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
AH3-Ch. 18
Preoperative Care
| Question | Answer |
|---|---|
| Surgery can be defined as? | the art and science of treating disease, injuries, and deformities by operation |
| What 4 people interact in surgery? | nurse, pt, surgeon, and anesthesia care provider |
| What are the 6 reasons surgery may be performed? | Diagnosis, Cure, Palliation, Prevention, Exploration, and Cosmetic improvement |
| What is surgery for diagnosis? | determination of the presence of pathology |
| What is cure surgery? | Elimination or repair of pathology |
| What is palliation surgery? | alleviation of symptoms without cure |
| What is prevention surgery? | like removal of a mole before it becomes malignant |
| What is exploration surgery? | surgical examiniation to determine the nature or extent of the disease |
| What is cosmetic surgery? | repairing scar, or changing breast shape |
| What is elective surgery? | carefully planned surgery |
| What is emergency surgery? | unexpected urgency |
| The setting in which a surgical procedure may be safely and effectively performed is influenced by? | the complexity of the surgery, potential complication and the general health status |
| What is same day admission? | pt who are going to be admitted to the hospital on the same day of surgery |
| What is ambulatory surgery? | same day (outpt) |
| Where is ambulatory surgery performed? | ER, endoscopy clinics, doc office, freestanding surgical clinics, and outpt surgery units in hospitals |
| What is it called when pt stays overnight after surgery but not over 24 hrs? | 23 hr stay |
| Ambulatory surgery is preferred by? | pt, physician and third pary payers |
| Ambulatory surgery generally involves? | fewer lab tests, few meds, less stress, and less risk of infections |
| What is the nurses action with surgery? | preparing pt, caring for pt, and fcilitating the pt recovery with surgery |
| What are the 4 main purposes of a presurgery interview? | Obtain the pt health info, determine pt expectations, provide and clarity into, ass the pt emotional state and readiness for surgery |
| What is the overall goal of the preoperative assessment? | to gather data in oder to identify risk factors and plan care to ensure pt safety |
| What are the goals of assessment? | psychlogic status of the pt, physiologic factors that are directly or indirectly related to surger, baseline data, identify and document surgical site, Identify meds, confirm results of tests, Identify ethnic factors, determine if pt has had adequate info |
| If stress is increased what can be affected? | recovery |
| What influences the pt susceptibility to stress? | Age, past experiences, current health, socioeconomic status |
| What are the most common psychologic factors? | anxiety, fear, and hope |
| Anxiety is a? | survival mechanism |
| What is diminished with an increased anxiety level? | congnition, decision making and coping abilities |
| Who is informed if anxiety is of excess? | surgeon |
| What should the nurse know in particular about culture of a person? | if they believe in blood transfusion |
| What is the greatest fear with surgery? | death |
| If the pt has a great fear of death what will the physician do? | postpone the surgery |
| Fear of pain and discomfort during and after srugery is? | universal |
| If fear is of excess who should be notified? | anesthesia care provider to give meds |
| What is keloid? | overgrowth of a scar |
| Most psychologic factos related to surgery seem to be? | negative |
| What is a possitive attribute? | hope |
| Hope may be the pt's strongest method of? | coping |
| Initially the nurse should determine if the pt understands the? | reason for the surgery |
| Before surgery women should be ask about their? | menstrual and obstetric hx |
| What should be documented before surgery? | hx of surgeries, past hospitilization |
| A family hx of what prob should be recorded? | heart or endocrine |
| Drugs and herbal products may interact with? | anesthetic |
| When liver function is decreased what is prolonged? | anesthetic agent affects |
| When asking about meds what should also be included? | illegal drug use, allergies, and drug intolerance |
| People should be screened for what? allergies? | risk factors, contact dermatitis, hibes, aerosol reaction, and hx of reactions that suggest allergy to latex |
| What is the last component of a pt hx? | review of body systems |
| Why is CV function evaluated? | to determine the presence of preexisting disease or problems |
| Ppl with asthma and COPD are at risk for what during surgery? | hypoxemia and atelectasis |
| What are conditions likely to compromise resp function? | smoking, obesity and airway deformities |
| What does assessing neurological fn include? | pt's ability to respond to questions, follow commends and maintain orderly thought patterns |
| Why is it important to document the pt ability to pay attention, concentrate and respond? | to compare it after surgery |
| What are diseases of the NS? | myasthenia gravis, parkinson's disease and multiple sclerosis |
| What renal function tests are usually ordered? | serum creatine, and blood urea nitrogen |
| The liver is involved in? | glucose hoemostatis, fat metabolism, proten synthesis, drug and hormone metabolism and bilirubin formation and excretion |
| The liver detoxifies many? | anesthtics and adjunctive drugs |
| A person with hepatic dysfunction may have increased risk of what after surgery? | clotting abnormalities and adverse resonses to meds |
| Who is especially at risk for AE of anesthesia nad surger? | pt with diabetes mellitus |
| Thyroid dysfunction can cause alterations in? | metabolic rate |
| impairment of immune system can lead to? | delayed wound healing and increased risk of infection |
| What causes F&E imbalances? | vomiting, diarrhea, or difficulty swallowing |
| Serum electrolyte levels are often? | evaluated before surgery |
| Obesity stresses what systems? | cardiac and pulmonary |
| Obesity predisposes a pt to? | wound dehiscence, wound infection, and incisional herniation |
| What is essential for wound healing? | protein, Vit ACB |
| an older adult is at increased risk for? | malnutrition and fluid volume deficits |
| Who can perform a physical exam? | nurse, nurse practitionars, physicias and physician assitants, ACP |
| Lack in the required diagnostic reports may? | delay or cancel surgery |
| Preoperative teaching increase? | pt satisfaction and may reduce postoperative fear, anxiety and stress |
| When there is minimal time for teaching what should be discussed? | the most important |
| When teaching the nurse must find a balance between? | telling so little the pt is unprepared and telling so much the pt is overwhelmed |
| Preoperative teaching concern what three types of info? | sensory, process, and procedural |
| What do ppl want to know with sensory info? | what they will see, hear, smell, and feel during surgery |
| What do ppl want to know with process info? | not specific details but desire the general flow of what is going to happen |
| What do ppl want to know with procedural info? | desired details are more specific |
| What approach is usually used with teaching? | team |
| All pt should recieve info on? | deep breathing, coughing and moving post op |
| Ambulatory surgical centers usually have a staff telephone so pts can? | call to answer last minute questions and to reinforce teaching |
| Arrival time for ambulatory surgery is usually? | 1-2 hours before surgery |
| What info should be told to the pt about ariving for ambulatory surgery? | pt registraction, parking, what to wear, what to bring, and how someone has to drive them home |
| Legal prep for surgery consists of? | checking that all required forms have been correctly signed and are present on the chart, and the pt understands |
| Before surgery can be legally performed the pt must? | sign an informed consent with a witness |
| What is informed consents? | an active, shared decision making process between the provider and the recipient of care |
| What are the 3 conditions that must be met for consent to be valid? | Must be adequate disclosure of the diagnosis (nature and purpose of treatment), pt must demonstrate clear understanding and comprehension of the info being provided, pt must give consent voluntarilty (not be persuaded) |
| Who is ultimately responsible for obtaining the pt consent? | physician |
| What may override the need to have consent? | a medical emergency |
| Benzodiazepines and barbiturates are used for their? | sedative and amnesic properties |
| Anticholinergics are given to reduce? | secretions |
| Antiemetics are given to decrease? | N |
| What is included in the preop assessment? | proposed surgery, hx of surgery, past health, smoking, allergies, review of systems, current resp and heart status, current height and weight, VS, mobility restriction, blood studies (CBC, electrolytes, coagulation studies), urinalysis, ECG, Chest X ray |
| How long does hemoglobin survive? | 120 days |
| What is normal RBC for male? | 4.5-6 x 10 (6) |
| What is normal RBC for female? | 4-5 x 10 (6) |
| What is the function of hemoglobin? | delievers oxygen through circulation to body tissues and returns CO2 from tissues to lungs |
| What is a decrease in hemoglobin? | anemia |
| What is an increase is hemoglobin? | polycythemia |
| What is the normal range of hemoglobin for men? | 13.5-18 |
| What is the normal range of hemoglobin for women? | 12-16 |
| What does hematocrit indicate? | relative proportion of plasma and RBC |
| What is the normal range of hematocrit for male? | 40-54% |
| What is the normal range of hemtocrit for female? | 38-47% |
| What do WBC do? | protect the body, they phagocytose bacteria and other foreign entities |
| What is the normal range for WBC? | 4,000-11,000 |
| How long to platelets last? | 7-10 days |
| What is the normal range of platelets? | 150,000-400,000 |
| What are surgical risk factors? | nutrtion, age, health habits, disease, environment, anemia |
| What is NPO prevent? | aspiration during sugery |
| What does NPO do? | return of normal intestinal motility, treat vomiting or diarrhea, treat medical prob |
| What are nursing interventions for NPO? | oral hygiene, ice chips, hard candy, gum, avoid exposure to others eating, need to clarify is order is NPO excepts meds |
| What does consent protect the pt from? | unsanctioned surgery |
| What does consent protect the surgeon from? | claims of unauthorized operation |
| If the pt is of legal age and mentally capable they can? | sign own form |
| If the pt is a minor, unconscious, or incompetent then who signs? | family member, next of kin |
| What is pt is emancipated minor who signs? | Married of independently earning own living may sign own permit |
| Sedative reduce? | nervousness, excitability, irritability, without causing sleep |
| Hypnotics cause? | sleep, more potent on CNS than sedatives |
| Barbiturates are? | CNS depressants, reduce nerve impulses to cerebral cortex, raise convulsive/seizure threshold |
| Antianxiety meds do what? | reduce anxiety by reducing overactivty in CNS, benzodiaziepines, barbiturates, antihistamines, MAOIs |
| Antocholinergics block? | action of acetylcholine, parasympathetic nerves |
| Low does of anticholinergics do what to heart rate? | decrease |
| High doses of anticholinergics do what to heart rate? | increase |
| What do anticholinergics do? | decrease secretions, decrease muslce rigidity and diminish tremors |
Created by:
alicia.rennaker
Popular Nursing sets