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Chapter 4
Preoperative
| Question | Answer |
|---|---|
| Obstructive sleep apnea | airway obstruction that causes periods of no breathing during leep |
| How is pregnancy a risk factor for surgical complications? | Fetal risk with anesthesia |
| How is Diabetes mellitus a risk factor for surgical complications? | Alters blood glucose levels Delays healing Causes impaired circulation Can cause infection |
| How is liver disease a risk factor for surgical complications? | Alters medication metabolism and incraeses risk for bleeding |
| How is kidney disease a risk factory for surgical complications? | Alters elimination and medication excretion |
| How are immune system disorders a risk factor for surgical complications? | Can lead to immunosuppresion |
| How is a coagulation defect a risk /for surgical complications? | Increases for bleeding |
| How is malnutrition a risk for surgical complications? | Delays healing |
| How is a BMI greater than 30 a risk for surgical complications? | Pulmonary complications due to hypoventilation, effect on anesthesia, elimination and wound healing |
| What is the nurses role in the process of informed consent? | To witness the clients signing of the consent form after the client acknowledges understanding of the procedure |
| What can the nurse discuss with the client regarding informed consent? | The nurse can clarify ant information that remains unclear after the providers explanation of the procedure. The nurse can not discuss any new or additional information not previously given by the provider. |
| How long should a client remain NPO from solids before surgery? | at least 6 hours |
| How long should a client remain NPO from liquids before surgery? | at least 2 hours |
| Why should a client remain NPO before surgery? | To avoid aspiration caused by anesthesia |
| What risk factors for surgical complications can be caused by hypothermia? | Hypothermia increases the chance for surgical wound infections alters metabolism of medication and causes coagulation problems and cardiac arrythmias |
| What must the provider explain to obtain informed consent? | -complete description of treatment -Description of professionals involved -Information on the risks of anesthesia -Description of anticipated benefits -Description of potential risks -Other options for treatment -The right to refuse treatment |
| A client legally capable of providing consent is: | -18 years of age or emancipated -Mentally capable of understanding the risks, reason, and options for surgery and anesthesia -Free from influence of medications or substances that affects decision making or judgement |
| When can two witnesses be required for consent? | -Client is only able to sign with an X -Client has vision or hearing impairment -There is a language barrier |
| What does a client have to do to give informed consent? | -Give it voluntarily -Receive enough information to make an informed decision -Be competent and legally capable |
| Diagnostic Surgery | Surgery to see what's going on internally and diagnosis a patient. |
| Curative Surgery | Surgery performed to resolve or repair the patient (cures the problem) |
| Restorative Surgery | Surgery to restore the patient back to their baseline |
| Palliative Surgery | Performed to relieve symptoms of a disease process but does not cure |
| Cosmetic Surgery | Performed to alter or enhance appearance |
| Elective Surgery | Planned surgery for non-acute problems |
| Urgent Surgery | Surgery that requires prompt intervention but can be delayed for 24 to 48 hours |
| Emergent Surgery | Requires immediate intervention because of life threatening consequences |
| Minor Surgery | Procedure without significant risk |
| Major Surgery | Procedure with greater risk |
| Simple Surgery | Surgery where only the most overtly affected area is involved |
| Radical Surgery | Extensive surgery, not just removing infected area but extending to areas that could possibly be affected |
| Minimally Invasive Surgery | Surgery performed in a body cavity or body area through one or more endoscopes |
| Why is the assessment such as important part of preoperative care? | Provides you with a baseline of the patient |
| Patient controlled analgesia (PCA) pumps | computerized devices that allow patients to safely self-administer pain medication (usually opioids like morphine or fentanyl) by pressing a button |
| What should you be aware of when giving steroids preoperative? | Steroids can cause immunosuppression increasing the risk for infection |
| What should you ensure you get when transferring a patient back from the PACU? | Set of Vitals |
| PACU | Post anesthesia care unit |
| What are the surgical suite zones | Unrestricted, Semi-Restricted and Restricted zone |
| Unrestricted Zone | Control desk area; street clothes may be permitted |
| Semi-Restricted Zone | Hallways and outer areas of the OR suite; clean scrub clothes and caps required |
| Restricted Zone | Area surrounding the operating table and instrument trays; sterility required |
| Scrub Nurse | Works within the sterile field. responsible for handling sterile instrument, supplies and counts |
| Circulating Nurse | Maintains patient safety and dignity acting as advocate for the patient, communication link between the OR and outside. Is not sterile but will verify the sterility is maintained. |
| Who is responsible for completing Time Out? | Circulating Nurse |
| "Time Out" | -Correct patient -Correct Procedure -Correct surgical site -Availability of necessary implants (if applicable) |
| General anesthesia | Induced loss of consciousness . Puts patient to sleep to point where they don't have control of airways |
| Regional anesthesia | Anesthetizes a local area of distal region -easily reversible |
| Local Anesthesia | Used for minor procedures, numbing of a small area |
| Moderate Sedation | Combines local and regional anesthesia. Used for procedures that can be done with local/regional anesthesia |
Created by:
kyebula