Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
EXAM 1 MED SURG
Overview, Standards, Ethics, Roles
| Term | Definition |
|---|---|
| The scope of med surg nursing | manage multiple clients with varying diagnoses, including administering meds, educating patients and families, admitting and discharging, and completing treatments, tracking IV fluids and lines. |
| Med surg nursing requires | high level critical thinking skills, vast clinical knowledge and the ability to stay calm under pressure. Physically, emotionally, clinically and intellectually challenging |
| Perioperative Nurse | Provide comprehensive patient care, assisting surgeons and surgical teams to care for a patient before, during, and after surgery |
| Preoperative Phase | From the time the decision to proceed with surgical intervention is made, and ends with the transfer of the patient onto the operating room (OR) bed. |
| Intraoperative Phase | Begins when the patient is transferred onto the OR bed and ends with admission to the PACU. Responsibilities involve acting as a scrub nurse, circulating nurse, or registered nurse first assistant |
| Postoperative Phase | Begins with admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home |
| General areas of the preoperative phase | Preadmission testing, admission to the surgical center, and the holding area |
| Preadmission testing consists of | Assessment, education, interview, verifies completion of needed testing, verifies the understanding of the surgeon-specific orders, discusses and reviews advance directive document, begins discharge planning by assessing assumed needs |
| Admission to the surgical center consists of | Assessment, and assess for risks and complications, reports unexpected findings or deviations, verifies consent has been signed, coordinates patient education and plan of car, reinforces previous education, explains the phases and expectations, answers the patients or families questions |
| the holding area consists of | Identifies patient, assess patient status, baseline pain, nutritional status, reviews medical record, verifies surgical site marking, establishes IV line, administers meds if prescribed, ensures patients comfort, provides psychological support, communicates patients emotional status to other health care team members |
| The intraoperative phase covers | safety, physiologic, and psychological support |
| Safety consists of | Maintains aseptic environment, manages human resources, equipment, and supplies for individualized patient care, transfers patient to OR bed or table, positions patient based on functional alignment, applies grounding device, ensures that the sponge, needle, and instrument counts are correct, completes documentation |
| Physiological consists of | Calculates effects on patient of excessive fluid loss or gain, distinguishes normal from abnormal cardiopulmonary data, reports changes in vital signs, institutes measures to promote normothermia |
| Psychological support consists of | Provides emotional support to patient, stands near or touches patient during procedures and induction, continues to assess patient's emotional status |
| the postoperative phase covers | the recovery area |
| The recovery area consists of | Determines immediate response, monitors vital signs, and physiologic status, assess pain, and performs pain interventions, maintains safety, provides oral fluids, assesses patient's readiness for transfer to in-hospital unit or discharge |
| Gerontologic Considerations | Less physiologic reserve, cardiac reserves are lower, renal and hepatic functions are depressed, and GI is likely reduced. Important to be skillful in the preoperative assessment and treatment, proficient in anesthesia and surgical care, and competent in postoperative and post anesthesia can. Monitor pain, and encourage good communication |
| Bariatric Considerations | Obese patients have an increased risk and severity of complications. Fatty tissue are more susceptible to infection and separation. Shallow respirations when supine, increasing pulmonary complication risks, possible impeded intubation from short thick neck, large tongue, recessed chins and redundant pharyngeal tissue |
| Patients with diabilities | Pay close attention to positioning and transferring. Ensure proper education, and maintain assistive devices. People who are hearing impaired may need an interpreter by law for consent. May be unable to sense pain and painful positioning. |
| Emergency Surgery | May include a quick general assessment to identify all sites of injury if the surgery is due to trauma. Unconscious patients, need to have informed consent and essential information such as allergies and past medical history from a family member, if available. |
| Ethical Considerations | A patient must be of legal age and be mentally capable, and not have any language barriers to give consent. There are cases when a surgeon must operate as a lifesaving measure without a patients consent. However, attempts must be made to locate the family. |
| Reasons surgery may be delayed | Fluid & Electrolyte imbalances, dental health, infections, allergies, cardiac and respiratory status, hepatic and renal functions, immune function |
| Perioperative teaching | Gown, untied in the back. No hair pins. Dentures removed, no jewelry or wedding rings, body piercings. Void immediately before going to OR. |
| Ambulatory surgical center | includes out patient, same-day, or short-stay surgery not requiring admission for an overnight hospital stay but may entail observation in a hospital setting for 23 hours or less |
| Nursing Process | Assessment, Diagnosis, Planning, Interventions, Evaluation |
| Valid Consent | Legal age, mentally capable, and before medications |
| Incompetent patient legal definition | An individual that is not autonomous and cannot give or withhold consent, such as cognitively impaired, mentally ill, or neurologically incapacitated. |
| Preoperative care | Safety, preadmission testing, admission to surgical center, care for patient in holding area, obtain consent, health history, allergies, testing, labs, and current meds, review expectations and orders |
| Intraoperative Care | Maintains aseptic environment, manages human resources, equipment, and supplies for individualized care. Transfers patient to OR bed or table, positions patient, applies grounding device, ensures that the sponge, needle, and instrument counts are correct, completes documentation |
| Postoperative Care | Communicates info such as patient name, type of surgery, type and amount of meds, reports vital signs, describes factors such as drains, catheters, blood, describes physical limitations, reports LOC, communicates needs, and presence of family members |
| Circulating Nurse Role | Coordinates care of the patient in the OR. Planning for and assisting patient with positioning, preparing site for surgery |
| Scrub Nurse Role | Provides sterile instruments and supplies to the surgeon during procedures by anticipating the surgical needs as the case progresses |
| Surgeon Role | Performs the surgical procedure, heads the surgical team, and is licensed physician, who is specially trained and qualified. |
| Anesthesiologist Role | Administers the anesthetic agent and monitors the patient's physical status throughout the surgery |
| Patient Role | Fears can increase the amount of anesthetic medication needed, the level of postoperative pain, and overall recovery time. |
| Intraoperative Nursing Assessment | Physical and physiological status, vital signs, ethical concerns |
| Intraoperative Nursing Diagnosis | Anxiety, risk of latex allergy, risk of perioperative positioning injury, risk for injury related to anesthesia and surgical procedure, and risk for compromised human dignity |
| Intraoperative Nursing Planning | Reduce anxiety, absence of allergies, positioning injuries, freedom from injury, maintenance of patients dignity and absence of complications |
| Intraoperative Nursing Interventions | Reducing anxiety, reduce latex exposure, prevent positioning injury, safety, patient advocacy |
| Cultural competence regarding surgery and complications that may arise | The nurse should be aware of medications that are prohibited by certain cultural groups , for instance some cultures apply their own surgical cap as the head is a sacred area. |
| Muslims & those of Jewish Faith, and Buddhists May not use which medications? | Heparin (Porcine or Bovine) |
| Focused Postoperative assessment | RESPIRATORY STATUS, monitoring airway, cardio function, skin color, LOC, vital signs every 15 minutes, ensures and maintains all IVs, lines, tubes. |
| Preventing respiratory complications in postoperative phase | To prevent administer supplemental oxygen as ordered, and assess respiratory rate, depth, and ease of breathing, oxygen saturation, and breath sounds. |
| PACU Phase I | Immediate recovery phase, intensive nursing care is provided |
| PACU Phase II | Patient is prepared for self-care or an extended care setting |
| PACU Phase III | Prepared for discharge |
Created by:
Nursing.Student.Help
Popular Nursing sets