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N103 test 2 (GRCC)
N103 test 2 (GRCC) : Perioptive
| Question | Answer |
|---|---|
| Define the perioperative care period | Entire process: Pre-Op, Inter-Op, Post-Op |
| Pre-operative period | Care of client before surgery |
| Intra-operative care | What happens during surgery. |
| Post-Operative | What happens after surgery |
| Classification of diagnostic surgery | Determines severity of situation (i.e. biopsy) |
| Classification of curative surgery | Cures health problems |
| Classification of palliative surgery | No cure but relieves symptoms |
| Classification of cosmetic surgery | Improves physical appearance |
| Classification of preventative surgery | Prevents a more serious problems from developing. |
| Classification of an elective surgery | Surgery is done that is convenient for the client or surgeon. It doesn't have to be done at a certain time. |
| Classification of emergency surgery | Must be done to save clients life. |
| Classification of Inpatient surgery | client begins recovery in hospital. client stays in hospital after surgery. |
| Classification of outpatient surgery | Client has surgery @ hospital, doctors offices, etc and are discharged if they are stable. Usually stated pre-surgery as they may end up in the hospital. |
| Pre-Operative | From the time surgery is decided till the actual surgery varies; emergency patients who need surgery have short pre-op period- know less of what is going to happen as there is usually no time to explain. No set time length. |
| Inter-op | No set time length, it can be long. |
| Post-op | No set time period of how long it will take for patient to recover. |
| Patients responsibility | It's up to the patient to make all the appointments. |
| Pre-op assessment looks at the following | Age, Tobboco/ETOH, medications, previous surgeries and hospitalizations, allergies, vital signs, respiratory-lung sounds, elimination, nutrition, coping/stress. |
| Pre-op assessment; Age | Risk factor related to age. (i.e. elderly people increase risk of infection). |
| Pro-op assessment:tobacco/ETOH (alcohol) | Risk factors related to tobacco and alcohol. Surgeons may ask patients to quit smoking to proceed, and if they don't quit smoking, then surgery may be canceled. |
| Pre-op assessment: medications | When patient goes to surgery- all meds they take need to be ordered. |
| Pre-op assessment: previous surgeries and hospitalizations | Learn how familiar patient is with surgery. |
| Anesthesiologist know certain reactions with different drugs and they need to know what patient takes so that they know to give them to avoid bad interactions. | Pre-op assessment: medications |
| Prevent drug interactions. | Pre-op assessment: medications |
| Patients need to stop taking certain drug at least one week prior to surgery. (i.e. aspirin, coumadin, etc) | Pre-op assessment: medications |
| Pre-op assesment: Allergies | Prevent allergic reactions to drugs and anesthesia given to patient. May be allergic to betadine, contrast solution, dressing allergy, latex allergy, etc. |
| Pre-Op assessment: Elimination | Anesthesia cause constipation- will it be a problem if patient has problems with constipation. |
| Pre-Op assesment: Nutrition | Obese people can have malnutrition. More lipids take forever to heal. |
| Pre-OP assessment: coping/stress | Teaching what can happen in surgery will help decrease patients anxiety. |
| Common nursing dx and client goals as it is related to surgery/pre-op: Knowledge Deficit | Demonstrate, explain, show how and what will happen throughout surgery process to help decrease anxiety. |
| Common nursing dx and client goals as it is related to surgery/pre-op: Anxiety | Explanations that is given to patient will help decrease anxiety. |
| Common nursing dx and client goals as it is related to surgery/pre-op:Sleep pattern disturbance | Example, patient may have 6 weeks advance notice of surgery. The waiting & anticipation may cause anxiety. |
| Common nursing dx and client goals as it is related to surgery/pre-op: Ineffective coping | Within family, over-extended, things aren't getting done causing pt stress. |
| Common nursing dx and client goals as it is related to surgery/pre-op:Client Goals | Demonstrate why the patient needs surgery and how it is going to help them. |
| Client teach Pre-op: Preventative measures post-op | Explaining what will happen decreases post-op complications as a result of knowledge deficit. |
| Is it proper protocol for a doctor to explains surgery procedure to his patient and then asks him to sign an informed consent form. | It is improper for the doctor to obtain a signature for the informed consent form. As this is a form of coercion. |
| What are expectation of doctor when discussing surgery with a patient? | Surgeon has to explain what patient needs to be done. (ex. gall bladder need to be removed because, discuss different surgeries, what happens, etc). |
| Informed consent | Patient can't sign informed consent with a doctor, it has to be signed with a witness such as a nurse or whoever is setting them the day of the surgery. |
| Nurse is a patients advocate | Not all patients are competent (ex. elderly) - if nurse has doubts about how much the patient knows of the surgery, then they should contact the surgeon. |
| Informed consent - when patient signs. | Document explaining surgical procedure- by signing document, patient understands what they are getting themselves into. |
| Informed consent- Who signs? | Client and a witness such as a nurse or hospital tech...(anyone but the surgeon) |
| Diagnosis test (pre-surgery) | common tasks done before surgery, such as lab work (CBC, Electrolytes, chem 7, chem 12, etc) |
| CBC test - Diagnosis test that may be ordered before surgery. | Looks at the number of platelets |
| Electrolytes - Diagnosis test that may be ordered before surgery. | Looks at the Potassium & sodium level. |
| Chem 7 test - Diagnosis test that may be ordered before surgery. | is a group (such as BUN & creatinine level) of blood tests that provides information about your body's metabolism. Abnormal results can indicate such things as kidney failure. |
| Chem 12 test- Diagnosis test that may be ordered before surgery. | Frequently ordered panel of tests that gives doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins. |
| Coagulation Studies- Diagnosis test that may be ordered before surgery. | Test shows how quickly blood clots. This group of tests is known as a coagulation study, individually these tests are commonly referred to as a PT (Prothrombin Time), PTT(Partial Thromboplastin Time), and INR (International Normalized Ratio) |
| Blood Sugar - Diagnosis test that may be ordered before surgery. | Measures the amount of sugar in the blood. |
| X-ray, CT, MRI, Ultrasounds - Diagnosis test that may be ordered before surgery. | |
| EKG - Diagnosis test that may be ordered before surgery. | Usually done on patients over 40. |
| Urine tests - Diagnosis test that may be ordered before surgery. | Usually done on females during child bearing age. |
| Make sure doctors fax pt history, the last physical by internist or general pa | Example of pre-op interventions |
| Patient history has to be documented in chart. | Example of pre-op interventions |
| Make sure all test results are in clients file | Example of pre-op interventions |
| Make sure client is NPO for at least 6-8 hours before surgery (only exception is local anesthetics) | Example of pre-op interventions |
| If any pre-op meds ordered, given and documented as they were ordered usually done by anesthesiologist orders medicine | Example of pre-op interventions |
| Shave usually happens in surgery room before surgery while pt is under anesthesia. | Example of pre-op interventions |
| Enema is done 2 hours before surgery or go-lytly may be given to make sure colon is clean. | Example of pre-op interventions |
| Go-lytly | Replaces electrolytes as a result of diarrhea. |
| NG tube or catherterization are done after patient is under anesthesia. | Example of pre-op interventions |
| Patient needs to remove all jewelry - put tape over ring (if ring doesn't come off) | Example of pre-op interventions |
| Remove glasses and watches | Example of pre-op interventions |
| Exceptions can be made for patient to bring items to surgery such as stuffed animal. | Example of pre-op interventions |
| Make sure patient empties bladder want to prevent over distension. | Example of pre-op interventions |
| Depending on hospital policy, may need to remove dentures. | Example of pre-op interventions |
| Client Teaching related to insertion of tubes | Client should understand (IV, Foley, O2, NG tube) |
| Lasts from the time the patient enters the operating room to when the surgery is complete and the patient goes to the recovery room. | Interaoperative Care |
| A surgical team that takes special care of patient to ensure that no complications arise. | Interaoperative Care Team |
| Interoperative care team member: Surgeon | Responsible for ALL judgments related to client care. |
| Which member of the interoperative team can decide to change procedure after opening up a patient? | The Surgeon |
| T or F. There can be more than one surgeon as part of the interoperative team? | True. Sometimes there will be another surgeon at an equal level as the other surgeon. |
| Interoperative care team member: First Assist | This individual helps the surgeon(s) with surgical procedures. |
| Which member of the interoperative team can be first assist? | Surgical med students, or med students, nurses, technician or PA. |
| Interoperative care team member: Anesthesiologist | A doctor who administers anesthesia and meds to a patient while in surgery. |
| CRNA | Certified Registered Nurse Anesthetist-are anesthesia professionals who safely administer anesthetics to patients |
| Interoperative care team member: Holding Area Nurse | Must be an RN who greets patient, checks pt chart, asks pt what surgery they're having, assess anxiety level, & call anesthesiologists letting them know pt is in holding area. |
| Which interoperative care team member ID's patient, looks at name band, verify and ID everything to make sure right surgery, right pt? | Holding Area Nurse |
| Interoperative care team member: Circulating nurse must be RN only? T or F | T. This nurse must be RN only. |
| Sets up sterile OR room. | Interoperative care team member: Circulating nurse |
| Responsible for cathetrization. | Interoperative care team member: Circulating nurse |
| Responsible for positioning and documenting position in which patient is placed. | Interoperative care team member: Circulating nurse |
| Helps anesthesiologist | Interoperative care team member: Circulating nurse |
| obtains tissue specimen from sterile area, labels it, and gets to lab ASAP. | Interoperative care team member: Circulating nurse |
| Communicates with anything going outside of room. | Interoperative care team member: Circulating nurse |
| Watch for sterile techniques. | Interoperative care team member: Circulating nurse |
| Interoperative care team member: Scrub Nurse | Sets up sterile fields and hands instruments/equipment to surgeon (hand assist) |
| Interoperative care team member: Scrub nurse could be an LPN in some hospitals? T or F | True. |
| Interoperative care team member: Scrub Nurses could also be OR techs or scrub techs). T or F | True. |
| Anesthesia | Artificially induces state of partial or total loss of sensation , occurring with or without LOC. |
| Who decides what type of anesthesia is given to a patient? | Anesthesiologist. |
| Surgery type and duration of a procedure is irrelevant determining factor in how anesthesiologists select an anesthesia. | False. Type and duration drives the decision in which anesthetic to use to determine the type of anesthesia to give. |
| Determining factor used by anesthesiologist in selecting appropriate anesthesia. | Emergency: This is factored in if procedure is an emergency. |
| Determining factor used by anesthesiologist in selecting appropriate anesthesia. | Last time food was eaten: This is factored in when selecting the type of anesthesia to administer. |
| Determining factor used by anesthesiologist in selecting appropriate anesthesia. | Body area that is being operated on: This is factored in when selecting the type of anesthesia to administer. |
| A joint replacement, surgery on fractured hips, etc are examples of factors used by the anesthesiologist on which type of anesthesia to administer to a client. T or F | True. The body area that is being operated on is factored into this decision. (i.e. Spinal anesthesia numbs the lower extremity and is appropriate for surgical procedures in those areas) |
| Methods to ensure client safety during interoperative care. | Traffic flow is controlled w/four zones. 1. Holding area 2. Clean area 3. Dirty area 4. Sterile area |
| Traffic flow control zone one: Holding area | Family members are okay, street clothes are ok. |
| Traffic flow control zone one: Clean area | Sterile area begins. No family allowed, no street clothes. |
| Traffic flow control zone one: Dirty area | Surgical scrub, using a sponge or brush and antimicrobial soap;remove dirt/oil & microorganisms from hands and forearm...do this until "surgically clean". |
| Traffic flow control zone one: Sterile area | Within OR; Personal are required to masks, caps, gloves, sterile gowns, etc. |
| T or F. A method to enusre client safety is to scrub 10 minutes for first surgeries, and then scrub 3 minutes between cases. | True. |
| Surgical scrubs are required because they are considered sterile. | Method to ensure client safety during interoperative care. |
| 10 minute handwash and then 3 minute wash between cases. | Method to ensure client safety during interoperative care |
| Remove jewelry (rings, etc) can't be worn by any surgical staff. | Method to ensure client safety during interoperative care |
| Patient covered with sterile drapes. | Method to ensure client safety during interoperative care |
| Patient must be identified. | Method to ensure client safety during interoperative care |
| Patient identified the site of the surgery. This is done with anesthesia. | Method to ensure client safety during interoperative care |
| Surgeon identified the site of surgery. | Method to ensure client safety during interoperative care |
| Patient positioning is done by the circulating nurse- and must be documented. | Method to ensure client safety during interoperative care |
| Sponge and instrument counts before used, as they are thrown away, and maybe counted a third time by circulating nurse and surgery tech. | Reasons for OR protocols during the interoperative care. |
| Reasons for OR protocols during the interoperative care. | Scrubbing, maintaining sterile field, counting instruments and sponges are all done for patient safety. |
| Pre-op assessment; vital signs | Assess for abnormalities with temp, pulse rate, respiration rate, Blood pressure. |
| Pre-op assessment; previous surgeries and hospitalizations | Determine patient familiarity with surgery. If pt had previous surgeries, its good to know their experience or complications. |
| Malignant hypothermia: Can be prevented if caught during Pre-op assessment. | This condition is a result of combination of anesthesia given to patient who lacks enzymes, resulting temp to increase- high temp will likely cause death if not dx in time. |
| Malignant hypothermia: preventative measures | Give patient dantrum pre-surgery. |
| Pre-op assessment; respiratory-lung sounds. | Patient has to be able to breath out anesthesia. |
| General anestesia | Reversable unconcious state characterized by amnesia (no recollection), analgesic (no pain), depression of reflexes, muscle relaxation & homeostasis. |
| Anestesiologist usually give a combination of drugs. | they may start out with versed, then follow up with a barbituate, then inhalation anesthetics. |
| What happeneds toward the end of surgery | Patient will be awaken with in five minutes or longer |
| Regional anestesia | Reversable;loss of sensation in a specific area or region of the body. |
| Local anestesia | Is injected pursposely to block or to anethesitize nerve block. |
| Spinal, epidural, cottal anesthesia | Examples of regional anesthesia. |
| Femoral block | Numbs groin to leg. |
| Brachial block | Numbs arm. |
| Conscious sedation | Drug induced depression of consciousness during which patients can respond to verbal commands. Fairly light to deep sedation. |
| During Conscions sedation | patient can respond to verbal commands, will have no recollection of what happened during surgery. Patient can maintain airway and vital signs remain stable. |
| Local anestesia uses | It is used for pain. |
| Monitor anesthesia | similar to conscious sedation except it is fairly deep type of sedation |
| Regional block | Surgery with regional block are used for hemaroid surgeries. |
| Balance anesthesia | patient vital signs remain normal and multiple drugs are used. |
| Adjunct meds used during surgery and usually start in the holding area. T or F | T. Adjunct meds are given in holding area to help reduce anxiety. Benzodiazepines may be given up to an hour before surgery by an anesthesiologist. |
| Benzodiazepines - preanesthetic drugs | aka versed. This is generally administered in the holding area to help with anxiety. It causes perioperative amnesia. |
| T or F. After the surgery it isn't required to give pain meds (opiods) to a patient. | True. Patient may not need pain meds at that time. |
| Muscarinic antagonists - preanesthetic drugs | Anticholinergics drugs used preoperatively to dry secretions and reduce suction during surgery. |
| Heparin - pre-anesthetic drugs | Mini-dose given subq 1/2 hour before surgery. It helps to prevent blood clots. |
| Other Pre-ansethetic drugs | Atropine (reduces secretions of respiratory tract) and robinul (reduces gastric secretions)& sometimes an antibiotic. |
| During balanced general anesthesia | Neuro muscular blocking agents are given and they totally paralyze the patient. |
| During balanced general anesthesia, patient has a known history of nausea | To prevent nausea, the anesthesiologist will give an IV push of anti-emetic drugs 10 minutes before surgery is over. |
| Nursing dx pertinent during OR : High risk for injury | Patient is unable to tell what is happening if they are having an allergic reaction. |
| Nursing dx pertinent during OR : High risk for injury | High risks due to adverse affects of anesthesia, interop positions, immobilization causing skin breakdown. |
| Nursing dx pertinent during OR : Impaired skin integrity | Related to pressure due to immobility from the surgery itself. |
| Impaired Tissue integrity | Nursing dx pertinent during OR |
| Fluid volume defecit | Nursing dx pertinent during OR |
| High risk for infection | Nursing dx pertinent during OR |
| Fear | Nursing dx pertinent during OR |
| Nursing dx pertinent during OR : powerlessness | Powerlessness my happen in Pre-op while in OR suite. This is why anesthesia is given before surgery to help avoid such feelings. |
| PACU | Post Anesthesia Care Unit- Anesthesiologists are responsible for patient as they wake up. |
| PACU | Scrubs only, family is not allowed while patient is waking up. |
| While in PACU, patients will not show anxiety even if they were anxious before the surgery. | False. A pt who is anxious before hand, may be anxious after surgery. |
| During PACU the anesthesiologist monitors respiratory | True. In order to get rid of the anesthesia in the system, patient needs to breath out. |
| During PACU, it is common for patients to be flexible and feel really good. | False. Patients may be stiff and achy following a surgery because of the length of time being on the table. |
| During PACU it is observed that different people have different reactions to anesthesia. | True. Some people wake up slower than others, some may vomit. |
| During PACU the anesthesiolgist is only looking at the effects of drugs and nothing else. | False. They observe to see if patient has regained joint and limb mobility |
| During PACU, patients need to know english to understand instruction. | False. It is important to know patients primary language, and if needed, obtain a translator to help with instructions, such as taking deep breaths. |
| During PACU, if the patient can't hear or has visual problems, then too bad. | False. It is good to know if the patient has hearing or visual problems so that the anesthesiologist can use alternative methods of communication. |
| During PACU, patient is held there to look for complications or expected outcomes. | True. i.e. the surgery took longer than expected due to complications, and it may not be unusual to see blood in urine as result. It would be unusual if surgery happened without a hitch. |
| Post-op care- nursing assessment/intervention while in PACU | Stable VS, Pulse ox, temp- Check every 15 minutes, make sure pt is maintaining airway. |
| Post-op care: overt bleeding | observe if bleeding is visible, or JP drain is filling up too quickly. it is normal to see blood, but if the dressing is soaked with blood, notify surgeon. |
| During post op care, nurse should check dressing & drains every 5, 10, 15, 20 minutes? | Check dressing and drains every 15 minutes. |
| During post op care- nurse observe dressing is saturated and should replace it immediately. | False. The nurse must notify doctor if dressing is saturated. |
| During post op care, nurse observes that the drainage container is not filling up. Is this a problem. | No, this is normal. Drainage container should not be filled. Something is not right if it fills up too quickly. |
| serosanguineous drainage | Sero = Clear sanguineous = bloody. Clear bloody drainage and should not be clotting. |
| Purpose of serosanguineous drainage | Surgeons preference to allow wound healing at the deepest part of the incision. |
| Post op care- why is it important for the return of gag reflexes? | Will have suction until they can swallow. |
| During post op care a patient is snoring, and the nurse walks away knowing its okay since this patient has a history of snoring. | False. Could mean the patient has partial airway obstruction. Tilt head back and lift chin to clear the airway. |
| Nurse observes a patient is gurgling. | Pt needs to be suctioned. |
| During post op, the nurse should count respiration's to see how well lung is functioning. | True...nurse is looking for airway patency and should instruct pt to take deep breaths the help increase pulse ox. |
| During post op, the nurse checks for peripheral circulation. | nurse looks at cap refill of finger and toes. The temp of either extremities should be warm to the touch, especially if they had leg or arm surgery. |
| During post op, the nurse looks at fluid volume. | In PACU, IV rates established with pumps- the PCA pump is set up in PACU. |
| During post op, the nurse should check LOC | Nurse observes if the patient is awake and alert, can they take deep breaths, and whether or not their LOC is increased. |
| During post op, while the pt is in PACU, anesthesiologists orders pain meds | Anesthesiologist makes sure pt is breathing well on their own, if patient is sleeping, then there is no sense to order pain meds. |
| During post op in PACU, vomiting and nausea. | Knowing which meds to give pt will help with this condition. |
| Common nursing diagnosis : Fluid volume defecit | Vomiting and nausea prevents patients from taking in adequate fluid and food..may prevent them from getting treatment such as heparin- can't get this until the nausea is gone. |
| Common nursing dx: Constipation | R/T meds, anesthesia, immobility. Are usually given a stool softner 2 x per day till discharge. Tell them how to avoid constipation. |
| Common nursing dx: Knowledge defecit | Patient needs to know side effect of pain meds. R/T peri-op period or post-op home care. |
| Nursing assess/interventions to prevent complications: Respiratory exercises | Cough and deep breath. |
| Nursing assess/interventions to prevent complications: suction | Nurse assess what drainage looks like, how much is in it, etc. |
| Nursing assess/interventions to prevent complications: dressings | Dressing changes need to be done. Avoid oinments as they prevent airflow. |
| Nursing assess/interventions to prevent complications: measure drainage | Document the amount of drainage. |
| Nursing assess/interventions to prevent complications: administer analgesia | Nurse should administer pain meds prn. |
| Nursing assess/interventions to prevent complications:Client and family teaching | Before pt goes home, pt and family need to be taught how and what to do in order to provide proper care at home. |
| Nursing assess/interventions to prevent complications: Client and family teaching | Prevention of infection |
| Nursing assess/interventions to prevent complications: Client and family teaching | Advise pt not to swim, sit in hot tubs or get the bandage wet as this increases the chance of infection. |
| Nursing assess/interventions to prevent complications: Client and family teaching | Family should replace dressing after shower don't put ointments/cream unless prescribed |
| Nursing assess/interventions to prevent complications: Client and family teaching | Family should report signs such as color change, discharge, etc from wound |
| Nursing assess/interventions to prevent complications: Client and family teaching | Pt diet should have increased fiber (pain meds cause constipation)vegetables, fruits (especially apples, pears with skin on). |
| Apple cider & bran flakes | Nurse can advise pt to drink & eat this because it helps with constipation. |
| Nursing assess/interventions to prevent complications: Client and family teaching | pt and family should be taught about drugs and advise them to stay away from tylenol, because a lot of pain meds contain tylenol. |
| Nursing assess/interventions to prevent complications: Client and family teaching | Advise pt not drive, sign or make legal decisions. |
| Post op meds: Stool softeners | These are ordered to help return GI function |
| Most common stool softener given postop | Colace. This is most commonly given to pt post surgery. It's a stool softener & laxative. mixes fat & water in stool. Helpful for recent rectal surgery, people w/ heart problems, high BP, hemorrhoids, hernias, women who've had babies. |
| 2nd most common stool softener given postop | Peri-colace. It contains senna or sennacide. a stool softener plus a stimulant laxative |
| 3 common stool softner given post op(if colace and peri colace aren't effective) | Saline laxatives, such as milk of magnesia. Pulls fluid into digestive track and it takes about 8 hours to work. Usually people take this at bedtime and in the morning they poop. |
| 4th common stool softener given post op if colace, peri colace and saline laxatives won't be effective) | Dulcolax suppository. It is a stimulant given prn for people with incisions- causes contractions in rectal area. only works on the rectal area. |
| 5th common stool softener given post-op - but is rarely used. | Fleets enema is done prn |
| 6th common stool softener given post op | Bulk laxatives such as metamucil. These are usually given to elderly people. the disadvantage is that it takes days to work and because of this is not used post op |
| Nursing responsibilities for post op meds | Pt may need to take vitamins such as iron, calcium that is ordered by the physician. it all depends on surgery and the doctor. |
| Theragan M | Most common multi-vitamin w/ minerals. Mainly given to elderly people. |
| Nursing responsibilities for post op meds is to see if pt needs heparin | Heparin is ordered to prevent blood clots (DVT's) and are given subq. |
| Aspirin vs. Heparin | Some doctors avoid heparin and will only prescibe aspirin. To prevent blood clots in legs and arms, pt needs to be given either 81 mg or 325mg. |
| Nursing responsibilities for post op meds is to see if pt needs antibiotics | Antibiotics are given to those with drains and may need to take them till drain is improved. Some pts are given antibiotics upon d/c |
| Nursing responsibilities for post op meds is to see if pt needs muscle relaxants | If ordered, nurses will administer to patients who've had neuro surgery |
| Nursing responsibilities for post op meds is to see if pt needs antispasmatice | These are usually given for patient who've had urinary surgery. |
| Nursing responsibilities for post op meds is to see if pt needs hormones | Usually given to pts who've had a hysterectomy. |
| Nursing responsibilities for post op meds is to see if pt needs GI drugs | Given to patients who've had GI surgery. |
| Nursing responsibilites for post op meds related to narcotics. | Need to know pain level, location and type of pain. |
| What does a nurse to know to determine appropriate intervention of what pain meds to give? | Level, location, type of pain, and count respirations. Knowing this info will help the nurse now how many meds to give pt, and how much they've had already. |
| Post-op pain mgmt: PRN pain meds | Come in either combination, inject or oral. |
| Post-op pain mgmt: PRN pain meds advantage | Pt doesn't get over-medicated &/or patient doesn't want or need them. |
| Post-op pain mgmt: PRN pain meds disadvantages | Pt doesn't get instant relief, pain will build up to intolerable levels - if it goes to high ten pain meds may not be effective & pt still have pain. |
| Patient controlled analgesic; narcotic is at bedside and dose is controlled by pt | Post-op pain mgmt: PCA Pump |
| Post-op pain mgmt: PCA pump advantages | Pain relief is immeadiate, pt controlled, pt's tend to use less overall narcotics, and pt has better pain relief. |
| Post-op pain mgmt: PCA pumps disadvantage | Pt has to be physically and mentally able to push pca button; it always IV, and while on PCA, pt can't have oral, even if they need it. |
| Post-op pain mgmt: PCA pumps disadvantage | Dosage is limited in quantity; doc determines how much and how many doses pt can have- result may ineffective pain relief. |
| Post-op pain mgmt: PCA pumps disadvantage | Pt has to be hooked up to an IV; all the tubes make it hard for pt to move around |
| Post-op pain mgmt: PCA pumps disadvantage | More record keeping for the nurse. |
| Post-op pain mgmt: PCA pumps disadvantage | Pt needs to be taught how to use it, and may need reminder on how to use it. |
| Catheter placed in back and numbs specific area; done by an anesthesiologist. | Post-op pain mgmt: Epidural |
| Post-op pain mgmt: Epidural | Depending on facility, some nurses can inject pain meds into cath- while only anesthesiologists can do this at other facilities. |
| Post-op pain mgmt: Epidural/pain pumps advantages | Pain pump is used frequently by outpatient surgery. Catheter is used to provide controlled amount of anesthetic which sits deep into the incision. |
| Post-op pain mgmt: Epidural/pain pumps disadvantage if not handled properly. | This is a temporary device and should be removed within 48-72 hours- but not more than 5 days as pt risks getting an infection. |
| Post-op pain mgmt: Epidural/pain pumps advantage | This device numbs area. |
| Post-op pain mgmt: Epidural/pain pumps disadvantage | Installing this is an invasive procedure and there is an increase risks and complications. |
| Post-op pain mgmt: Epidural/pain pumps disadvantage | Limits pt mobility and decreased ability to control pain. |
Created by:
Wends1984
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