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50 Cards in this Set
- Front
- Back
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__ __ and __ techniques and the use of an incentive spirometry after surgery helps to prevent __ and ___.
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deep breathing, coughing
pneumonia, atelectasis |
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deep breathing and coughing exercise
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1. sitting position provides the best lung expansion for exercise.
2. deep breath 3x (inhaling through the nostrils, exhaling slowly through pursed lips) 3. The 3rd breathe should be held for 3 secs 4. cough deeply 3x 5. perform exercise every 2 hours |
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incentive spirometry
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1.assume sitting or upright position
2. place mouth tightly around mouthpiece 3. inhale slowly(raise and maintain the flow rate indicator between 600-900) 4. hold breath for 5sec 5. exhale through pursed lips. 6. repeat 10 minutes every hour |
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splinting incision
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1. if incision is (thoracic or abdominal) place a pillow or 1 hand over the top of the other hand over the incision area.
2.During deep breathing and coughing the pt, gently presses against the incision to splint/support. |
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preoperative client verification
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1.clients name on the ID band
2. date of birth 3. medical record # 4. consent forms 5. scheduled procedure and marked surgical site 6. availability of implant if needed 7. availability of blood 8. radiologic examinations |
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time out procedure
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occurs after pt has been prepped and draped. Entire team must verify their agreement on;
pt name, procedure to be performed, surgical site, laterality implants and radiologic exams (IA) |
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time out procedure- documentation
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correct client
correct site and side agreement to procedure correct client position availability of implant, special equipment |
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why would ANTIBIOTICS affect surgical client?
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these potentiate the action of anesthetic agents.
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why would ANTICHOLENERGICS affect the surgical client?
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increase the potential for confusion
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why would ANTICOAGULANTS affect the surgical client?
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alter normal clotting factors increase hemorrhaging
*Aspirin* Garlic and ginseng may also alter clotting factors. Should be dc at lease 48 hours b4 surgery |
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why would ANTICONVULSANTS affect the surgical client?
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long term use can alter the metabolism of anesthetic agents.
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why would ANTIDEPRESSANTS affect the surgical client?
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may lower BP during anesthesia.
*St. Johns wort may also lower BP* |
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why would antidysrhytmics affect the surgical client?
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reduce cardiac contractility and impair cardiac conduction during anesthesia.
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why would ANTIHYPERTENSIVE affect the surgical client?
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interact w anesthesic agents cause bradycardia, hypotension and impaired circulation
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why would CORTICOSTEROIDS affect the surgical client?
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cause adrenal atrophy, reduce the body's ability to withstand stress
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why would DIURETICS affect the surgical client?
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potentiate electrolyte balances after surgey
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Postoperative time frame is _ to _ __ after surgery.
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1, 4, hours
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After surgery the respiratory rate should be more than __ less than __ breaths per minutes.
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10, 30
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Unless contraindicated, place the client in __ __ position after surgery to increase the size of the thorax.
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low fowlers.
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if the client is comatose or semicomatose place the client on their ___, unless contraindicated.
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side
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Expect the client to void _ to _ hours after the surgical procedure depending on the type of anesthesia given.
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6,8 hours
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intermediate postoperative stage is _ to _ hours after surgery.
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4 to 24 hours
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in the intermediate postoperative stage assess for bowel sounds over the __ __ area. If no sounds assess all four quadrants.
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ileocecal valve area
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Intermediate postoperative stage, urine should be more than __ml/hr.
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30 ml/hr
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Pneumonia which is an ___ of the ___caused by an infectious process may develop _ to _ _ after surgerical procedure because of _, _,or _.
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inflammation, aveoli.
3, 5 days infection, aspiration, immobility |
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Atelectasis which is a __ of the __ with retained mucous secretions, is the most common postoperative complication and occurs _ to _ _ after surgical procedure.
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collapse, aveoli
1, 2 days |
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pneumonia and atelectasis s/s
(CHEPDD) |
Crackles over involved lung area
Hyperglycemia in diabetic clients Elevated temp Productive cough, chest pain Dyspnea, ^ RR Delirium in older patients |
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what is hypoxia?
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inadequate concentration of o2 in the arterial blood.
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hypoxia s/s
(DDIRCC) |
Dyspnea
Diaphoreses Increased HR, BP Restlessness and agitation Confusion Cyanosis |
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what is PULMONARY EMBOLISM?
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embolus blocking the pulmonary artery and disrupting blood flow to one or more lobes of the lungs
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pulmonary embolism s/s
(DISC) |
Dyspnea
Increased HR, decrease BP Sudden sharp chest, upper abd. pain Cyanosis |
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what is hemorrhage?
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loss of large amount of blood externally or internally during a short period of time
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hemorrhage s/s
(TRRWC) |
Tachypnea
Restlessness Reduced urine output Weak rapid pulse, hypotension Cool, clammy skin |
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what is shock?
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loss of circulatory fluid volume that is caused by hemorrhage.
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shock s/s
(same as hemorrhage, TRRWC) |
Tachypnea
Restlessness Reduced urine output Weak rapid pulse, hypotension Cool, clammy skin |
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what is thrombophlebitis?
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inflammation of a vein accompanied by clot formation
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thrombophlebitis s/s
(AVE) |
Aching or cramping leg pain
Vein inflammation, vein feels hard and cordlike, tender to touch Elevated temp |
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what is urine retention?
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involuntary accumulation of urine in the bladder from loss of muscle tone.
appears 6 to 8 hours after surgery |
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urine retention s/s
(ORLIE) |
On percussion the bladder sounds like a drum
Restlessness or diaphoresis Lower abd. pain Inability to void or distended bladder Elevated BP |
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what is constipation?
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abnormal or infrequent passage of stool.
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When a client resumes a solid diet after surgery, failure to pass stools within __ __ is a cause for concern.
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48 hours
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constipation s/s
(AAA) |
Abdominal distention
Absence of bowel sounds Aneroxia,headache, and nausea |
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what is paralytic ileus?
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failure of the appropriate forward movement of bowel contents.
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paralytic ileus s/s
(AAP) |
Abdominal distention
Absence of bowel sounds, bm, or flatus Postoperative N&V |
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What causes WOUND INFECTION?
When does it occur? |
Poor aseptic technique, wound that was contaminated b4 surgery.
3 to 6 days after surgery. |
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wound infection s/s
(FEEW) |
Fever and chills
Elevated WBCs Edematous skin at the incision and tight skin stutures Warm, tender, painful, and inflamed incision site. |
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what is WOUND DEHISCENCE?
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separation of the wound edges at the suture line.
Occurs 6 to 8 days after surgery |
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wound dehiscence s/s
(OTI) |
Opened wound edges
The appearance of underlying tissue through the wound Increased drainage |
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what is WOUND EVISCERATION?
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protusion of the internal organs and tissues through and opening in wound edges.
occurs 6-8 day post op *most common in OBESE, abd. surgery, and poor wound healing clients* THIS IS AN EMERGENCY!!!!! |
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wound evisceration s/s
(FAD) |
Feeling a popping sensation after coughing or turning
Apperance of loops of bowels or other abd. contents Discharge of serosanguineous fluid from previously dry wound |
