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26 Cards in this Set
- Front
- Back
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what is the Goal of the preoperative evaluation?
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to uncover comorbidity that may impact operative outcome
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what are the considerations addressed at the preoperative eval?
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*timing
*site of operation *anesthesia type *consent |
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what is a baseline best practice ethical standard in modern medical care?
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infomred consent
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what is informed consent?
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explaining benefits and risks and available alternatives of the proposed procedure to the pt and/or legal guardian
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what must the informed consent include?
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bleeding complications, infection, allergic rxns, blood clots, damage to adjacent organs, death
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what two elements make consent valid?
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must be informed and voluntary
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what should you avoid when trying to elicit consent from a patient?
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avoid overwhelming the pt w/ extarneous data
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What are pre op eval screening tests?
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1. EKG
2. CXR 3. Hemoglobin 4. Creatinine 5. GLucose 6. U/A 7. Hcg-Serum 8. Coag studies (PT, PTT) |
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why is an EKG impt?
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for CV dz, HTN< DM
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when is a CXR indicated for pre op screen?
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if they are:
over 60, smokers or anesthesia |
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how much blood loss is expected when a hemoglobin screen test is performed?
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over 500ml blood loss
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what is a high risk of failure after surgery?
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renal failure
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when is a glucose pre screen eval impt?
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if pt uses steroidsor is diabetic
*if pt is older than 45 or younger w/ risk factors |
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what elements are included in the preoperative note?
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*date
*preo dx *procedure planned *indications for procedure *TEST results *Lab results *special orders *risks/complications *expected pt recovery plan *consent signed |
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what should pt receive pre operative?
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*written instructions regarding time of surgery and management of special peri operative issues
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what are two good tips for OR success?
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*accompany pt to recovery room
*volunteer to write operative note and postoperative surgical orders *always let attending phys or chief surgical resident know when you are attending mandatory meeting |
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what concludes the preop eval?
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a review of all pertinent studies and info obtrained from investigative tests
***DOCUMENT the review in the chart |
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what procedure is required by JCAHO before operating?
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time out procedure must be conducted in location whre procedure will be performed
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when is the time out procedure performed?
who initiates it? who is required to participate? |
must be conducted immediately before the start of any invasive procedure or surgical incision
RN will initiate it requires active participation of all team members involved in the procedure |
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what are mental notes to take during procedure?
when do you write this info into the chart? |
1. pt position
2. anesthesia type 3. incision 4. exposure and operative technique 5. closure type, sutures, layer of tissue and skin closure handwritten into chart RIGHT AFTER procedure |
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is the post op note the same as the operative report?
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no the operative report (OP) is dictated by surgeon and is not immediately available or transcribed
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when is the follow up post op note written?
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at 24 hrs , 48 hrs and each subsequent 24 hr period while pt is in hospital
POD#1, POD#2, POD#3, etc. |
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what is the post op note baseically?
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a soap note
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what do surgeons expect on newly admitted pts?
what do surgeons place considerable emphasis on? |
surgeons expect brief presentations on newly admitted pts
surgeons place emphasis on quality of oral presenations |
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what is included in presenting newly admitted pts?
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1. name and rom #
2. cc 3. HPI 4. PMH/Past surgical hx 5. Meds 6. Allergies 7. Social Hx 8. Fam Hx only if pertienent 9. ROS pertient only 10. PE pertient findings |
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what are some tips for OR success
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arrive before anesthesia
*read OR schedule and look up condition/procedure *reveiew pt case info *always intro yourself to OR nurses *offer to help w/ surgical prep of pt *intorduce yourself to attending(even while scrubbing) *assis w/ retractors, controlling suction and cutting sutures *ask if it is a good time to ask a question before asking *when leaving OR in scrubs, remove hat and shoe covers |
