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82 Cards in this Set

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What is the care that clients receive before, during, and after surgery
Perioperative care
What is light amplification by the stimulated emission of radiation
LASER
What are some advantages of Laser Surgery?
• Cost effectiveness
• Reduced need for general anesthesia
• Smaller incisions
• Minimal blood loss
• Reduced swelling
• Less pain
• Decreased incidence of wound infections
• Reduced scarring
• Less time recuperating
Laser technology requires unique safety precautions such as...
eye, fire, heat, and vapor protection
What are some important disadvantages of lasers?
lasers produce heat so fire and electrical safety are very important
When a laser is used along with smoke and odors, a substance is released that is composed of vaporized tissue, carbon dioxide, and water?
plume
To maintain skin integrity - you must?
always rinse peroxide off with saline
wash with mild soap and rinse
keep skin clean and dry
use a barrier substance i.e. karaya
What is self-donated blood called?
autologous transfusion
What is blood donors chosen from among the client's relatives and friends?
directed donors
What is the criteria for banking one's own blood?
Have a physician's recommendation
Have a hematocrit within safe range
Be free of infection at time of donation
Meet the blood collection center's minimum weight requirement
Donate 40 to 3 days before the anticipated date of use
Donate no more frequently than every 3 to 5 days; once per week is preferred
What is the criteria to be a directed donor?
Be at least 17 years of age
Meet all the criteria of a public donor
Have the same blood type as the potential recipient or one that is compatible
What are three things that are preoperative teaching that a nurse should teach to her client?
They should explain and demonstrate how to perform...

deep breathing
forced coughing
leg exercises
What is a form of controlled ventilation that opens and fills small air passages in the lungs also reduces the postoperative risk for respiratory complications?
Deep breathing
After inserting an indwelling retention catheter into a male client, which of the following describes an appropriate technique for stabilizing the catheter to avoid a penoscrotal fistula?

1) Tape the catheter to the abdomen
2) Pass the catheter under the client's leg
3) Fasten the drainage tube to the bed with a safety pin
4) Insert the catheter into the tubing of a collecting bag
Tape the catheter to the abdomen

Anchoring an indwelling retention catheter to the male’s abdomen eliminates pressure and irritation at the penoscrotal angle. Pressure in this area predisposes to fistula formation.
Is there any preventative measures you can do to prevent the need of catheter irrigation?
generous oral fluid intake is usually sufficient to dilute urine, keeping small mucus or tissue from obstructing the catheter.

If it is necessary to irrigate its not a nursing call, you must have orders from a physician.
Another preoperative teaching - is coughing that is purposely produced?
Forced coughing
When is Forced coughing most appropriate?
for clients who have diminished or moist lung sounds or who raise thick sputum
Because Forced coughing is painful, administering pain medication _____ min before can reduce discomfort.
30 min before
What is another technique that a client can do to reduce discomfort while coughing?
splinting the incision during coughing
Pressing on the incision with both hands, pressing a pillow placed over the incision or wrapping a bath blanket around the client are ways to do what?
splinting
How do you teach the client and family to Performing Forced Coughing?
• Sit upright • Take a slow, deep breath through the nose • Make the lower abdomen rise as much as possible • Lean slightly forward • Exhale slowly through the mouth • Pull the abdomen inward • Repeat but this time, cough three times in a row while exhaling
What can you do to help to promote circulation and reduce the risk for forming a thrombus in the veins?
Leg exercises
What is a stationary blood clot?
thrombus
What is a mobile blood clot?
embolus
Surgical clients have reduced circulatory volume because of preoperative restriction of food and fluids and blood loss during surgery. What can they do to keep from getting blood clots?
Leg Exercises or wear antiembolism stockings
What is another name for antiembolism stockings?
TED or thromboembolic disorder hose
What is the form called that identifies the status of essential presurgical activities and is completed before surgery?
preoperative checklist
What is the nurses major challenge in caring for clients with an ostomy?
Preventing skin breakdown because ammonia in urine or enzymes in stool can quickly cause excoriation.

Washing the stoma and surrounding skin with mild soap and water and patting it dry can preserve skin integrity.
If a patient becomes overly sedated, what are the medications that counteract the effects of those used for conscious sedation?
Reversal drugs
The immediate postoperative period refers to the first ____ hours after surgery.
24 hours
What are the postoperative acute care unit (PACU) nurse's major responsibilities?
• ensure a patent airway
• help to maintain adequate circulation
• prevent or assist with the management of shock
• maintain proper positions & function of drains, tubes, & intravenous infusions
• detect evidence of any complications
A nurse starts providing directions for managing self-care and medical follow-up ASAP before the client leaves, this is the?
discharge instructions
Common area surgical discharge Instructions are?
• How to care for the incision site
• Signs of complications to report
• What drugs to use to relieve pain
• How to self-administer prescribed drugs
• When presurgical activity can be resumed
• If & how much weight can be lifted
• Which foods to consume or avoid
• When & where to return for a medical appointment
• Give an opportunity for questions
What are some post operative complications?
Hemorrhage, Shock,
Thrombus, Embolus, Pulmonary Embolism,
Dehiscence, Evisceration
What is a Hemorrhage and what is the treatment?
Severe and rapid blood loss

Control bleeding, adminster iv fluid and replace blood
What is shock and how is it treated?
Inadequate blood flow (low blood pressure)

Place client in modified Trendelenburg position
What is a Pulmonary Embolus and how is it treated?
obstruction of circulation in the lung by a blood clot

give o2 and administer anticoagulant drugs
What is a Dihiscence and how is it treated?
seperation of incision

reinforce wound edges and apply a binder
What is evisceration and how is it treated?
protusion of abdominal organs through separated wound

position patient in position of least strain, cover with wet dressing and reapproximate wound
In providing postoperative care repeat vital signs every 15 min until stable, then if they aren't in normal limits check ________?
every hour
Preoperative skin preparation is best performed?

• The night before surgery
• After the morning shower
• Before preoperative sedation
• In the operating room area
Before preoperative sedation
From whom is it most appropriate to obtain consent to perform surgery on an adolescent with a fractured tibia?

• The client himself or herself
• The client's physician
• The client's minister
• The client's parent
The client's parent
If a client who will undergo surgery is wearing a ring, which action is most correct?

• Put the ring in the bedside stand.
• Leave the ring on the client's finger.
• Give the ring to the security guard.
• Lock the ring with his valuables.
Lock the ring with his valuables
After giving a preoperative medication containing a narcotic, the most important nursing action is to?

• Raise the side rails.
• Help the client to the toilet.
• Provide oral hygiene.
• Teach leg exercises
Raise the side rails
When the nurse assesses a client postoperatively, which assessment is most indicative of shock?

• Bounding pulse
• Slow respirations
• Low blood pressure
• High body temperature
Low blood pressure
Post-operatively, while checking the Homans' sign, the client experiences pain in the calf. Why?
possibility of a thrombophlebitis
What is the inflamation of a vein as a result of a thrombus?
thrombophlebitis
A clean separation of skin and tissue with smooth, even edges
Incision
A separation of skin and tissue in which the edges are torn and irregular
Laceration
A wound in which the surface layers of skin are scraped away
Abrasion
Stripping away of large areas of skin and underlying tissue, leaving cartilage and bone exposed
Avulsion
A shallow crater in which skin or mucous membrane is missing
Ulceration
An opening of skin, underlying tissue, or mucous membrane caused by a narrow, sharp, pointed object
Puncture
Injury to soft tissue underlying the skin from the force of contact with a hard object, sometimes called a bruise
Contusion
a wound where there is no opening in the skin or mucous membrane is called?
closed wound
What are the three phases of wound repair?
inflammation
proliferation
remodeling
What is the physiologic defense immediately after tissue injury that lasts approximately 2 to 5 days?
Inflammation
signs and symptoms of inflammation:
swelling, redness, warmth, pain, and decreased function
period during which new cells fill and seal a wound
Proliferation
period during which the wound undergoes changes and maturation
Remodeling
What are Several factors that affect wound healing?
• Type of wound injury
• Expanse or depth of wound
• Quality of circulation
• Amount of wound debris
• Presence of infection
• Status of the client's health
The speed of wound repair and the extent of scar tissue that forms depend on whether the wound heals by?
first, second, or third intention
What is the reparative process in which the wound edges are directly next to each other?
First-intention healing, also called healing by primary intention
What is the process where wound edges are widely separated, leading to a more time-consuming and complex reparative process?
second-intention healing
What is the process where the wound edges are widely separated and are later brought together with some type of closure material?
third-intention healing
separation of wound edges
dehiscence
wound separation with protrusion of organs
evisceration
What has happened if a client describes something has given way?
an evisceration
What do you do if your client has an evisceration?
1. position client where there is the least strain on the operated area
2. place sterile dressings moistened with normal
saline over the protruding organs and tissues
3. notify physician
What type of dressing would you use for covering fresh wounds that are likely to bleed or wounds that exude drainage?
gauze
What type of dressings are used to cover peripheral and central intravenous insertion sites?
Transparent dressings such as Op-Site
What type of dressing would you use so you only have to change twice a week and that keeps tissues moist?
Hydrocolloid dressings such as DuoDerm
What are tubes that provide a means for removing blood and drainage from a wound?
drains
knotted ties that hold an incision together, generally are constructed from silk or synthetic materials such as nylon
Sutures
wide metal clips
Staples
what holds a weak incision together temporarily?
steri-strips or butterflys
What turn is especially beneficial when wrapping the stump of an amputated limb or the head?
recurrent turn
removal of necrotic tissue (nonliving tissue) from the healthy areas of a wound with sterile scissors, forceps, or other instruments
Sharp debridement usually done by a physician
What flushes a toxic chemical from one or both eyes or displaces dried mucus or other drainage that accumulates from inflamed or infected eye structures?
eye irrigation
Where do you direct the solution in eye irrigation?
the conjuctiva holding away from the eye 1"
If you you use a hot water bottle it should be what temp?
115-125˚
To access for Othostatic or Postural Hypotension
1st have client lie down in a supine position for 2-3 minutes then check the blood pressure