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SOPN Surgical Nursin
SOPN Surgical Nursing 2
Question | Answer |
---|---|
nursing care of the patient who requires surgical intervention | peri-operative nursing |
the period before nursing | preoperative |
period during surgery | intra-operative |
the period after surgery | postoperative |
written permission to perform surgery | informed consent |
patient may sign informed consent if they are found to be: | mentally capable and of legal age |
involve a limited body area and short period of time to complete the procedure | minor surgical procedure |
involve a larger body area and require a longer period of time. RISK IS GREATER | Major surgical procedure |
performed IMMEDIATLY to save a patients life, to maintain organ function, or to remove a non-functioning organ that may endanger a patient's life or stop hemorrhage | Emergency surgery |
Performed within 24-48 hours and includes procedures such as removal of a kidney or uretheral calculi | Urgent Surgery |
surgery that must be performed but is scheduled ahead of time | Required Surgery |
Surgery that involves a condition which surgery is recommended but if not performed there would be NO ill effects | Elective Surgery |
surgery is performed on the basis of the patients choice. Cosmetic surgery | Optional Surgery |
For the love of god before surgery find out if the patient is allergic to | LATEX!!! |
what herbal supplement is used for depression that could affect surgical outcomes | St Johns Wort |
Elective Surgery will be postponed of the patient has: | elevated temperature, skin leisons, sore throat, cough, or sneezing |
would delay wound healing and increase risk of infection | Immunosuppressant therapy |
Would someone with Chronic infections have their surgery cancelled? | Nope |
Patients with WHAT condition have an increased risk of complications because the patients ability to adjust to alteration in fluid balance and blood loss is compromised because of their status | Cardiac Disease |
Patients with unstable angina, recent MI, cardiac dysrthymia , or valvular disease should do what before surgery | have symptoms under control |
what would cause a risk for fluid and electrolyte imbalance from altered excretion of waste products and fluid retention | Impaired Renal Function |
Who will require dialysis the day before surgery and as soon as possible after the surgery to reduce accumulation of toxic materials | Patients who are on dialysis |
what is necessary for detoxification of drugs adn for the production of clotting factors | adequate liver function |
what disorder must be treated pre-operatively to prevent hormone imbalances triggered by stress or anesthetic agents | Endocrine Disorders |
what endocrine disorders would place the patients at risk for infection, impaired wound healing, and cardiovascular complications? | Patients with Diabetes, chronic thyroid, or adrenal disorders |
Disorder increases the risk for impaired respiratory function. Anesthesia and the stress of surgery may exacerbate disorders like epilepsy, MS, myasthenia gravis | neurological disorders |
what increases the risk of hemmorrhage | aspirin and anticoagulants |
what increases teh risk of fluid and electrolyte imbalances | diuretics |
Patient should bring what in a "BROWN BAG" | all meds both prescription and non-prescription |
withdrawl form what could cause malnutrition and clotting disorders. Platelets may be reduced and cause bleeding problems. | Alcohol |
bleeding from the GI Tract could be from | esophageal varicies, gastritis, or hemorrhoids |
what irritates the respiratory passages, destroys cilia, and decreases vital capacity | Smoking |
Patients unable to cough effectively to clear secretions increases risk for | pulmonary tract infections and atelectasis |
patients are encouraged to quit smoking how long before surgery | 6 weeks |
patient with upper or lower respiratory tract infection would have their surgery? | postponed due to increased risk of airway obstruction and post-op atelectasis |
what would you do for a patient w' a history of pressure ulcers during surgery? | Xtra Padding |
What period begins with the recommendation for surgery and ends with the patients admittnce into the operating room | Pre-operative period |
when are diagnostic studies completed, teaching started, and underlying disorders are stabilized. Consent is obtained | Pre-Op |
NPO at least 8 hours prior to surgery to prevent | aspiration |
prep cannot begin until what are written | ORDERS |
Tape to finger and document in record. SIGN | Wedding ring |
Who is responsible for obtaining consent | Doctor and Anesthesiologist |
*depress the respiratory and cardiovascular system and decrease gastric motility which can cause N/V* | Narcotics |
*Reverses respiratory depression and should be available at all times* | Narcan or naloxone hydrochloride |
*prove sedation and rarely cause post-op N/V. They may help reduce aanxiety & apprehension.* | Benzodiazipine ie: Valium |
*Benzodiazipine antagonist - reverses respiratory depression* | flumazenil |
potentiate a sedative effect also given for nausea | antiemetics ie reglan, tigan, and compazine |
provides sedation, relief of anxiety and decrease nausea. Also increases the action of other meds therefore decreased dose of anagelsic can be administered | Antihistamines |
help reduce oral, respiratory and gastric secretions to facilitate intubation | anticholinergics ie Atropine |
used for pre-op for its relaxation effect. Helps reduce anxiety. Normal dose 50-100mg IM | Demerol |
8-10mg IM or subcutaneous | Morphine Sulfate |
5-10mg IM or IV anesthesia | Valium |
includes local, nerve block or epidural or spinal. Temporarily blocks transmission of pain and sensory nerve impulses from specific part of the body | Regional Anesthesia |
RARE side effects could include spinal headache following spinal anesthesia | Complications of Anesthesia |
Anesthesia produced by injection of an agent into a vein or by inhalation | General Anesthesia |
Stage where patient becomes detached from the world. Can experience buzzing in the ears, CAN BECOME AWARE THAT SHE/HE CANNOT MOVE EXTREMITIES | Stage 1 anesthesia |
stage of excitement when the patient might struggle, shout, laugh, cry, can be avoided through slow even administration | Stage 2 anesthesia |
stage of SURGICAL ANESTHESIA or the operative stage when a patient is unconscious, has quiet relaxed muscles, sm pupils that still respond to light. Can be maintained for a long time if color good and vitals stable | Stage 3 anesthesia |
Stage of DANGER reached from too much anesthesia OBSERVE PATIENTS VITALS | Stage 4 anesthesia |
Produces rapid induction. The advantage is the ability to control the depth of anesthesia by controlling the rate of which the agent enters and exits the lungs. Administered through mask or endotracheal tube | Inhalation |
Inhalation anesthetics are primarily eliminated though the body via | Respiratory System |
What causes rapid onset of unconsciousness and may be administered alone or in combo with inhalation agents | Intravenous - general anesthesia |
They must be metabolized by the liver before they are excreted by the kidneys | disadvantage to intravenous meds |
Once injected, intravenous meds cannot stopped unless you have........ | the ANTIDOTE, Mr. Bond!!!! |
Where do you keep your gloved and oh so sterile hands? | above the waistline and in front of you |
The failure to provide adequate cellular oxygenation accompanied by failure to remove waste products leads to what condition? | SHOCK |
decreased fluid volume leads to what condition | hypovolemic shock |
cardiac failure leads to what condition | Cardiogenic shock |
failure of arterial resistance, neuron, stimulation to blood vessels is disrupted causing dilation leads to what condition | neurogenic shock |
septicemia leads to what condition | septic shock |
what must you report immediatly as it may be a sign of pulmonary or cardiac problems | Any cardiac complaints |
complete return of sensation to what body part indicates that the patient is recovered from expected effects of anesthesia | TOES |
Most common reason for shock | hemorrhage |
hemorrhage that occurs at the time of surgery | primary |
hemorrhage that occurs in the 1st few hours after surgery | Intermediary |
hemorrhage that occurs sometime after surgery | Secondary |
capillary hemorrhage | slow going |
venous hemorrhage | bubbles out, dark in color |
arterial hemorrhage | bright red, appears in spurts |
concealed hemorrhage | cannot be seen, perineal cavity |
evident hemorrhage | can be seen |
inflammation of the vein | femoral phlebitis |
clot in the vein | thrombosis |
how would you treat a femoral phlebitis or thrombosis | anticoagulants, elastic stockings, or ligation of the clot |
mucous plug closes off one of the bronchi entirely, the pulmonary tissue collapses | ateletasis |
productive cough, no elevation of pulse or temp, happens 5-6hrs after surgery | bronchitis |
productive cough with increased temp, pulse, and respiration rate | bronchopneumonia |
seen in old and weak patients: stagnation of secretions at the base of both lungs, slight cough, slight increase in temp, pulse, and respirations | hypostatic pulmonary congestion |
(less frequent) no cough, difficulty breathing, chill w' increased temp, pulse, and respirations | lobar pneumonia |
acute, knife like pain when patient takes a deep breath, slight increase in temp, pulse, and respirations | pleurisy |
prevention of bronchitis | cool mist |
prevention of pneumonia | fluids, expectorant, antibiotics |
prevention of pleurisy | analgesics |
bleeding beneath the skin, resulting in a clot. Sm clots may be absorbed but lg clots may need to be removed | hematoma |
Symptoms: increased temp and pulse. WOUND is tender, swollen, and warm | Wound Sepsis |
excessive growth of a scar, unexplainable, unpredictable, and unavoidable in some individuals | keloid |
An older patient with a lower basal metabolism and loss of subcutaneous fat is at a higher rish for | hypothermia |
what drugs can cause confusion and disorientation especially in the elderly | Morphine, benzodiazepines, and barbiturates |
what simple job after discharge would help reduce anxiety and prevent errors after discharge | follow up phone call the answer questions and reinforce instructions |