Lecture Week 2 Med Surg

Front 1

Maslow's Hierarchy of Needs

Back 1

1. Physiologic needs

2. Safety & Security

3. Belongingness & Affection

4. Esteem & Self-Respect

5. Self-Actualization

Front 2

Preoperative Phase

Back 2

begins when surgery is agreed upon and they will be on an OR bed

Front 3

Intraoperative Phase

Back 3

Begins when they transfer to OR bed and end with admission to PACU

Front 4

Postoperative Phase

Back 4

Begins with the admission of patient to PACU ends with follow-up evaluation in clinical setting or home.

Front 5

Surgeries Performed because of:

Back 5

1. finding diagnosis

2. a cure

3. repair

4. reconstructive or cosmetic

5. palliative

6. rehabilitative

Front 6

Surgery Classified by Urgency:

Back 6

- emergent

- urgent

- required

- elective

- optional

Front 7

PAT

Pre-Admission Testing

Back 7

Done prior to surgery involves interviews and lab diagnostics. Saves hospital and patient time and money.

Front 8

Preoperative Assessment

Back 8

- Nutritional, Fluid Status

- Dentition

- Drug or alcohol use

- Respiratory status

- Cardiovascular status

- Hepatic, renal function (messes with excreting meds, so they build up)

- Endocrine function

- Immune function

- Previous medication use

- Psychosocial factors

- Spiritual, cultural beliefs

Front 9

Smoking

Back 9

Must be stopped 4 - 8 weeks prior to surgery

Front 10

Glycemic Index

Back 10

80 - 110

Patients sugar must be normal at all times during surgery, during stress levels go higher and make them more prone to infection

Front 11

Herbal Medications

Back 11

Must be stopped 6 - 8 weeks prior to surgery

BOOK SAYS 2 WEEKS

Front 12

Aspirin

Back 12

Must be stopped 7 - 10 days prior to surgery

Front 13

Gerontological Considerations

Back 13

Constipation, dehydrated, and urine retention, and infection all things that can make a person delirious

Front 14

SCIP

Surgical Care Improvement Project

Back 14

works with Joint Commission, Identifies performance measures aimed at preventing surgical complications

Front 15

Bariatric Patients

Back 15

-fatty tissue are more susceptible to infection

-shorter necks can impede intubation

-sleep apnea is an issue as well

Front 16

Same-day, Outpatient, or Short Stay Surgery

Back 16

less than 23 hours in hospital observations

Front 17

Surgery contraindicated for:

Back 17

acute nephritis

acute renal insufficiency with oliguria or anuria

exceptions:

Life-saving measures

easier access for dialysis

improve urinary function

Front 18

Corticosteroids

Back 18

Can cause adrenal insufficiency during surgery and can cause cardiovascular collapse if discontinued suddenly

have to be reported if taken within the past year

Front 19

Diuretics

Back 19

Can cause respiratory depression during surgery

Front 20

Phenothiazines

Back 20

can increase hypotensive action of anesthetics

Front 21

Tranquilizers

Back 21

can cause anxiety, tension, and even seizures if withdrawn to suddenly

Front 22

Insulin

Back 22

Surgery causes stress, under stress glucose goes up and body needs more insulin

Front 23

Antibiotics

Back 23

should be given before and after

Front 24

Anticoagulants

Back 24

Doctor will determine if they will take during surgery or not

Front 25

Antiseizure Medications

Back 25

must be given to prevent seizures

Front 26

Thyroid Hormone

Back 26

must maintain thyroid levels so may be given during post op period

Front 27

Opioids

Back 27

may have to increase anesthesia due to tolerance

Front 28

Pre-medication for Surgery can only be given once:

Back 28

only after informed consent has been signed

Front 29

Fasting Before Surgery

Back 29

* Should be determined by doctor

8 hours after eating fatty food

4 hours after ingesting milk

2 hours for clear liquids

Front 30

Voiding

Back 30

Patients should void before going to OR except those with urologic disorders

Front 31

Surgical team

Back 31

1. circulating nurse

2. scrub role

3. surgeon

4. Registered Nurse first assistant works under surgeon

5. anesthesiologist

Front 32

PACU Phase 1

Back 32

used during the immediate recovery phase, intensive nursing care is provided

Front 33

PACU Phase 2

Back 33

Patient prepared for self-care or care in hospitals

Front 34

PACU Phase 3

Back 34

patient is prepared for discharge

most hospitals phase 2 or 3 are combined

Front 35

Nurse Admits to PACU

Back 35

nurse who admits patient to pacu reviews essential info with anesthesiologist and circulation nurse. O2 applied, monitor equipment is attached, and immediate physiologic assessment is conducted.

Front 36

When entering PACU always make sure a patient has?

Back 36

A patent airway. ABC's

Front 37

Primary nursing Goal for immediate post-op period

Back 37

prevention of hypoxemia and hypercapnia and maintenance of pulmonary function

Front 38

Assessing after Post-op

Back 38

always assess for bleeding and pain immediately post-op

Front 39

Hypertension dysrhythmias

Back 39

caused by pain

Front 40

Hypovolemic Shock

Back 40

- pallor

- cool moisten skin

- rapid respirations

- cyanosis

- rapid weak, thready pulse

- decreasing pulse pressure

- low blood pressure

- concentrated urine

Front 41

When ambulating post-op

Back 41

sit and dangle feet, stand for 2 - 3 mins before walking

Front 42

how many days for post-op infection to develop

Back 42

5 days

Front 43

Normal urinary output

Back 43

30 ml any less call MD