area of the body

Nerve block, epidural or spinal

36
Q

What is local anesthesia?

A

Loss of sensation at a site

Topical/local infiltration

37
Q

What is a time out?

A

Procedure aimed to prevent medical and surgical errors. Conduction of a final verification of the ​correct pt, procedure, surgical site.

38
Q

When is a time out done?

A

As the pt is brought into the OR

39
Q

What is included in the operative report postop?

A

Procedure, anesthesia, blood loss, blood products, fluids, drains

40
Q

What is impt in postop care?

A 
Maintaining resp function
Preventing circulatory complications
Achieving rest and comfort
Temp regulation
Maintaining neurological function
F&E balance
Bowl elimination/adequate nutrition
Urinary elimination
Wound healing
Self-concept
41
Q

What surgery puts a pt at the highest risk for DVT?

A

Pelvic surgeries

42
Q

What is paralytic ileus?

A

When a portion of the ileum remains sleeping after surgery

Can be medically or surgically treated

43
Q

When is risk for hemorrhage greatest?

A

First 24 hours

Later - DVT

44
Q

When is a distended abdomen expected?

A

After laparoscopic surgery

45
Q

What are risk factors for dehiscence?

A

Conditions that impair circulation, tissue oxygenation, and wound healing
Mechanical stress on the wound

46
Q

How can we avoid dehiscence?

A

Stool softeners to prevent straining during defecation and alleviate constipation
Antiemetics PRN to prevent straining that can occur with vomiting
Abdominal binder - reduce mechanical stress
Monitoring blood sugar to maintain tight glycemic control (<140 mg/dL [7.8 mmol/L] fasting glucose, <180 mg/dL [10 mmol/L] random glucose)
Splinting

P&A II midterm (8 decks)

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