Perioperative Process

Front 1

-ectomy

Back 1

excision or removal

Front 2

-lysis

Back 2

destruction of

Front 3

-orraphy

Back 3

repair or suture of

Front 4

-oscopy

Back 4

looking into

Front 5

-ostomy

Back 5

creation of opening into

Front 6

-otomy

Back 6

cutting into or incision of

Front 7

-plasty

Back 7

repair or reconstruction of

Front 8

4 main things the nurse must do at a pre-op patient interview

Back 8

obtain health information, determine client's expectation, clarify information, perform nursing assessment

Front 9

objective data preoperatively includes...

Back 9

physical examination, lab and diagnostic testing

Front 10

INR

Back 10

measures prothrombin time, determining the clotting tendency of blood when a patient is under warfarin (coumadin) therapy (normal range 0.8-1.2; warfarin range can be up to 2.5)

Front 11

3 conditions that must be met for an informed consent to be signed

Back 11

1. adequate disclosure of the diagnosis
2. patient must demonstrate clear understanding and comprehension of information provided
3. recipient of care must give consent voluntarily

Front 12

frequently used pre-op meds

Back 12

Benzos, narcotics, histamine H-2 receptor antagonists, antacids, antiemetics, anticholinergics

Front 13

3 areas of surgical suite

Back 13

1. unrestricted
2. semi-restricted
3. restricted

Front 14

what is the difference between semirestricted and restricted areas of the surgical suite?

Back 14

mask must be worn in the restricted suite

Front 15

what does the circulating nurse do?

Back 15

remains at a safe distance to avoid contaminating anything; runs around and makes sure everything is ok and setup for surgery

Front 16

what does the scrubbing nurse do?

Back 16

remains in area of surgical procedure/prepares equipment table; assists with procedure

Front 17

surgeon's responsibility?

Back 17

preop medical history, physical assessment, management of preop workup, management in OR, postop management

Front 18

registered first nurse assistant's responsibility?

Back 18

handling tissue, using instruments, providing exposure to surgical sites, assisting with hemostasis, assisting with suturing

Front 19

conscious sedation

Back 19

a drug-induced depression of consciousness; still able to maintain airway and respond appropriately to verbal commands

Front 20

symptoms of an anaphylactic reaction

Back 20

hypotension, tachycardia, bronchospasm, pulmonary edema

Front 21

treatment for anaphylaxis?

Back 21

ensure patency of airway, give epinephrine, IV fluids, benadryl, possibly vasopressants and H2 blocker

Front 22

Malignant hyperthermia

Back 22

a rare metabolic disease characterized by hyperthermia with rigidity of skeletal muscles that can result in death

Front 23

cause of malignant hyperthermia?

Back 23

exposure to certain types of anesthetic agents; can occur during surgery or in recovery

Front 24

symptoms of malignant hyperthermia?

Back 24

muscle contracture, hyperthermia, acute tachycardia

Front 25

treatment for malignant hyperthermia?

Back 25

dantrolene (slows metabolism)

Front 26

hypoxemia is indicated by what lab level

Back 26

PaO2 < 60

Front 27

notify ACP or surgeon if what occurs post-op?

Back 27

SBP <90 or >160
PULSE RATE <60 or >120
B/P gradually decreases
irregular cardiac rhythm

Front 28

emergence delirium

Back 28

when a patient is restless, agitated, thrashes around in bed in PACU

Front 29

hypothermia is indicated by a temp of...

Back 29

<96.8˚ F or 36˚ C

Front 30

side effect of antiemetic drugs?

Back 30

can lower BP and cause respiratory depression

Front 31

what to do if a patient suffers from dehiscence of a wound?

Back 31

put on sterile gloves, soak sterile gauze with saline and apply to site and call MD

Front 32

normal blood calcium range?

Back 32

8.5-10.3 mEq/dL

Front 33

normal blood PO4 range?

Back 33

2.5-4.7 mEq/dL

Front 34

normal blood CO2 range?

Back 34

35-45

Front 35

normal BUN range?

Back 35

10-20 mg/dL

Front 36

normal creatinine range?

Back 36

0.5-1.1 mg/dL

Front 37

normal blood Na range?

Back 37

135-145 mEq/L

Front 38

normal blood Cl range?

Back 38

95-113 mEq/L

Front 39

normal blood K range?

Back 39

3.5-5.0 mEq/L

Front 40

normal blood Mg range?

Back 40

1.5-2.5 mEq/L

Front 41

3 most common psychologic factors pre-op?

Back 41

anxiety, fear, hope

Front 42

how can chronic alcohol use affect anesthesia?

Back 42

prolongs anesthesia; withdrawal can occur during surgery and become fatal (alcoholics are at higher risk b/c they already have lung, GI and liver damage)

Front 43

what vitamins are essential for wound healing?

Back 43

Vitamins A, C & B ... and protein!

Front 44

PT (& why would it be high?)

Back 44

prothrombin time- (10-14 seconds); high due to deficiency of certain clotting factors, liver disease, vitamin K deficiency, WARFARIN (coumadin) therapy

Front 45

PTT (& why would it be high?)

Back 45

activated partial thromboplastin time (24-36 seconds); high due to deficiency of certain clotting factors, hemophilia, HEPARIN therapy, liver disease

Front 46

3 types of preop information and describe

Back 46

1. SENSORY- patient wants to know what they will see, hear, smell and feel during surgery.
2. PROCESS- not specific details, but the general flow of what will happen
3. PROCEDURAL- desired details are more specific-- not only what will go on, but more specific, like an IV that will be placed while they are in the holding area

Front 47

oral meds are given how long before going into surgery?

Back 47

60-90 min (unless otherwise ordered) with minimal amount of water

Front 48

IM and SubQ meds are given how long before going into surgery?

Back 48

30-60 min (minimum 20 min)

Front 49

bruit

Back 49

sound HEARD because of turbulent blood flow in an ARTERY. It is heard due to a narrowed or bulging wall. It is the sound that blood makes when it rushes past an obstruction.

Front 50

thrill

Back 50

PALPABLE vibration of a vessel wall if the vessel is narrow or bulging

Front 51

what prevents air from entering the OR from the halls and corridors and thus reduces contamination?

Back 51

positive air pressure

Front 52

the only parts of the gown considered sterile are...

Back 52

the front from chest to table level and the sleeves to 2 inches above the elbow

Front 53

what does general anesthesia do to peripheral blood vessels?

Back 53

causes them to dilate

Front 54

4 classes of sedation?

Back 54

1. MINIMAL- patient responds normally
2. MODERATE/ANALGESIA- conscious sedation; airway and CV function are maintained (nurse can do this)
3. DEEP- patient not easily aroused
4. ANESTHESIA- patient requires assisted ventilation

Front 55

4 phases of general anesthesia

Back 55

1. PREINDUCTION- preop meds, initiation of appropriate IV/arterial access, application of monitors
2. INDUCTION- initiation of sequence of meds that render the patient unconscious, securing the airway
3. MAINTENANCE- benzos, opioids, hypnotics, volatile gases
4. EMERGENCE- reversal agents- anticholinergics, sympathomimetics, opioid antagonists, benzo antagonists

Front 56

who administers the aspiration prophylaxis during surgery? the ACP or the nurse?

Back 56

the nurse

Front 57

who removes the airway assist devices post-op? the ACP or the nurse?

Back 57

the ACP

Front 58

who administers incremental meds as appropriate during surgery? the ACP or the nurse?

Back 58

the ACP

Front 59

who secures the airway during surgery? the ACP or the nurse?

Back 59

the ACP

Front 60

Versed

Back 60

most common benzo; used for its excellent amnesic property; others in its class last too long

Front 61

decreased SaO2 recorded by pulse ox is a ____ sign of ____ ________

Back 61

late; respiratory depression