Exam 1 Chapter 5 Flashcards Preview

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Flashcards in Exam 1 Chapter 5 Deck (141)
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1

surgical classifications

diagnostic (eg. biopsy, exploratory laparotomy)
curative (eg. excision of a tumor or an inflamed appendix)
reparative (eg.multiple wound repair)
reconstructive or cosmetic (eg. mammoplasty or a facelift)
palliative (eg. to relieve pain or correct a problem-gastrostomy tube)

2

Emergent surgery

patient requires immediate attention; disorder may be life-threatening.
without delay.
Eg: severe bleeding
bladder or intestinal obstruction
fractured skull
gunshot or stab wounds
extensive burns.

3

Urgent surgery

within 24-30 hours
Eg:
acute gallbladder infection
kidney or ureteral stones

4

Required surgery

patient needs to have surgery
plan within a few weeks or months
Eg:
prostatic hyperplasia without bladder obstruction
thyroid disorders
cataracts

5

Elective surgery

patient should have surgery
failure to have surgery not catastrophic
Eg:
Repair of scars
simple hernia
vaginal repair

6

Optional surgery

decision rests with patient
Eg:
cosmetic surgery

7

surgical intervention should be tailored to?

patient's symptoms
overall functional
health status
predicted benefit of the intervention

8

Elderly people frequently do not report symptoms because?

fear of serious illness.
acceptance of symptoms as part of the aging process.

9

Protective measures for the elderly patients

adequate padding for tender areas.
moving patient slowly
protecting bony prominences

10

Surgical risk for the elderly patients

decrease ability to respond to stress.
increase vulnerability to changes in circulating volume and blood O2 levels.
pulmonary edema (excessive or rapid IV solutions).
increase susceptibility to hypothermia.
skin complications.
airway occlusion

11

surgical risk for the obese patient

dehiscence
wound infections.
shallow respirations when supine=hypoventilation and pulmonary complications.

12

nursing management for the obese patient before surgery.

careful assessment of the cardiopulmonary status.
thorough wound assessments.

13

when does the preoperative phase begins and ends?

begins when the decision to proceed with surgical intervention is made, and ends with the transfer of the patient onto the OR table.

14

Nursing activities during the preoperative phase

base line evaluation of..
H and P (history and physical)
emotional assessment
previous anesthetic
identification of allergies or genetic issues.
ensuring necessary labs have been done or will be performed.
arranging appropriate consultations
providing education about recovery from anesthesia and postoperative care.

15

what is the primary purpose of the informed consent process for surgical services?

To ensure patients, or their representative is provided information necessary to enable him or her to evaluate the proposed surgery before agreeing to it.

16

who obtains the informed consent?

it is the responsibility of the performing surgeon.

17

How should the nurse determined patient's nutritional needs?

measurement of body mass index (BMI) and waist circumference.

18

Normal BMI

18.5-24.9

19

BMI of less than 18.5

underweight

20

great than 25 BMI

overweight

21

BMI greater than 30

obese

22

A waist circumference measurement of greater than 40 inches for men and 35 inches in women is associated with?

increased cardiac risk.

23

Nutrients important for wound healing.

protein
Arginine (amino acid)
carbohydrates and fats
water
Vitamin C, E, A, K, B complex
magnesium
copper
zinc

24

Alcohol withdrawal syndrome or delirium tremens may be anticipated?

between 48 and 72 hours.

25

The patient with diabetes undergoing surgery is at risk for?

hypoglycemia = during anesthesia or postoperatively from inadequate carbohydrates or excessive administration of insulin.
hyperglycemia= stress of surgery because it triggers increased release of catecholamines .

26

surgical patients with type 1 diabetes are at risk for developing?

ketoacidosis : absence or inadequate amount of insulin.
SxS:
hyperglycemia
ketosis
dehydration
electrolyte loss
acidosis
polydipsia
polyuria
acetone breath (fruity odor similar to overripe apples)

27

signs of adrenal insufficiency

hyponatremia
hypoglycemia
hyperkalemia
weakness
fatigue

28

patients with uncontrolled thyroid disorders (hyperthyroid) are at risk for?

thyrotoxicosis

29

patients with hypothyroid disorders are at risk for?

respiratory failure

30

Foods to determine latex allergies

bananas
avocados
kiwi
chestnuts