Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
100 Cards in this Set
- Front
- Back
|
Practice settings that you would fine preoperative care
|
-Physicians office
-Surgical centers (Free standing) -Acute care facilities (hospital) |
|
|
A surgery that involves the use of minimally invasive techniques such as a small incision to decrease the hospital stay, recovery time and risk of acquiring HCI
|
Laparoscopic Procedure
|
|
|
Classification that involves extensive reconstruction or alterationin body parts: poses a great risk to well being.
|
Major (seriousness)
Ex: coronary artery bypass, Colon resection, removal of larynx resection of lung lobe. |
|
|
Coronary artery bypass, Colon resection, removal of larynx & resection of lung lobe are all examples of what classification of seriousness?
|
Major (seriousness)
|
|
|
What classification involves minimal alteration in body parts:often designed to correct deformities:involves minal risks compared with major procedures
|
Minor (Seriousness)
Ex: Cataract extraction,facial plastic surgery, tooth extraction. |
|
|
Cataract extraction,facial plastic surgery, tooth extraction are all examples of what classification of seriousness?
|
Minor (Seriousness)
|
|
|
A classification of Urgency that is performed on basis of client's choice; is not essential and is not alway necessary for health .
|
Elective (urgency)
EX: Bunionectomy, facial plastic surgery,hernia repair,breast reconstruction. |
|
|
Bunionectomy, facial plastic surgery,hernia repair,breast reconstruction are all examples of what Urgency Classification
|
Elective (Urgency)
|
|
|
Classification of Urgency that is necessary for clients health, often prevents additional problems from developing (Tissue destruction or impaired organ function) not necessarily emergency.
|
Urgent (Urgency)
Ex: Excision of cancerous tumor, removal of gallbladder for stones, vascular repair for obstructed artery(coronary artery bypass) |
|
|
Excision of cancerous tumor, removal of gallbladder for stones, vascular repair for obstructed artery(coronary artery bypass) are all examples of what classification of Urgency
|
Urgent (Urgency)
|
|
|
Classification of Urgency that must be done immediately to save life or preserve function of body part is
|
Emergency (urgency)
Ex: Repair of perforated appendix,repair of traumatic amputation, control of internal hemorrhaging. |
|
|
Repair of perforated appendix,repair of traumatic amputation, control of internal hemorrhaging are all examples of what classification of Urgency
|
Emergency (Urgency)
|
|
|
Classification of purpose that surgical exploration that allows HC providers to confirm diagnosis:often involves removal of tissue for further diagnostic testing
|
Diagnostic (Purpose)
Ex:Exploratory laparotomy (incision into peritoneal cavity to inspect abdominal organs) breast mass biopsy. |
|
|
Exploratory laparotomy (incision into peritoneal cavity to inspect abdominal organs) breast mass biopsy are examples of the classification of what Purpose
|
Diagnostic (Purpose)
|
|
|
Classification of Purpose that is the excision or removal of diseased body part
|
Ablative (purpose)
Ex: Amputation,removal of appendix, & cholecystectomy |
|
|
Amputation,removal of appendix, & cholecystectomy are examples of what classification of Purpose
|
Ablative (Purpose)
|
|
|
Classification of Purpose that relieves or reduced intensity of diease symptoms: will ot produce cure.
|
Palliative (purpose)
Ex:Colostomy, debridement of necrotic tissue resection of nerve roots. |
|
|
Colostomy, debridement of necrotic tissue resection of nerve roots are all examples of what classification of Purpose
|
Palliative
|
|
|
Classification of purpose that restores function or appearanceto traumatized or malfunctioning tissues
|
Reconstructive/Restorative
Ex:Internal fixation of fractures, scar revision. |
|
|
Internal fixation of fractures, scar revision are examples of what classification of Purpose
|
Restorative/reconstructive
|
|
|
A classification of purpose which the removal or organs and/or tissues from a person pronounced brain dead for transplantation into another person
|
Procurement for transplant
Ex:kidney heart or liver transplant |
|
|
A classification of purpose that restores function lost or reduced as result of congenital anomalies
|
Constructive
Ex: Repair of cleft palate, closure of atrial septal defect in heart |
|
|
Repair of cleft palate, closure of atrial septal defect in heart is known as what classification of purpose
|
Constructive
|
|
|
A classification of purpose that is performed to improve personal appearance
|
Cosmetic
Ex: Blepharoplasty to correct eyelid deformities: rhinoplasty to reshape nose. |
|
|
Blepharoplasty to correct eyelid deformities: rhinoplasty to reshape nose are examples of what classification of purpose
|
Cosmetic
|
|
|
Principles for sucessful perioperative care would be
|
Airway management
infection control pain management discharge planning |
|
|
Since infants have an underdeveloped shivering reflex, anesthesia is a risk factor because
|
Anesthetics often cause vasodilation and heat loss
|
|
|
Unique aspects of a child's surgical care include
|
Airway management
temperature alteration treatment of emergence delirium or delayed emergence from anesthesia |
|
|
During surgery an infant has difficulty maintaining a normal circulatory blood volume.. Why?
|
Since they have less total blood volume then children & Adults if they lose any blood it can be serious
reduced circulatory volume makes it hard for the infant to respond to increased oxygen demands during surgery. |
|
|
Infants as highly susceptible to complications associated with dehydration but if the fluids are replaced to quickly
|
they will become overhydrated
|
|
|
Normal tissue repair and resistance to infection depend on?
|
Adequate nutrients
required 1500kcal/day to maintain energy after surgery |
|
|
What nutrients increase wound healing
|
Protein
Vitamin A & C Zinc |
|
|
WHy is a person who is malnourished proned to poor tolerance to anesthesia?
|
Lack of protein- negitive nitrogen balance
Delayed clotting mechanisms infection poor wound healing potential for multiple organ failure |
|
|
This phase Begins with the determination that the client requires surgery and ends with the transport to the operating room ?
|
Preoperative Phase
|
|
|
What are the nursing responsiblities during the preoperative phase
|
identification of the client
assessment of the client identifying potential or actual problems beginning of postoperative teaching * Skills or knowledge. |
|
|
This client often has difficulty resuming normal activity after surgery and is suscepitible to poor wound healing and infection.
|
Obese patient
|
|
|
Why after surgery the obese patient prone to poor wound healing and infection.
|
bc of the structure of fatty tissue which contains a poor blood suppy
|
|
|
Why is an obese patient at risk for dehisence and evisceration?
|
Because of the thick layer of adipose tissue it is difficult to close the surgical wound
|
|
|
Obesity increases surgical risk by?
|
reducing ventilation and cardiac function
|
|
|
What Type of problems are common in the Bariatric population
|
Obstructive sleep apnea
hypertension Coronary Artery diease diabetes mellitus CHF |
|
|
OSA
|
Obstructive sleep apnea
|
|
|
A Syndrome of periodic, partial or complete obstruction of the upper airway during sleep
|
Obstructive sleep apnea
results in sleep associated oxygen destaturation |
|
|
Signs of OSA
|
snoring
morning headaches frequent arousals during sleep chronic fatigue daytime somnolence |
|
|
Body responds to surgery as trauma. Protein breakdown causes negitive nitrogen balanceand elevated blood glucose levels, both of these effects.. ?
|
Decrease tissue healing and increase the risk for infection
|
|
|
Within the first 2 - 5 days of surgery, as result of the adrenocortical stress response the body..?
|
retains sodium and water and loses potassium causing a fluid and electrolyte imbalance
|
|
|
a patient with an excessive or depleted of K+ increases the chances of?
|
dysrhythmia during and after surgery
|
|
|
Fluid and electrolyte imbalances are even greater if the client has pre existing conditions of
|
Diabetes mellitus
renal gastrointestinal cardiovascular anormalities |
|
|
It is important to assess a clients prior surgery history that has experienced motion sickness, nausea and vomitting because
|
These factors increase the risk for aspiration
|
|
|
Why does a smoker have a greater risk for postoperative pulmonary complications?
|
Because anesthetics increase airway irriatation and stimulate pulmonary secretions and reduce ciliary activity.
|
|
|
Why is it important for a smoker after postoperative to practice deep breathing and coughing
|
Because they have difficulty clearing the airways of mucous secretion
|
|
|
Conditions that increase the risk of hemorrhaging during & after surgery
|
Bleeding drisorders
Ex: Hemophilia & Thrombocytopenia |
|
|
the medical term for a low blood platelet count.
|
Thrombocytopenia
|
|
|
A disorder of your blood-clotting system
|
hemophilia
|
|
|
A condition that increases susceotibility to infection and impairs wound healing from altered glucose metabolism and associated with circulatory impairment
|
Diabetes mellitus
*stress of surgery increases blood glucose levels |
|
|
A condition, due to stress of surgery causes increased demands on mycardium to maintain cardiac output.
|
Heart diease
*MI, Dysrhythmias,CHF Peripheral vascular diease *general anesthetic agents depress cardiac function |
|
|
A condition when opiods are administered, increased risk of airway obstruction postoperatively
|
OSA
|
|
|
A condition that increases the risk of respiratory complications duringanesthesia
|
Upper respiratory infections
Pneumonia spasm of laryngeal muscles |
|
|
A condition that alters metabolism and elimination of drugs administered during surgery and impairs wound healing anc clottingtimebecause of alterations in protein metabolism
|
Liver Diease
|
|
|
Condition that predisposes client to fluid and electrolyte imbalances and may indicate underlying infection
|
Fever
|
|
|
A condition that reduces clients means to compensate foracid-ase alterations. Anesthetic agents reduce this function increasing the risk for severe hypoventilation
|
Chronis respiratory diease
Emphysema Bronchitis & Asthma |
|
|
A condition that increases the risk of infection and delayed wound healing after surgery
|
Immunological disorders
Aids Leukemia use of chemo drugs bone marrow depression |
|
|
A condition due to a person abusing drugs sometimes have underlying diease that affects healing
|
Abuse of street drugs
|
|
|
A condition where regular use of painmedicationoften results in higher tolerance.
Increased doses are sometimes necessary to achieve pain control |
Chronic pain
|
|
|
A drug that enhances action of anesthetic agents. Taken 2 weeks before surgery may cause mild resppiratory depression
|
Antibiotics
|
|
|
Beta blockers drugs that can reduce cardiac contractility and impair cardiac conduction during anesthesia
|
Antidysrhythmics
|
|
|
Long term use of this drug alters metabolism of anesthetics
|
Anticonvulsants
Dilantin Phenobarbital |
|
|
This drug alters normal clotting factors and thusincrease risk of hemmorrhaging, dscontinued 48 hrs prior to surgery
|
Anticoagulants
Warfarin -Coumadin Aspirin |
|
|
A drug which interact with anesthetic agents to cause bradycardia,hypotension,& impaired circulation
|
Antihypertensives
*Beta blocker & Calcium channel blockers |
|
|
Prolonged use of this drug causes adrenal atrophy which reduces the bodys ability to withstand stress.
|
Corticosteroids
*Prednisone Often increases before and during surgery |
|
|
Stress response and IV administration of glucose solution often increase dosage requirements after surgery. Decreased nutritional intake often decreases doasage requirements
|
Insulin
need changes after surgery |
|
|
Drug that Potentiate electrolyte imbalances particularly K+ after surgery
|
Diuretics
Furosemide Lasix |
|
|
Drug that inhibits platelet aggregartion and prolong bleeding time increasing susceptibility to postoperative bleeding.
|
NSAIDs
Ibuprofen |
|
|
These herbal therapies have the ability to affect platelet activity and increase susceptibility to postoperative bleeding.
|
Ginger ginko & Ginseng
*Ginseng is reported to increase hypoglcemia with insulin therapy |
|
|
Clients with a history of excessive alcohol ingestion are often?
|
Malnourished which delays wound healing
*have a high tolerance to anesthetics |
|
|
This is done to identify poential risk factors and reduce complications
|
Nursing Health history & Physical Assessment.
|
|
|
Written permission obtained from the client prior to any invasive procedure or one that has potentially serious side effects or complications
|
Informed Consent
|
|
|
Peripheral venous sample of blood that may reveal infection, low blood volume andpotential of oxygenation problems, blood replacement
|
Complete Blood Count CBC
|
|
|
Normal RBC
|
Men 4.6-6.1
Women 4.2 - 5.4 |
|
|
Normal HGB
|
Men 14-18
Women 12 -16 |
|
|
Normal HCT
|
Men 42% - 52%
Women 37% - 47& |
|
|
Normal WBC
|
Adults an children
5000 - 10,000 |
|
|
Peripheral venous blood sample of blood may reveal significant fluid & electrolyte imbalances preoperatively
|
Serum electrolytes
|
|
|
Normal Na+
|
136 -145 meq/L
|
|
|
Normal K+
|
3.5 -5.0 meq/L
|
|
|
Normal Cl+
|
98- 106 meq/L
|
|
|
Normal Bicarbonate
|
21-28 meq/L
|
|
|
Normal prothrombin time PT
*reveals the risk for bleeding |
11 -12.5 seconds
|
|
|
Normal international normalized ratio (INR)
|
0.76-1.27
|
|
|
Normal APTT
|
30 - 40 seconds
|
|
|
Normal Platelets
|
150,000 -400,000
|
|
|
Ability of kidneys to excrete Urea and Nitrogen indicate renal function
|
10 -20 mg/100 ml
|
|
|
Bun becomes elevated if the client is ?
|
Dehydrated
*preoperative IV fluid replacement is often necessary |
|
|
Ability of kidneys to excrete creatinine, by-product of muscle metabolismindicates renal function.
|
Serum Creatinine
|
|
|
Elevated level of serum creatinine can indicate
|
Renal failure
|
|
|
Normal Levels of Serum Creatinine
|
Men 0.6-1.2mg/100ml
Women 0.5-1.1mg/100ml |
|
|
Finger stick or peripheral blood sample. Client often requires treatment of low or high levels preoperatively and postoperatively.
|
Glucose
Fasting:70-105mg/100ml |
|
|
Name of the option for some cllients who choose to donate their own blood before surgery to reduce the risk of transfusion -related infections and reaction
|
Autologous infusions
|
|
|
Anyone over the age of 40 or has heart diease, the MD will order
|
ECG and chest X-ray
|
|
|
Where blood loss is expected this type of blood test will indicate if the client needs a blood transfusion during surgery
|
Type and crossmatch
* the surgeon designates the # of blood units to have available |
|
|
Whos responsibility is it to explain the procedure and obtain the informed consent
|
it is the surgeons responsibility
|
