NUR171
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| what comes after ABC in surgical pt? | NGSP. neuro, genitourinary, sugical site, pain
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| why do we assess motion sickness in pre op pt? | b/c of twirling
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| why do we assess for family that have had problems w or died during surgery? | have inherited gene. lack esterase enzyme, drug doesn't come out x 48h
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| why are pt npo for surgery | prevent aspiration
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| for what surgeries are general anesthesia the anesthesia of choice? | abd/deep surgeries
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| is sersanguanous drainage on asurgical dressing always a bad thing? | no, it is a normal part of healing
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| why is it essential to ambulate your pt asap after surgery? | GI peristalsis, DVT, circulation
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| paralytic ileus is a post surgical complication. what is it, what causes it? how can we prevent? | In paralytic ileus, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and fluid through the digestive system. can create blockage. Make NPO and bowel rest.
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| list and describe post op complications assoc w surgery. how will you prevent? | Water, wind, wound, DVT. Assess frequently.
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| what is your responsibility in obtaining informed consent? what do you do if the pt has questions? | Nurse is a witness, makes sure pt understands what they are signing. if pt has questions about surgery, get dr.
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| develop a teaching plan that differentiates btwn general, regional, and concious sedation anesthesia | General anesthesia is loss of sensation with loss of conciousness,can lose vent/CV function, so ET tube. Regional involves spinal block. sedation can be done by nurse
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| identify important part of surgical consent | 1.adequate disclosure of dx. risk and consequences of tx. 2. pt must demonstrate clear understanding. 3.pt must give consent voluntarily. Consent can be withdrawn at anytime before procedure.
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| what is nurses primary role in all stages of peri-op experience? | pt safety
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| 6 important things to verify complete before sending someone off to surgery or procedure | NPO status, consent signed, allergies, meds, H/P, labs
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| urinary retention is post surg complication. what is it, what causes it, how can we prevent? | anesthesia causes it. assess early, can give meds. must pee before leaves o/p surgery
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| explain health problems (meds) that increase surgical risk | coumadin, glucocorticoids, dm, smoker, htn, obesity.
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| explain most common psychological factors assoc w surgery... | fear, anxiety, stress
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| when does post op get water? | when we hear bowel sounds, pt can swallow, and w dr order.
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| what is general rule for medicating your pt for 24 hours post surg | opioid analgesics and nsaids. after that non-opioid can be used w nsaids.
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| when does the post op pt get food? | when hears bowel sounds, and can swallow.
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| what is #1 post op assessment | AIRWAY!
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| When is pre op check list started? | can start as soon as in dr. ofc., or when pt gets there, to pre op
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| explain how we prevent Water, Wind, Wound, and DVT | TCDB, ambulation, avoid cath, check lung sounds, incentive spirometry, assess frequently
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| why is it so imperative to assess bowel and bladder function post op | to prevent paralytic ileus, make sure they are back to baseline, make sure they are coming out of sedation ok.
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| post op has risk for respiratory acidosis. explain this risk. | anesthesia puts lungs to sleep, chest doesn't rise and fall, and CO2 gets trapped.
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| what post op complication is a smoker at higher risk of developing than non smoker | respiratory, like pneumonia,atelecasis, etc.
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| In addition to pain scale, how esle will you assess post op pain? | facial expressions, full bladder, vital signs, holding area that hurts, shallow breathing.
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| why is BMI calculated prior to surgery? when would the healthcare team be concerned? | Obesity increases risk of intubation problems, apnea, and short neck syndrome (difficulty getting ET tube down.
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| how is general anesthesia different from regional? | n general anesthesia, you are unconscious and have no awareness or other sensations. In regional anesthesia, your anesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery.
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| Difference btwn. local and 'twilight' sedation? | a local anesthetic may be injected into the skin and tissues to numb a specific location, like remove a mole. twilight is like concious sedation (regional w semi concious state)
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| what food allergy would alert you to a possible latex allergy | banana, avocado, tomato, apricot, tree nuts
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| why is egg allergy important info w pre op pt when we don't plan to feed them? | Propalol
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| what hx might lead to pre op anxiety? how can rn help decrease anxiety/ | lack of knowledge, fear. Educate pt.
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| what conditions may lead to evisceration of a a post op wound? | coughing without splinting, sudden twist or turn of body part, fall.
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| if a wound eviscerates, what will you do? | wet to dry dressing, call dr.
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| explain protocol of removing sutures, staples. | remove every other one, steri strip, then take off others.
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| explain diff btwn medical and surgical asepsis | Medical Asepsis - Clean - Reduces or inhibits number and growth of microorganism
Surgical Asepsis - Sterile - Eliminates all organisms, both pathogenic and non-pathogenic, including spores.
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| what is healthy BMI | 18-24.9
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| explain how we prevent DVT, skin bkdwn, and pna post op | ambulation, turn pt, incentive spirometer, assess pt, cough/db
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| how does dependency of glucocorticoid therapy affect pre, intra, post op care? | prolongs healing time, decreases inflammatory response, decreases immune response, increases BGL
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| when would dr choose regional over a general anesthesia? | depends on procedure...
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