Test 3 Pre Op

Front 1

This type of surgery is usually same day and the patient may not be admitted as an inpatient and go home the same day.

Back 1

Outpatient surgery

Front 2

What are some of the Pros of outpatient surgery

Back 2

Not separated from comfort, allows them to have the security of family and friends.

Front 3

What are some things to think about with outpatient surgery? Keep in mind?

Back 3

This is a same day surgery, sometimes patients dont expect to have this surgery and life goes on without them, they may not have family members who can come be with them during the process, maybe they are old and the spouse cant come.

Front 4

In this type of surgery the patient is already admitted to the hospital.`

Back 4

Inpatient surgery

Front 5

What other places are surgery's being done?

Back 5

In surgi-centers

Physicians office

Front 6

This type of surgery usually doesnt require immediate action. Examples of it are a cataract removal and hernial repairs.

Back 6

Elective surgery

Front 7

This type of surgery usually requires surgery verily quickly and some examples of this type of surgery are, intestinal obstruction, kidney stones, and bone fractures

Back 7

Urgent Surgery

Front 8

This type of surgery is high priority and needs to be done right away. Examples of this type of surgery are:

Gunshot, stab wound, severe bleeding, abdominal aortic aneurysm, compound fracture

Back 8

EMERGENT Surgery

Front 9

This type of surgery usually is done with local anesthesia and some examples of this surgery are:

incision and drainage, implantation of a venous access device, muscle biopsy.

Back 9

Minor Risk Surgery

Again these are usually not long procedures and dont require a lot of anesthesia or for the patient to be put under which places them at a less of a risk for complications.

Front 10

This type of surgery is longer and more invasive than minor surgery. Some examples of this surgery are:

Mitral valve replacement, pancreas transplant, and lymph node dissection.

Back 10

Major risk surgery:

Again requires patient to be under anesthesia for longer periods of time with more exposure.

Front 11

This type of surgery is performed to determine the origin and cause of a disorder or the cell type of cancer.

Back 11

Explorative Surgery

Front 12

This surgery involves taking out the tumor or curing the patient of that specific issue or problem.

EX: cholecystectomy and appedndectomy

Back 12

Curative/ Ablative

Front 13

In this type of surgery the dr goes in and trieds to remove as much of the tumor as they can to help relieve symptoms of a disease. NOT A CURE!

Back 13

Palliative surgery

Front 14

This type of surgery is done to help people feel better about themselves

Back 14

Cosmetic.

Front 15

This type of surgery is when the Dr will cut straight through the patient. Opens them up.

Back 15

Traditional surgery

Front 16

This type of surgery is done without cutting the patient open, they will have 3/4 stab wounds and recovery time is 2 weeks. During this surgery they are at risk for being cut open depending on what is found.

Back 16

Laproscopic Surgery

Use of scopes and lazers

Front 17

This type of surgery increases the patients ability to function.

EX: Total knee replacement.

Back 17

Restorative

Front 18

What are the main goals of preoperative nursing?

Back 18

SAFETY

ADVOCACY

Patient Education

Front 19

Decision to perform surgery------->

transportation of patient to OR

What period is this?

Back 19

Pre-operative period

Front 20

In OR--------->

transfer to post-anesthesia care unit (PACU)

What period is this

Back 20

Intra-operative period

Front 21

Admission to PACU------------>

Recovery time----> anesthesia/ stress of surgery----->then back up to floor.

What period is this?

Back 21

Post-operative period.

Front 22

Major responsibilities for perioperative nursing?

Back 22

Safety

Consistency of process

Effectiveness

Front 23

______ _____ _______ is critical to the outcome, education and intervention before surgery to decrease anxiety

Back 23

Readiness for surgery

Front 24

This needs to be obtained before surgery.

Back 24

Informed consent

Front 25

The informed consent gives the patient ____________

Back 25

Details about surgery and whats involved.

Front 26

The patient must be informed of these 6 things.

Back 26

1. Need for procedure, what is involved

2. Risks of having and not having procedure

3. Benefits and expected results

4. Alternative treatments(what else can we do)

5. Right to refuse or withdraw consent.

6. Risks associated w/ anesthesia

Front 27

What is the nurses responsibility with informed consent, what do we do?

Back 27

We validate, we clarify and we reinforce the infor the pt received from the surgeon or other members of the medical team.

We witness the signature and sign after witnessing.

Front 28

We must have these 3 separate consents before surgery

Back 28

Consent for surgical procedure

Consent for anethesia

Consent for blood and blod products

Front 29

Why do we do informed consents? Who does it protect?

Back 29

One way to ensure patient safety

Protects the pt from unwanted procedures

Protects surgeon and facility from lawsuit.

Front 30

It patient is unable to sign the consent who signs the consent?

Back 30

Medical power or attorney or the parent if they are under 18

Front 31

You want to make sure the patient is ______ when receiving informed consent and that this ______ can alter this.

Back 31

That patient is coherent and that pain med can alter coherence.

Front 32

What do we do to ensure that the correct site is located?

Back 32

By marking the site and having the patient involved or mark the site as well.

Front 33

What is this called?

Dr asks patient what we are doing today, has the patient explain and has the patient mark the surgical site. This all happens before the ER and name, DOB, and procedure are discussed as well.

Back 33

This is called time out and most facilities have adopted this procedure.

Front 34

Why does age play a factor with surgery?

Back 34

Age: the older you are the more dangerous surgery is and the more at risk you are.

Front 35

What are some things that happen when you age?

Back 35

Chronic Illness increases

Decrease in muscle mass

Decrease in water retention = dehydration
Thin skin

Front 36

This affects the ability of anesthesia to work properly.
Which is why it should be included in the medical history assessment.

Back 36

Tobacco

Front 37

This changes the way they react to narcotics and also alters the response to anesthesia and pain.

Back 37

Alcohol

So again important to ask during the per op phase assessment in medical history

Front 38

We must treat this before the patient goes to surgery.

Back 38

Infection, asking if the patient has had or has a infection is critical, dont want them to go to surgery with infection.

Front 39

Why must we know if the patient has a latex allergy?

Back 39

To prevent complications

Front 40

Why do we want to know about prior surgeries during the preoperative assessment?

Back 40

So that we know if there are any complications, reactions or if they tolerated the surgery well, it not so that we can know what to do.

Front 41

Why do we want to know about the patients experience to anesthesia.

Back 41

Have they had anesthesia before? Nausea? Vomiting? Sufficient pain control?

Front 42

Why do we want to know who the patients support team is?

Back 42

WE want to know who will be helping take care of them after surgery. Who will be there with them before surgery, providing comfort.

Front 43

We want to know about the patients cardiac history and its relation to surgery

Back 43

The patient has a greater chance for a MI during surgery for patients who have heart problems.

Front 44

Cardiac problems that increase risk during surgery are: (there are 6)

This is why we want a cardiac history.

Back 44

Coronary artery disease

Angina

MI w/in 6 months prior surgery

HF

Hypertension

Dysrhythmias

Front 45

Patients that have cardiac issues withstand ______ changes and & alter response to _______

Back 45

hemodynamic

Anethesia

Front 46

Loss of lung elasticity reduces ________ excretion

Back 46

Anesthesia

Front 47

Who usually has respiratory issues?

Back 47

Problems occur with older patients, chronic respiratory problems, and smokers.

Front 48

Smoking causes _______ and ______ gas exchange and causes intolerance to _______

Back 48

Atelectasis

Decreases

Anesthesia

Front 49

Asthma, chronic bronchitis, and emphysema cause Decrease in _______, decrease in _______, and decrease in __________ ___________

Back 49

elasticity

gas exchange

tissue oxygenation

Front 50

F, purulent sputum, dysuria, cloudy or foul smelling urine, any red swollen, draining IV or wound site.

These are signs of what?

Back 50

Signs of infection

Front 51

What is the protocol if they patient cannot sign their name for the informed consent.

Back 51

Can sign with a X but must be witnessed by two.

Front 52

What is an advanced directive

Back 52

Legal instructions about pts wishes that are to be followed.

Front 53

True or False

Surgeries provide an exception to a pts advanced directive or living will.

Back 53

False, they do not provide an exception.

Front 54

When do you prepare for discharge?

Back 54

Right away, we need to know what they may need after surgery, who is their support group? Do they have an help.

Front 55

shortened stays require adequate _________

_________

Back 55

discharge planning

Front 56

What emotional considerations should you consider before surgery?

Back 56

How much fear and anxiety do they have?

Front 57

Anesthesia can cause what kind of emotional response?

Back 57

Can cause fear if they had a bad experience in the past.

Front 58

By _________ the pt and family members we can help decrease __________

Back 58

teaching

Anxiety

Front 59

We want to explore the pts ___________ & __________ of their disease process and surgery to decrease ___________

Back 59

knowledge & understanding to decrease anxiety.

Front 60

We want to report a _______ in prothrombin time (lab)

Back 60

Increase

Front 61

We want to report these 2 labs, what are they?

Back 61

international normalized ration INR

Activated partial thromboplastin time

Front 62

We want to make sure our patient is not _______

(lab/diagnostic test)

Back 62

Pregnant, pregnancy test

Front 63

We want to make sure that this electrolyte level is not high or low.

Back 63

Potassium (hypo or hyperkalemia)

Front 64

What clinical changes do we want to report to the physician before surgery?

Back 64

Change in mental status

Vomiting

Rash

Recent administration of an anticoagulant drug.

Front 65

Dehydration, polycythemia, chronic pulmonary disease, and CHF can cause a Increase in this lab

Back 65

Hemoglobin

Front 66

Blood loss, anemia, and renal failure show a decrease in these labs

Back 66

Hemoglobin and Hematocrit

Front 67

Dehydration, polycthemia, and high altitude cause a increase in this lab

Back 67

Hematocrit

Front 68

In the preop area this is done for the patient

Back 68

IV

Gown

EKG

BP check

Talk about consents, verify surgical site, what to expect, teaching checklist, other surgeries may push back time.

Front 69

How can we prepare for post op before surgery?

Back 69

Talk to them, tell them what to expect after surgery, they will be assess again, they will be checked out and they should expect that. There might be tubes or drains in place. IV is needed for meds, VS will be done Q15mins so prepare them for that.

Front 70

To help reduce post op pulmonary issues we should teach our patient how to use this and how to decrease pain when doing this.

Back 70

Incentive spirometry and how to splint their incision to decrease pain when coughing.

Front 71

The pt should be NPO for ___ to ___ hrs before surgery, if patient is dehydrated this is ok to use.

Back 71

8-12 hours

IV is okay to help keep the patient hydrated

Front 72

What meds are okay to take before surgery? How much water?

Back 72

Some meds are ok for seizures, cardiac diseases, respiratory disease and hypertension, only with a sip of water.

Front 73

DM patients are usually given this type of INSULIN before surgery

Back 73

Intermediate or long acting depending on BG level

Front 74

Anticholinegic drugs are given preop to do what?

Back 74

Decrease fluids

Front 75

H2 blockers and PPI's are given before surgery to

Back 75

Decrease acid to help with GI surgery

Front 76

Why are prophylactic antibiotics given before surgery?

Back 76

To prevent infection.

Front 77

What can we do to prevent DVT, PE, and VTE

Back 77

Ted hose

pneumatic compression devices

Leg exercises

Front 78

This person of the operating team takes care of the patient before coming into the OR.

Back 78

Holding area nurse

Front 79

This person of the operating team is responsible for documenting, providing supplies, ensure patient safety and is responsible for coordinating all activities within that particular OR.

Back 79

Circulating nurse

Front 80

This person of the operating team helps with sterile table set up, hands instruments and helps with sterile field.

Back 80

Scrub nurse.

Front 81

Scrub attire is clean not sterile.

True or False?

Back 81

True, the scrub material is clean and the actual scrub does not make the hands and forearms sterile.

Front 82

What is the process for scrubbing into surgery. The step

Back 82

1st scrub up to elbows, make sure your hands are held up, put on gown, keep hands inside of gown, someone ties the gown loosely and then put on gloves

Front 83

This type of anesthesia uses gases and or IV meds to put the patient under.

Back 83

General

Front 84

This type of anesthesia uses lidocaine, only to the area where surgery is happening.

Back 84

Regional

Front 85

In this type of anesthesia, the patient is somewhat awake but not aware and forgets about the procedure.

Back 85

Conscious sedation

Front 86

General anesthesia can cause ______ & _______

Back 86

Vomiting and restlessness during emergence

*Emergence means recovery from anesthesia*

Front 87

When they do general anesthesia, why do they combine an IV and inhalation drug?

Back 87

Provides safe and controlled anesthesia which is especially good for older and high risk patients.

Front 88

How would you treat shivering an cyanosis as a side effect of general anesthesia?

Back 88

Blankets and provide O2

Front 89

If the patient is vomiting after general anesthesia, what can you do as a nurse?

Back 89

make sure suction equipment is available and use to prevent aspiration.

Front 90

What is malignant hyperthermia?

Back 90

Acute life threatening complication of certain drugs used for general anesthesia.

Front 91

This causes a increase in Ca+ in muscle cells and a Increase muscle metabolism. Increase Ca+ and increase of K+ as well as a increase metabolic rate lead to acidosis, cardiac dysrhythmias and increase body temp.

Back 91

Malignant hyperthermia

Front 92

Manifestations of the cardiac system with malignant hyperthermia.

Back 92

Sinus tachycardia

tachycardia

dysrhythmias

hypotension

Front 93

Other manifestations of malignant hyperthermia.

(pulmonary, Muscle, Skin, Urine?)

Back 93

Pulmonary: cyanosis, decrease in 02 sat., tachypnea

Muscle: muscle rigidity

Skin: skin mottling (patchy)

Urine: myogobinuria (muscle protein in urine.)

Front 94

Spinal, epidural, nerve block and field blocks are what types of anesthesia?

Back 94

Regional anesthesia

Front 95

Injection of the local anesthetic agent into or around one nerve or group of nerves in the involved area, commonly used for limb surgery or to relieve chronic pain.

Back 95

Nerve block

Front 96

Injection of anesthetic agent into CSF in the subarachnoid space. Used for lower abd, pelvic, hip, or knee surgery.

Back 96

Spinal

Front 97

Injection of an agent into epidural space used for anorectal, vaginal, perineal, hip and lower extremity surgeries

Back 97

Epidural

Front 98

What are some complications of local or regional anesthesia?

Back 98

Complications r/t sensitivity of agent, incorrect delivery technique, system absorption and over dose, CNS stimulation followed by cardiac depression = systemic toxic reaction.

Front 99

Some S&S of complications of Regional anesthesia include:

Back 99

Restlessness, excitement, incoherent speech, HA, blurred vision, metallic taste, N, V, tremors, seizures, increase pulse, RR, and BP.

Front 100

What is the first thing you would do if someone is showing signs & symptoms of complications r/t regional anesthesia.

1. give epinephrin

2. call dr

3. establish an open airway

4. Give O2

Back 100

1st, establish an open airway, give O2 then give epinephrin and notify dr.

*epinephrin is given to prevent cardiac arrest*

Front 101

Edema, inflammation, abscess formation, tissue necrosis and gangrene are signs of....

Back 101

Complications r/t local anesthesia

Front 102

What is conscious sedation used for?

Back 102

Endoscopy, cardiac catheterization, closed fracture, reduction, cardioversion and other special but SHORT procedures.

Front 103

What do you want to monitor the patient for who has had moderate sedation?

Back 103

LOC, airway, capnography, O2 sats, ECG, VS q15-20mins until pt is awak and oriented and when VS return to normal baseline levels.

Front 104

Patient is expected to be sleepy and not arousable several hours after moderate sedation.

True or False

Back 104

False, patient will be sleepy but they should be arousable.

Front 105

When performing MIS, sometimes air or gas is injected into the area, what is this called and why do they do it?

Back 105

Air and gas is injected to help separate the organs to prevent accidental injury to other organs while doing surgery.

Front 106

The ______ or _____ can contribute to complications and pt discomfort when doing MIS.

Back 106

Gas or Air

Front 107

What are the pros of using lasers for surgery?

Back 107

Cuts tissue more cleanly, rapidly clots blood vessels or tissue.

Front 108

This type of wound closure is used on long lacerations and requires a special tool for removal

Back 108

Staples

* These is no increase in inflammatory response vs suturs

Front 109

This type of wound closure is used on the dermis for superficial wounds, or used to close laparoscopic wounds.

Back 109

Steri-strips

* sometimes the dr will suture the underlying layer of the skin but on top of skin will use steri strips which is common with laparoscopic surgery.

Front 110

This type of wound closure can be self dissolving, and requires manual removal.

Back 110

Sutures

Body enzymes break up the dissolving sutures.

Front 111

This type of sutures are used for large abdomen wounds, helps tighten the abdomen over time.

Back 111

Retention sutures.

Front 112

This type of wound closure is not the easiest or prettiest but is the only way for it to heal.

Back 112

Secondary.

Front 113

What are the main things we want to check right away when the patient is admitted to the PACU

Back 113

ABC- AIRWAY
Vital signs

Fluids- I&O

Incisions/tubes

pain management

LOC

Front 114

The pt is in PACU for at least _______, DC to floor when adequate score on the ______ _______ .

Back 114

1 hour

Recovery scale ex aldreti score

Front 115

The patients ______ _____ must be stable and they should have no overt ________ and have a return of _______ & _______ ________ before returning to their floor or being discharged

Back 115

Vtial signs

Bleeding

Cough and Gag reflux

Front 116

When having a patient coming into the PACU what should you have ready for them?

Back 116

Bed ready

VS equipment in the room

IV pole

Front 117

This must be done when a patient is coming into the PACU

Back 117

Both the PACU RN and anesthesiologist do a hand off report.

Front 118

If the patients O2 saturation drops below 95% what should you do?

Back 118

Call the surgeon and or anesthesiologist provider

Front 119

If the patients O2 saturation drops by 10 percentage points and you are certain its an accurate measure what should you do?

Back 119

Call the rapid response team!

Front 120

Rapid shallow breaths could indicate what?

Back 120

Shock, cardiac problems, increased metabolic rate or PAIN

Front 121

How do you know if there is an excessive anesthetic effect on the patient

Back 121

Using accessory muscles, airway obstruction or paralysis which could result in hypoxia

Front 122

Listen for _____ & ______ these occur with airway obstruction.

Back 122

Snoring and stridor

Front 123

How does a airway obstruction happen?

Back 123

Could result from tracheal or layngeal spasm or edema, mucus in the airway, or blockage of the airway from edema or tongue relaxation.

Front 124

Muscle weakness can impair _______ _______

Back 124

Gas exchange

Front 125

What are signs and symptoms of impaired gas exchange.

Back 125

Inability to maintain a head lift, weak hand grips, and abdomen breathing pattern.

Front 126

You should check the patients lungs every _____ ____ in the first 24 hrs then every _____ ____

Back 126

4 hours

8 hours

Front 127

How often should you do VS in the PACU?

Back 127

Q15mins

Front 128

You want to report a BP change that are _____ to ____ point difference, systolic or diastolic to the Anesthesiologist or to the surgeon.

Back 128

15 to 20 points off

Front 129

What are some Signs of possible cardiac depression?

Back 129

Decrease BP, Pulse pressure and abnormal heart sounds.

FVD, shock hemorrhage or the effects of drugs.

Front 130

Bradycardia could happen because of the ______ _________ or hypothermia.

Back 130

Anesthesia effect

Front 131

A increased pulse rate indicates what?

Back 131

Shock, hemorrhage, pain

Front 132

Why do you want to do a peripheral vascular assessment post op?

Back 132

Anesthesia and positioning during surgery may impair peripheral circulation and contribute to VTE, and DVT.

Front 133

What interventions could you do to prevent DVT and VTE?

Back 133

Compare distal pulses on both fee for quality of pulsation, observe the color and temp of extremities, evaluate sensation, determine speed of cap refill

Front 134

You want to do a Focus assessment post up based on _____ of ________.

Back 134

Type of surgery

Front 135

This is one of the best indicators to tell if your patient is in pain

Back 135

Vital signs

Front 136

How often should you do vital signs. Why do we do vital signs?

Back 136

Q15 MINS X4 ---->Q30 MINS X2------->Q1HR X4

We do vitals so often because it is often teh first sign of complications.

Front 137

How often do you want to do a Neuro assessment?

Back 137

Q4-8HR or as indicated by the Dr

Front 138

General anesthesia depresses all ______ ______ ______. Whereas regional anesthesia alters the motor and sensory function of only part of the body

Back 138

Voluntary motor function.

Front 139

Motor and sensory assessment are very important after _______ or _______ anesthesia. Evaluate motor function by asking the pt to move each extremity

Back 139

Epidural or Spinal

Front 140

What is a way to assess the patients neuro capabilities?

Back 140

Assess push and pulls, compare sides.

Front 141

Why do we want to know the type and amount of blood or fluid given during surgery?

Back 141

How much given affects the patients fluid and electrolyte balance after surgery.

Front 142

Imbalances in fluid, electrolyte, and acid and base often occur in _______ patients.

Back 142

Older

*also those who have health problems. DM, Debilitated, crohns, HF.*

Front 143

Record any intake or output, including IV fluid intake, _______, urine, ______ _______ and NG drainage.

Back 143

Vomitus

Wound drainage

Front 144

You must know the total I&O from both the _____ and ____ to assess fluid balance accurately and to complete the 24hr I&O record

Back 144

OR and PACU

Front 145

You want to consider _______ _______ loss such as sweat when reviewing total output.

Back 145

insensible loss

Front 146

NG drainage or vomit cause a loss of ______ ____ and leads to metabolic alkalosis

Back 146

hydrochloric acid

Front 147

Postoperative _____ and _____ are the most common reactions after surgery

Back 147

Nausea and vomiting

Front 148

Patients with a history of ______ ______ are more likely to develop Nausea and Vomiting after surgery.

Back 148

Motion sickness

Front 149

Obese patients may be at risk because ________ are retained and fat cells and remain in the body ________

Back 149

Anesthetics

Longer

Front 150

Abdomen surgery and use of opiod analgesics Decrease ____ _____

Back 150

intestinal peristalsis

Front 151

Patients often have ______ _______ when HOB is raised after surgery.

Back 151

Increased N

* Have pt be in side laying position before raising HOB SLOWLY!*

Front 152

What is the best indicator of intestinal activity?

Back 152

Stool and Flatus

Front 153

S&S of a paralytic illeus

Back 153

Few or absent bowel sounds, ABD discomfort, Vomiting, no passage of Flatus or Stool

Front 154

What is the most common NG tube used after surgery?

Back 154

Salem pump, continuous suction on low.

Front 155

After surgery do not or move, or irrigate the ____ _____ unless prescribed by the dr.

Back 155

NG Tube

Front 156

What assessment techniques can you do to assess if the patient is retaining urine?

Back 156

inspection, palpation, percussion of Lower abdomen for bladder distention or use a bladder scanner.

Front 157

Urine retention is NOT common after surgery.

True or False

Back 157

FALSE

urine retention is common early after surgery and requires intervention such as a straight catheterization to empty bladder.

*common because of preoperative drugs, anesthetic agents, or manipulation during surgery.

Front 158

you want to report a urine output __________ to the physician

Back 158

<30ml

(240ml/8hr shift)

Front 159

This is a high priority after surgery and is worst during the first 48 hours

Back 159

Pain

Front 160

When treating pain you want to be worried about ______ _______

Back 160

effects of narcotics

*narcotics depress the respiratory system.

Front 161

When in between medication doses what can you do for pain?

Back 161

Positioning, massage, relaxation/ diversion, TV

Front 162

We dont want to medicate pain before it starts, we want to medicate when the patient feels the pain so that we can get a baseline.

True or False?

Back 162

False

Medicate before pain becomes severe or before it starts.

Front 163

When assessing his/her pain discomfort and need for med, consider the _____, ____, and ______ of the surgical procedure.

Back 163

Type,

extent

length

Front 164

What are some physical signs of pain?

Back 164

Increased HR

Increased BP

Increased RR

Profuse sweating

Front 165

What are some emotional signs of pain?

Back 165

Restlessness

Confusion (older pt)

Wincing

Moaning

Crying

Front 166

What are ways to relieve vomiting and N.

Back 166

oral care afterwards

Elevate HOB

Anti-emetics

small frequent amounts of food

Front 167

We want our patient up and moving _______

Back 167

ASAP

Front 168

What are the nutrition guidelines?

Back 168

Begin with clear liquids, advance per orders.

*before giving anything to the patient make sure cough and gag reflex are working!*

Front 169

changes in these specific lab tests during the 1st 24 - 48hrs could indicate blood and fluid loss and the body's reaction to the surgical process.

Back 169

CBC

H&H

Electrolytes

Front 170

Infection increases what specific lab value

Back 170

Immature neutrophils

Called the Left shift

Front 171

We want to monitor SpO2 with Pulse ox every _____ _____ or more often according to the pts condition

Back 171

9 hours

Front 172

This after surgery increases o2 demand and induces hypoxemia.

Back 172

Hypothermia

Front 173

How can we prevent and manage hypothermia

Back 173

Warm blankets, manage with O2 therapy.

Front 174

If the patient cannot be in the SEMI-FOWLERS position to improved o2 what can you do?

Back 174

Turn them on their side to increase o2

Front 175

What are S&S of hypoxia

Back 175

restlessness, pallor, dyspnea, diaphoresis, bounding pulse

Front 176

Interventions for hypoxia

Back 176

Raise HOB, o2, suction, pain management.

Front 177

How can we prevent aspiration?

Back 177

Make sure to check cough and gag reflex. Slowly advance diet, start with clear liquids. Have pt sit up to swallow.

Front 178

What can we do to prevent pneumonia?

Back 178

Turn Cough Deep Breathe

Incentive spirometer.

Front 179

What can we do to prevent atelectasis?

Atelectasis- lungs dont expand at the bottom

Back 179

Turn cough deep breathe

Incentive spirometer

SVN

Mobility

Front 180

How often should the pt use the Incentive spirometer, cough, and deep breathe?

Back 180

q1-2hrs

Front 181

If patient is unable to clear secretions, it requires _____ or ______ _______.

Back 181

Oral or nasal suctioning

*provide oral care after*

Front 182

Why do we encourage movement after surgery?

Back 182

Helps with removal of secretions decreases chances of VTE, or DVT

Front 183

If the patient cannot ambulate what can you do to help them with movement?

Back 183

Assist with turning q2hrs, and ensure that breathing exercises and leg exercises are being performed

Front 184

We want to offer pain meds _____ to _____ mins prior to movement

Back 184

30-45 mins

Front 185

RBC Value for Males

Back 185

4.7-6.1 million

Front 186

RBC value for F

Back 186

4.2-5.4

Front 187

Hemoglobin values for Male

Back 187

14-18

Front 188

Hemoglobin values for Female

Back 188

12-16

Front 189

Hematocrit Values for Male

Back 189

42-52%

Front 190

Hematocrit Values for Femal

Back 190

37-47

Front 191

WBC values

Back 191

5,000-10,000

Front 192

Iron levels for Female

Back 192

60-160

Front 193

Iron levels for Males

Back 193

80-180

Front 194

platelet count value

Back 194

150,000-400,000