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H&C Ch 16 Post Op
H& C Ch 16 Post Op
| Question | Answer |
|---|---|
| When does the post op period start ? | When the patient leaves the OR |
| Which PACU phase describes: immediate recovery phase, intensive nursing care is provided | phase 1 |
| Which PACU phase describes: nursing care is less intense, the patient is prepared for transfer to an inpatient nursing unit, an extended care setting, or discharge | phase 2 |
| Who is responsible for the transfer of the post op patient from OR to PACU ? | anesthesiologist, CRNA or licensed member of the OR team |
| What ocurrs on admission to the PACU ? | Oxygen is applied, monitoring equipment is attached, and an immediate physiologic assessment is conducted |
| True or False : if the patient had an extensive surgery may be transferred from the OR directly to ICU, they do not need to go to PACU | true, p. 374 |
| Patients with obesity are at higher risk for ______ _______ ______ | obstructive sleep apnea |
| The primary objective in the immediate postoperative period is to : | maintain airway and prevent hypoxemia |
| Post operatively patients may have a relaxed tongue. What device can prevent obstruction of airway by tongue ? | OPA (oral pharyngeal airway) |
| The most common cause of hyptension and shock is ______ | blood and plasma loss |
| The types of shock are: | hypovolemia, neurgenic, anaphylactic and septic |
| The most common type of shock in the post op period is ________ | hypovolemia associated with hemorrhage |
| How can hypovolemic shock be avoided ? | timely administration of IV fluids, blood, blood products, and medications that elevate blood pressure |
| What is the primary intervention for hypovolemic shock is : | volume replacement with LR , 0.9% NS, colloids or blood therapy |
| A patient with hemorrhage presents as : | hypotensive, rapid thready pulse, disorientation, restlessness, oliguria, cold, pale skin |
| Primary hemorrhage occurs when ? | at the time of surgery |
| Secondary hemorrhage occurs when ? | sometime after surgery if wound closures slip or a blood vessel is bleeding |
| What are the differentiations of veseel hemorrhages ? (color of blood, rate) | CAPILLARY slow, general ooze VENOUS darkly colored flows quickly ATERIAL bright red appears in spurts with each heartbeat |
| Arrhythmias post op are associated with: | electrolyte imbalance, altered respiratory function, pain, hypothermia, stress, and anesthetic agents |
| True or False: family members may visit patients in the PACU | true p. 376 |
| What GI stiumulant is used to control postop nausea and vomiting ? | metoclopramide |
| What anti emetic is sued to control post op nausea and vomiting ? | ondansetron |
| What is the aldrete score used for ? | to determine the patient’s general condition and readiness for transfer from the PACU |
| before discharging the patient what instructions should be given ? | written instructions that include, medications, contact for surgeon, complications/signs and symptoms to report |
| Limited activity as a general rule is usually recommeded for how many hours post op : | 24 to 48 (limited means, not resuming FULL activity) |
| For pain and immediate post op restlessness what drug class may be prescribed ? | opioids |
| Prior to administering opioids post operatively the nurse must assess for : | level of sedation p. 382 |
| What are the 2 requirements for use of a PCA? | understanding of the need to self-dose and the physical ability to self-dose |
| if the patient has an indwelling Foley catheter and urinary output has decreased or stopped, what is the FIRST step to take ? | check tubing for kinks, check for obstruction then notify surgeon if continues |
| Why is early ambulation important ? | reduces risk of complications for atelectasis, hypostatic pneumonia, gastrointestinal [GI] discomfort, circulatory problems |
Created by:
Kelly Quijano
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