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Perioperative
Ch. 38 Nsng 105
| Question | Answer |
|---|---|
| PERIOPERATIVE CH. 38 NSG 105 What is perioperative nursing | care before, during, after surgery |
| Surgical procedures are classified according to | seriousness, urgency, purpose of surgery |
| there are two classifications of seriousness | major- extensive alteration in body parts, great risks minor- correct deformities, min. risks |
| What are the three classifications of urgency surgery | elective- pt choice, not essential urgent- necessary for pt health, not emerg emergency- done to save life or preserve body part |
| What are the 7 purposes for surgery | diagnositc- confirm diagnosis ablative- amputation of body part palliative- tumor pressing on organ reconstructive/restorative procurement for transplant constructive- congential anomalies cosmetic |
| What are some surgical risk factors | smoking-pneumonia, atelectasis age-infant cold and low blood vol nutrition- 1500 cal obesity pregnancy immunocompetence fluid/electrolytes medical illness |
| What is malignant hyperthermia | inherited disorder, complication resulting in high CO2 levels, tachypnea, tachycardia, heart rhythm irregularities, muscular rigidity with high temps |
| what is the only treatment for malignant hyperthermia | Dantrium IV |
| What should be obtained in assessment before surgery | hx or surgeries, med hx, allergies |
| who is ultimately responsible for informing pt of surgery | dr and anesthesia care personnel |
| When should preoperative teaching begin for pt | About a week before admission and reinforced before surgery |
| The ASA recommends these guidelines about food and fasting before surgery | fast from clear liquids 2+ hours breast milk 4 hrs formula/milk 6 hrs meat/fried foods 8 hrs |
| To prepare pt for postoperative care what should the nurse try and do | not overprepare nor underprepare |
| what are some postoperative excercises | diaphragmatic breathing, incentive spirometry, controlled coughing, turning, leg exercises |
| when can pt remove hearing aids, eyeglasses, contact lenses | right before surgery |
| What is important about dentures | remove and assess for loose teeth, so don't get down endotracheal tube |
| what happens in teh preanesthesia care unit | insert IV, adm sedation |
| What does the AORN recommend | use electric or battery-operated clippers for hair removal |
| what are the two roles an OR nurse assumes | circulating nurse or scrub nurse |
| What are the duties of the circulating nurse | care for pt while in operating room by completing operative assessment, est and implement intraoperative plan of care, evaluate care, continuity of care postoperatively |
| What is the scrub nurse resopnsible for | maintina sterile field, apply surgical drapes, hands instruments, counts instruments,sponges,etc |
| what is duty of intraoperative nurse and what is goal | prevent injury and complications. Act as advocate, protect dignity and rights of pt Pt free of infection, pressure ulcer, injury, maintain body temp, maintain fluid/electrolyte balance |
| What is a "time out" | before procedure, surgical team does final verification of rt pt, procedure, site. Part of JCHO universal Protocol for Eliminating Wrong Site, Wrong Procedure, Wrong Person Surgery |
| What three things are done first to physically prepare for surgery | apply plastic electrodes on chest for EKG, next BP cuff, then PaO2 |
| What is general anesthesia | pt loses all sensations, consciousness, reflexes (gag,blink), amnesia. Major procedures and minor in children |
| what is regional anesthesia | loss of sensation in area of body, nerve blocks |
| What is local anesthesia | loss of sensation at desired site by inhibiting peripheral nerve conduction. Used with general and regional |
| what is moderate sedation or conscious sedation | Used for diagnostic or therapeutic procedures(colonoscopy)req. decr level of consciousness |
| What are two courses for postoperative phases | immediate recovery period and convalescence |
| What is the PACU | Post anesthesia care unit, immediately after surgery |
| what signs are found in pt who is coming out of anesthesia | gag reflex returns, hand grasp, mvmt of extremities |
| What is the critical time period for wound healing | 24 to 72 hours |
| For pts with indwelling catheters, how much output is expected | 30 mL/hr in adults, 1 to 2mL/kg/hr infants/children |
| When do normal bowel sounds return after surgery | in about 24 hrs |
| What is paralytic ileus | loss of fx of intestine that casues abd distention. Pt must pass gas |
| What three positive factors can occur with mgmt of pain after surgery | ambulation begin earlier, deep breathing and coughing less difficult, pt have better sense of well being |
| what is one of greatest concerns following surgery | airway obstruction from weakness of pharyngeal/laryngeal muscle tone, aspiration of emesis, accumulation of secretions in pharynx |
| what should you always check under the pt for | check under pt for drainage even if dx is not saturated |
| Pain after surgery is most intense when | First 24 to 48 hrs |
| Coughing is contraindicated in after what procedures | brain, spinal, head, neck, eye surgery b/c of intracranial pressure |
Created by:
palmerag
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