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Perioperative I


Is nursing given before (preoperative), during (intraoperative), and after surgery (postoperative)? Perioperative Nursing
Was the first nursing organization to develop structure, process and outcome standards as defined by ANA. Is the driving force for the practice of perioperative nursing? Association of periOperative Nurses (AORN)
Incision into peritoneal cavity to inspect abdominal organs? Laparatomy
Excision or removal of diseased body part? Ablation
Relieves or reduces intensity of disease symptoms; will not preduce cure? Palliative
ASA physical status classes 4 & 5 require? Inpatient Surgery
Also refered to as outpatient surgery, short-stay surgery, or same-day surgery? Ambulatory Survey
Influence the choice of anesthetic agents used, as well as the clients ability to tolerate surgery and reach full recovery? Preexisting illness
These clients are at risk during surgery because of immature or declining physiological status? Very young and old clients
Have an underdeveloped shivering reflex and often wide temp. variations occur with anesthesia? Infants
Normal tissue repair and resistance to infection depend of what? Adequate nutrition
A post-op patient require how many calories to maintain energy reserves? 1500 kcal/day
These facilitate wound healing? Increased protein, Vitamin A&C, zinc
How does preoperative stress effect the heart? Increase demands on myocardium to maintain cardiac output and general anesthetic agents depress cardiac function.
Stress of surgery causes ______ in blood glucose levels? Increase
This disease increase susceptibility to infection and impairs wound healing from altered glucose metabolism and associated circulatory impairment? DM
Predisposes client to F&E imbalances and may indicate underlying infection? Fever
Increase surgical risk by reducing ventilatory and cardiac function? Obesity
Embolus, atelectasis and pneumonia are frequent postoperative complications in this type of client? Obese clients
Frequent arousal during sleep, morning headaches, daytime somenolence and chronic fatigue are signs of what? Obstructive Sleep Apnea (OSA)
A patient diagnosed with OSA and is scheduled for surgery, should be asked to bring what with them to the hospital? CPAP or NIPPV
Ideally, how long do surgeons wait to perform surgery after completion of radiation treatment? 4-6 weeks
Severe protein breakdown causes what? Negative Nitrogen Balance
What happens as a result of adrenocortical stress response? Body retains sodium and water and loses K within the first 2-5 days after surgery.
Potentiate anesthetics if taken within 2 weeks before surgery? Antibiotics
These drugs reduce cardiac contractility and impair cardiac conduction during anesthesia? Antidysrythmics
Pre-op assessment for a pt. on anticoagulants? D.C. at least 48hrs before surgery.
This drug alters metabolism of anesthetic agents? Anticonvulsants
Affect platelet activity and increase susceptibility to postoperative bleeding? Ginseng, Gingko, Ginger (GGG).
Is reported to increase hypoglycemia with insulin therapy? Ginseng
This becomes elevated if a pts. is dehydrated? BUN 10-20 mg/100ml
What is the normal platelet count? 150,000-400,000/mm3
What is the normal PT? 11-12.5 seconds
Normal INR? 0.76-1.27
Normal APTT? 30-40 seconds
Normal RBC's? M and F? M= 4.7-6.1 million/mm3 and F=4.2-5.4 million/mm3
An option for some clients who choose to donate their own blood before surgery to reduce the risk of transfusion related infections and transfusion reactions? Autologus Infusions
What are some postoperative exercises? Diaphragmatic breathing, incentive spirometry, coughing, turning and leg exercises
Review of the preoperative plan of care, evaluating the care, establish and implementing the intraoperative plan of care and providing for continuity of care postoperatively? Circulating Nurse (RN)
Either on RN, a licensed practical nurse, or surgical technologist. Helps with surgery? Scrub Nurse or Tech
This is where you conduct a focused preoperative assessment to verify the client is ready for surgery and to plan intraoperative care? Preanesthesia Care Unit (PSCU)
What is the primary focus of intraoperative care? Prevent injury and complications r/t anesthesia, surgery, positioning and equipment use.
What are 4 types of anesthesia? General, Regional, Local, and Conscious Sedation
Results in an immobile, quiet client who does not recall the surgical procedure? General Anesthesia
What are 3 phases of anesthesia? Induction, Maintenance, and Emergence (IME)
Results in loss of sensation in an area of the body? Regional Anesthesia
What prevents paralysis during regional spinal anesthesia induction? Elevation of the upper body.
Involves loss of sensation at the desired site? Local Anesthesia
Routinely used for procedures that do not require complete anesthesia but rather a depressed level of consciousness? Conscious Sedation
A pts. postoperative course involves what 2 phases? Immediate recovery period and postoperative convalescence.
It is the _______ responsibility to describe the clients status, the result of sxg, and any complications that occurred? Surgeon's
An objective scoring system that helps identify when pts. are ready for discharge from PACU? The Aldrete score and Postanesthesia Recovery Score (PARS)
The staff nurse assuming care of a pt coming from PACU must do what in the presence of the PACU nurse? Take new set of V/S to compare with PACU findings.
Pts. must receive a composite score of ___ to ___ before discharge from PACU? 8,10
In this phase of recovery you initiate postoperative teaching with clients and family members? Phase II
A life threatening complication of anesthesia, which causes hypercarbia, tachypnea, tachycardia, PVC's, unstable BP, cyanosis, skin mottling, and muscular rigidity? Malignant Hyperthermia
An increased CO2 is one of the 1st signs? Malignant Hyperthermia
Segmental skin areas innervated by specific segments of the spinal cord? Dermatomes
This is the guiding principle when medicating older adults because of their slow drug-clearance capabilities? "Start slow and Go slow"
Pts. with known OSA should be placed in what position throughout the perioperative period? Lateral, prone, or side lying position.
Pain that is not amenable to analgesics and pain alleviated interventions? Intractable pain
How often do you administer analgesics after surgery to improve pain control? Around-the-clock, the first 24-48hrs
This is late sign of Malignant Hyperthermia? Elevated temp.
A medication used to treat Malignant Hyperthermia? Dantrolene Sodium
Clients need to void within ___ to ____ hours after surgery? 8,12
Pt. is admitted to the hospital? Inpatient
Pt. who goes to sxg the day of sxg and returns home on the same day (same day sxg)? Ambulatory (outpatient)
The purpose of using a vent for a brain dead pt? Keep major organs viable.
What type of sxg is used to repair cleft palate, or closure of atrial septal defect in the heart? Constructive Sxg
A bunionectomy, facial plastic sxg, hernia repair, breast reconstruction are what type of sxg? Elective Sxg
Do not send pts to sxg if they have what? Fever
How long are consent forms good for? 30 days
Created by: BOjangles1006