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253 Cards in this Set
- Front
- Back
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Nursing activities carried out before, during, and after surgery is called ______.
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perioperative nursing
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There are 3 phases of perioperative nursing:
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-Pre-operative
-Intraoperative -Post-operative |
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The _____ phase of perioperative nursing is the actual surgery itself thru the transfer to the recovery phase.
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Intra-operative
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The _____ phase of perioperative nursing is from the time the client decides to have the surgery until the client is transferred to the operating table.
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Pre-operative
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The _____ phase of perioperatvie nursing is the time the patient is in the recovery room and throughout the healing process.
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Post-operative
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There are 3 phases of the Post-operative phase:
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-Post Anesthesia Care Unit
-Acute Care -Extended Care after hospital release |
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Surgical classifications based on urgency are:
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elective or emergency.
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_____ surgery has no ill effects. It can be serious or less serious and is often outpatient.
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Elective
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_____ surgery must be done immediately to preserve life or function.
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Emergency
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Surgical classifications based on purpose include:
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-diagnostic
-ablative -palliative -reconstructive -transplantation -constructive |
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_____ surgery is done to make or confirm a diagnosis. ex. biopsy
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Diagnostic
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_____ surgery is done to remove a diseased body part. ex. tonsilectomy, colocisectomy
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Ablative
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_____ surgery is done to relieve/reduce the intensity of illness. It is not a cure! ex. debridement of a wound or obstruction relief
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Palliative
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_____ surgery is done to improve self concept or restore function. ex. breast reconstruction after mastectomy.
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Reconstructive
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_____ surgery is done when diseased organs are removed and replaced with other organs.
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Transplantation
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_____ surgery allows for function where there hasn't been function before. ex. cleft palate repair.
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Constructive
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An example of diagnostic surgery is...
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biopsy
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An example of ablative surgery is...
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tonsilectomy or colicisectomy
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An example of palliative surgery is...
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debridement of a wound or obstruction relief.
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An example of reconstructive surgery is...
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breast reconstruction after a mastectomy
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An example of constructive surgery is...
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congenital anomalies (cleft palate)
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Surgery can be classified based on the degree of risk...
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major or minor
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_____ surgery could be elective or emergent. There is a high degree of risk and the surgery is prolonged with a great deal of blood loss. There could be potentially life threatening complications.
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Major
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_____ surgery is usually elective and performed outpatient or in a1 day surgery center.
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Minor
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4 preoperative nursing interventions include:
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-nursing history
-physical assessment -informed consent signed -pre-operative teaching |
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Factors to focus on when obtaining the nursing history are:
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-age and developmental considerations
-general health -physical assessment -medical history -nutritional status -medications -mental status -lifestyle -support systems (coping) -knowledge of surgery |
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General health of the patient is important because ____ disease adds risk to surgery.
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chronic
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During the preoperative nursing history physical assessment, the nurse should listen for _____ and _____.
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heart/lungs and bowel sounds
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A good nutritional status means the patient is getting adequate ______ and is in a good nutritional state.
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protein
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Medications that can be problematic for surgery are:
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diuretics, anticoagulants, and tranquilizers.
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Assessing the mental status of a patient preoperative is important because...
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a patient with intact mental status can understand preoperative teaching and follow instruction better (TCDB).
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_____ can't be abruptly withdrawn for surgery because it can cause cardiovascular collapse and the patient can die during surgery.
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Adrenal steroids
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______ is problematic for inhalation anesthesia.
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Smoking
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_____ can potentiate anesthesia.
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Drinking
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Heavy drinkers may have DT's ____ days post-op.
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2-3
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Preoperatively- the patient should know...
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-why they are having the surgery
-the risks -exactly what the surgery is |
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Informed consent must be obtained _____ to ANY surgical procedure.
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prior
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The _____ is legally responsible for providing the client with all information needed to make a decision.
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physician
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The ______ responsibility is to make sure the consent is correct and signed.
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nurse's
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Surgical consents include:
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-description of surgery
-possible alternative therapies -underlying disease process -natural course if surgery isn't done -name and qualification of person performing surgery -explanations of risks of procedure up to and including death -explanation of patient right to refuse procedure (will not change pt care) |
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Informed or Surgical consent is usually obtained by...
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the nurse the night before surgery.
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Surgical/Informed consent must be _____, cannot be _____, and the patient must be ______ (no sedatives given prior!)
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voluntary
coerced mentally aware- unmedicated |
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If the patient is not competent, people who can give consent include:
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-next of kin
-health care power of attorney -legal guardian or parent if pt is a minor |
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If the patient speaks a different language, the informed consent should be...
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provided in that language or obtained with an interpreter.
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____ allow a patient to specify instructions for his or her healthcare treatment.
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Advance directives
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2 types of advance directives are:
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-Healthcare power of attorney
-Living Will |
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_____ is the most important thing the nurse can do that will help the patient after surgery.
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Pre-operative teaching
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_____ is when you help the client understand what will occur during each phase of the surgical experience.
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Pre-operative teaching
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Pre-operative teaching _____ client anxiety and promotes _____.
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decreases
recovery |
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Teach the client post-op exercises during the _____ phase.
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pre-op
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Examples of post-op exercises include:
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TCDB
leg exercises incentive spirometry |
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_____ prevents alveoli collapse, improves lung expansion, and facilitates oxygenation to the tissue.
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Deep breathing
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_____ is an important post-op exercise because is improves venous return, causes peristalsis to return sooner and improves respiratory function.
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TCDB
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Patients should be taught to TCDB post-op Q___.
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2h
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Leg exercises post-op should be performed _____ when awake.
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Q4h
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______ are important post op exercises because they increase venous return and reduce the chance of thrombosis.
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Leg exercises
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During incentive spirometry, the patient ______. This is done Q1h for 10 times.
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inhales
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Pre-operative teaching should include informing the patient of the following that he/she may have post-op:
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-NPO status
-IV access -Pre-op screening/tests -bowel/skin prep -pre-op medications -tubes (catheters/ng tubes) -Drains (penrose, JP, hemovac) -dressings |
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The client usually can't eat after _____ or ____ prior to surgery.
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12am, 8 hours
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A ____ prep may be something like having to drink a preparation to clean out colon.
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bowel
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A skin prep could be something like...
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shaving the client's chest.
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Always let the patient and family know when _____ will be given so that the family can arrange to be at hospital early to visit.
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pre-op medications
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Pre-operatively, teach the client that medications will be available and administered by _____, can be also given by a _____, and other _______
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the nurse
PCA pump non-pharmacological methods |
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Other pre-op considerations include:
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-valuables
-prostheses -TED stockings/SCD's -CPM (continuous passive motion machine) -Family Concerns -Body jewelry -early confusion in elderly -ICU psychosis -drowsiness -Intubated pt will have sore throat and dry mouth |
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All prostheses should be removed pre-op except _____ which sometimes may need to be left in place.
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hearing aids
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_____ should be fit to the patient prior to surgery and sent with patient to the OR.
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TED hose
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Lifespan considerations for children are:
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-allow parent to express concerns not in the presence of child
-minimize separation time -gear pre-op teaching to child's developmental level -don't talk down to teens |
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Separation anxiety _____ the longer the child is away from the parent.
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increases
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Lifespan considerations for elderly include:
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-hearing aid may need to be left in place
-repeat or reinforce information as needed -strongly encourage post-op exercises to prevent complications |
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Immediately before surgery the nurse should ensure the preop checklist is completed to include:
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-procedure verification completed
-site is marked with Yes and No -Client is medicated -there is a "Time Out" for the OR staff to repeat the verification process- Right client, Right procedure, Right Site. |
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The responsibilities of the surgical nurse during the intra-operative phase are:
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-assess the client (IV, catheters, LOC, VS, labs, positioning draping, documentation)
-monitor equipment -maintains a safe environment for the client |
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The _____ nurse scrubs in on the surgery itself. They wear STERILE gown, mask, headgear, gloves, shoe covers and eye protection. This may also be a _______.
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scrub
surgical tech |
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The _____ assists the surgeon with instruments during the surgery.
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scrub nurse/surgical tech
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The _____ nurse controls the surgical environment. This includes: set up OR, maintain supplies, take specimens to lab, get blood/blood products from blood bank, position client and supplies, take client to PACU, give report on the surgery to the PACU nurse.
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Circulating
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Members of the surgical team during the intra-operative phase include:
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-surgeon/surgical assistant/resident
-anesthesiologist -surgical technician/OR tech |
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_____ is the intra-operative position in which the client lies flat on their back. It is most often used with abdominal, thoracic, extremity and sometimes head surgeries.
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Dorsal recumbent
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_____ is the intra-operative position that leaves the client's neck exposed for neck or thyroid surgery.
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Semisitting
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_____ is the intra-operative position that has the patient lying on stomach , face down. It is best for spinal or rectal surgeries.
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Prone
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____ is the intra-operative position where the patient is lying on their side. It is used for hip replacements.
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Lateral Chest
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_____ is the intra-operative position used for gynecological or perineal surgeries.
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Lithotomy
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____ is the intra-operative position used for colonoscopy, hemorrhoidectomy, and sigmoidoscopy.
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Jackknife
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_____ and ______ are two intra-operative positions in which the patient's lung capacities are decreased therefore it is important to monitor respirations.
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Lithotomy and Jackknife
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When putting the patient in the _____ intra-operative position, the patient begins in prone position and then the hips are tilted forward so the patient is in a kneeling position. This better exposes the rectal area.
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Jackknife
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The desired effects (3) of general anesthesia during the intra-operative phase are:
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-loss of consciousness
-relaxation of skeletal muscles -depression of reflexes |
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There are several different routes and types of general anesthesia during the intra-operative phase of surgery. 3 of these are:
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-inhalation
-IV -endotracheal |
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The route and type of general anesthesia depend on the type of ______ and the patient's _____.
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surgery
condition |
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3 types of Intra-operative phase anesthesia include:
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-General
-Conscious Sedation/Analgesia -Regional |
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A rare but life threatening condition that may occur during surgery due to a reaction from general anesthesia is called ______.
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malignant hyperthermia
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Malignant hyperthermia usually occurs _____ but rarely can occur in ______.
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while patient is on operating table
PACU |
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S/Sx of malignant hyperthermia are:
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increased body metabolism
increased muscle calcium levels high T (up to 111 degrees) vigorous muscle contractions tachycardia dysrhythmias psyanosis hypotension myoglobinuria |
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Myoglobinuria comes from ______ during malignant hyperthermia. It is basically muscle breaking down and releasing protein into the urine which turns rust colored.
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vigorous muscle contractions
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Tx for myoglobinuria include:
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-immediate discontinuation of general anesthesia
-ventilate patient with 100% O2 -increase IV fluid -monitor output and color of urine -monitor cardiac status -Monitor T, cool with cooling blanket to extremities -give skeletal muscle relaxant -stop surgery if possible |
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_____ is a type of intra-operative phase anesthesia that reduces the level of consciousness but allows the patient to maintain patent airways and follow commands.
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Conscious sedation/Analgesia
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Conscious sedation /analgesia has an action that is _____ but the patient may be _____.
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short
drowsy for a long time |
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An example of when Conscious sedation/analgesia may be used is...
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when removing wisdom teeth
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The most common conscious sedation/analgesia anesthetics are:
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valium, versed, fentanyl
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A type of intra-operative phase anesthesia that inhibits the transmission of stimuli or causes sensation to be lost to specific parts of the body is called _____ anesthesia.
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regional
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7 types of regional anesthesia are:
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-topical
-local or infiltration -peripheral nerve block -IV or Bier block -Field block -Spinal -Epidural |
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Malignant hyperthermia usually occurs _____ but rarely can occur in ______.
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while patient is on operating table
PACU |
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S/Sx of malignant hyperthermia are:
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increased body metabolism
increased muscle calcium levels high T (up to 111 degrees) vigorous muscle contractions tachycardia dysrhythmias psyanosis hypotension myoglobinuria |
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Myoglobinuria comes from ______ during malignant hyperthermia. It is basically muscle breaking down and releasing protein into the urine which turns rust colored.
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vigorous muscle contractions
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Tx for myoglobinuria include:
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-immediate discontinuation of general anesthesia
-ventilate patient with 100% O2 -increase IV fluid -monitor output and color of urine -monitor cardiac status -Monitor T, cool with cooling blanket to extremities -give skeletal muscle relaxant -stop surgery if possible |
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_____ is a type of intra-operative phase anesthesia that reduces the level of consciousness but allows the patient to maintain patent airways and follow commands.
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Conscious sedation/Analgesia
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Malignant hyperthermia usually occurs _____ but rarely can occur in ______.
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while patient is on operating table
PACU |
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S/Sx of malignant hyperthermia are:
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increased body metabolism
increased muscle calcium levels high T (up to 111 degrees) vigorous muscle contractions tachycardia dysrhythmias psyanosis hypotension myoglobinuria |
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Conscious sedation /analgesia has an action that is _____ but the patient may be _____.
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short
drowsy for a long time |
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An example of when Conscious sedation/analgesia may be used is...
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when removing wisdom teeth
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The most common conscious sedation/analgesia anesthetics are:
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valium, versed, fentanyl
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Myoglobinuria comes from ______ during malignant hyperthermia. It is basically muscle breaking down and releasing protein into the urine which turns rust colored.
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vigorous muscle contractions
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A type of intra-operative phase anesthesia that inhibits the transmission of stimuli or causes sensation to be lost to specific parts of the body is called _____ anesthesia.
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regional
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Tx for myoglobinuria include:
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-immediate discontinuation of general anesthesia
-ventilate patient with 100% O2 -increase IV fluid -monitor output and color of urine -monitor cardiac status -Monitor T, cool with cooling blanket to extremities -give skeletal muscle relaxant -stop surgery if possible |
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_____ is a type of intra-operative phase anesthesia that reduces the level of consciousness but allows the patient to maintain patent airways and follow commands.
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Conscious sedation/Analgesia
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7 types of regional anesthesia are:
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-topical
-local or infiltration -peripheral nerve block -IV or Bier block -Field block -Spinal -Epidural |
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Conscious sedation /analgesia has an action that is _____ but the patient may be _____.
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short
drowsy for a long time |
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An example of when Conscious sedation/analgesia may be used is...
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when removing wisdom teeth
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Malignant hyperthermia usually occurs _____ but rarely can occur in ______.
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while patient is on operating table
PACU |
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The most common conscious sedation/analgesia anesthetics are:
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valium, versed, fentanyl
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S/Sx of malignant hyperthermia are:
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increased body metabolism
increased muscle calcium levels high T (up to 111 degrees) vigorous muscle contractions tachycardia dysrhythmias psyanosis hypotension myoglobinuria |
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A type of intra-operative phase anesthesia that inhibits the transmission of stimuli or causes sensation to be lost to specific parts of the body is called _____ anesthesia.
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regional
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Myoglobinuria comes from ______ during malignant hyperthermia. It is basically muscle breaking down and releasing protein into the urine which turns rust colored.
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vigorous muscle contractions
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7 types of regional anesthesia are:
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-topical
-local or infiltration -peripheral nerve block -IV or Bier block -Field block -Spinal -Epidural |
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Tx for myoglobinuria include:
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-immediate discontinuation of general anesthesia
-ventilate patient with 100% O2 -increase IV fluid -monitor output and color of urine -monitor cardiac status -Monitor T, cool with cooling blanket to extremities -give skeletal muscle relaxant -stop surgery if possible |
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_____ is a type of intra-operative phase anesthesia that reduces the level of consciousness but allows the patient to maintain patent airways and follow commands.
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Conscious sedation/Analgesia
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Conscious sedation /analgesia has an action that is _____ but the patient may be _____.
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short
drowsy for a long time |
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An example of when Conscious sedation/analgesia may be used is...
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when removing wisdom teeth
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The most common conscious sedation/analgesia anesthetics are:
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valium, versed, fentanyl
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A type of intra-operative phase anesthesia that inhibits the transmission of stimuli or causes sensation to be lost to specific parts of the body is called _____ anesthesia.
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regional
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7 types of regional anesthesia are:
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-topical
-local or infiltration -peripheral nerve block -IV or Bier block -Field block -Spinal -Epidural |
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_____ is a type of regional anesthesia that is applied to the skin or mucous membrane.
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Topical
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_____ is a type of regional anesthesia that is injected directly into or very close to the site.
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Local or infiltration
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_____ is a type of regional anesthesia that is injected into a nerve clump in an area away from the site.
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Peripheral nerve block
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_____ anesthesia is used in dental procedures or suturing.
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Local
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_____ is a type of regional anesthesia that is injected around the area.
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IV or Bier block
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_____ is a type of regional anesthesia that is injected directly into spinal fluid via the subarachnoid space thru a lumbar puncture.
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Spinal
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_____ anesthesia is used for lower body surgeries.
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Spinal
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Side effects of Spinal anesthesia include:
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hypotension
post dural headache urinary retention |
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_____ is a type of regional anesthesia that is usually used in childbirth or c-section. It is injected into the epidural space and numbs the perineum and lower extremities.
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Epidural
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_____ anesthesia is used most often for procedures involving the arm, wrist, and hand.
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IV or Bier block
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Adjuncts to anesthesia medication include:
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-anti-anxiety and sedatives
-anticholinergics -opioid analgesics -neuromuscular blocking agents |
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_____ is an anti-anxiety/sedative given adjunct to anesthesia that is often given prior to the OR.
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Valium
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_____ is an anti-anxiety/sedative given adjunct to anesthesia that causes amnesia so that the patient doesn't remember.
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Versed
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_____ is an anti-anxiety/sedative given adjunct to anesthesia that induces a very pleasant sleep. The patient wakes up when it is stopped.
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Propofol
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______ are adjuncts to anesthesia that are used to prevent vagal stimulation and dry up secretions. Two kinds are atropine and glycopyrrolate.
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Anticholinergics
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_____ are adjuncts to anesthesia that are used so that less anesthesia is needed. They are used with pain relief in the immediate post-op period when the patient is in PACU.
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Opioid analgesics
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Two opioid analgesics that are used adjunct to anesthesia are:
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-morphine
-fentanyl |
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_______ are adjuncts to anesthesia that cause muscle relaxation and allow for the use of less anesthesia.
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Neuromuscular blocking agents
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Neuromuscular blocking agents also cause relaxation or paralysis of the ______. Therefore _____ must be used. These have to be reverser prior to taking patient off the ventilator.
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respiratory muscles
artificial ventilation |
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Succinylcholine, Tubcurarine, and Mivacurium are types of _____.
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Neuromuscular blocking agents
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______ have higher risk of complications with anesthesia and have higher anesthetic requirements.
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Children
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Children require ____ anesthesia per kg than adults.
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more
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Considerations for anesthesia in children include:
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-higher risk for complications
-higher anesthetic requirements -parental presence -Post-op N and V |
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______ have higher risk of complications with anesthesia and have higher anesthetic requirements.
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Children
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Children are at higher risk of complications from anesthesia because...
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the sympathetic nervous system is more easily stimulated.
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Children require ____ anesthesia per kg than adults.
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more
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Considerations for anesthesia in children include:
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-higher risk for complications
-higher anesthetic requirements -parental presence -Post-op N and V |
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Complications for children receiving anesthesia may include:
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-laryngospasms
-bronchospasms -aspiration -cardiac dysrhythmias -death |
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_____ have a higher risk of complications from anesthesia due to other conditions such as HTN, diabetes, heart disease and the agin process.
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Older adults
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Children are at higher risk of complications from anesthesia because...
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the sympathetic nervous system is more easily stimulated.
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Complications for children receiving anesthesia may include:
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-laryngospasms
-bronchospasms -aspiration -cardiac dysrhythmias -death |
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Considerations for anesthesia in older adults include:
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-higher risk of complications
-delayed excretion -lower doses |
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Delayed excretion of anesthesia in older adults is because the liver and kidneys don't work as well. Therefore ______ are needed.
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lower doses
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_____ have a higher risk of complications from anesthesia due to other conditions such as HTN, diabetes, heart disease and the agin process.
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Older adults
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Clients with renal and hepatic impairment will have delayed ____ and _____ of anesthesia.
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metabolism and excretion
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Considerations for anesthesia in older adults include:
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-higher risk of complications
-delayed excretion -lower doses |
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Delayed excretion of anesthesia in older adults is because the liver and kidneys don't work as well. Therefore ______ are needed.
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lower doses
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During postoperative nursing assessment in the PACU, the following respiratory assessments should include observation for _______.
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bilateral chest movement
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______ have higher risk of complications with anesthesia and have higher anesthetic requirements.
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Children
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Clients with renal and hepatic impairment will have delayed ____ and _____ of anesthesia.
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metabolism and excretion
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Children require ____ anesthesia per kg than adults.
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more
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During postoperative nursing assessment in the PACU, the following respiratory assessments should include observation for _______.
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bilateral chest movement
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Considerations for anesthesia in children include:
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-higher risk for complications
-higher anesthetic requirements -parental presence -Post-op N and V |
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Children are at higher risk of complications from anesthesia because...
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the sympathetic nervous system is more easily stimulated.
|
|
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Complications for children receiving anesthesia may include:
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-laryngospasms
-bronchospasms -aspiration -cardiac dysrhythmias -death |
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_____ have a higher risk of complications from anesthesia due to other conditions such as HTN, diabetes, heart disease and the agin process.
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Older adults
|
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Considerations for anesthesia in older adults include:
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-higher risk of complications
-delayed excretion -lower doses |
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Delayed excretion of anesthesia in older adults is because the liver and kidneys don't work as well. Therefore ______ are needed.
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lower doses
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Clients with renal and hepatic impairment will have delayed ____ and _____ of anesthesia.
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metabolism and excretion
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During postoperative nursing assessment in the PACU, the following respiratory assessments should include observation for _______.
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bilateral chest movement
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During postoperative nursing assessment in the PACU any significant change could indicate complications like shock, hemorrhage, or hypothermia. Significant is a ____% change from baseline.
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25
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Cardiovascular assessments that should be made in the PACU post-op include:
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VS Q15min until stable
-cardiac monitoring- esp. if there was a problem in OR or dysrhythmia -peripheral vascular monitoring - |
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Vital signs should be assessed _____ in the PACU
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at least 2 times
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Peripheral vascular monitoring includes:
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distal pulses, capillary refill, color, temperature and sensation of extremities
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Cardiovascular assessment in the PACU also includes checking ____ sign which is calf pain with dorsiflexion of the foot. This could indicate a blood clot in the leg.
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Homan's
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In terms of assessment, the nurse should think ____.
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Airway
Breathing Circulation |
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During PACU neurological assessment the patient should be able to...
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be aroused when their name is called, be oriented, and have movement and sensation in extremities. Also, gag reflex should return.
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During PACU care the nurse should assess fluid and electrolyte balance. This includes:
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-look at I and O
-is IV running -is patient well hydrated -If NV is present try comfort measures other than antinausea meds. |
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When assessing normothermia and the wound in the PACU...
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some drainage is normal.
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When assessing a patient post-op for PACU discharge, the nurse should assess for...
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-conscious and oriented
-Airway clear, cough, deep breathing on command -VS stable at least 30 min -Gag/swallowing reflexes in tact -moving extremities -I&O> 30mL/hr -Normothermia -No excessive drainage from wound -patency and character of tubes (IVs, caths, drains) |
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Always ask the patient to rate his/her ____.
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pain
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When assessing a patient for PACU discharge, look at the I&O. Anything less than _____mL/hr could be indication of _______.
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30
renal failure |
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Intact gag and swallowing reflexes can be assessed by looking for...
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absence of drooling
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Ongoing postoperative care on the nursing unit includes...
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systems assessment- general health status, respiratory, cardiovascular, CNS, fluid and wound status.
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Post-op care on the nursing unit also includes checking VS _____, listen to _____, and assess for _____ to be sure patient isn't experiencing DVT.
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q15min for at least an hour
bowel sounds Homan's sign |
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____ sutures are used in abdominal surgery.
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Retention
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A ____ looks like a tourniquet except it is an open tube which has a sterile safety pin to prevent it from going down into the wound and there is split wound drain dressing.
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Penrose drain
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Advance a drain means you will...
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pull it out a little.
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A _____ drain is very painful to remove.
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Jackson Pratt
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With a _____ drain the drainage is put back in the patient within 24 hrs.
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Consta Vac
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24 hours post-op the pain should...
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not be severe.
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If pain worsens after _____, notify the physician.
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36 hrs
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Positioning post-op can help with _____.
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pain control
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A patient with spinal anesthesia should remain ____ 8-12hrs to avoid ________.
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flat
post dural headache |
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If GI suction is used with a patient, ____ and ____ care is required.
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nares and oral
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Post-op the patient should urinate within ____ hrs.
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8
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If a patient has no bowel sounds post op and we feed them, they could get an _____.
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ileus
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After bowel sounds have returned, the patient can begin _____ and progress from there.
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clear liquids
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Possible nursing diagnoses for a patient who is post-op include:
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-Risk for Aspiration
-Ineffective Tissue Perfusion (if surgery was on extremity) -Acute pain -Deficient knowledge -Anxiety -Fear |
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Examples of outcomes for the client include: The client will...
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-perform leg exercises q4h
-TCDB at least q2h -verbalize decreased pain level -have balanced I&O -remain free of infection -verbalize and demonstrate self wound care |
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Nursing implementation and interventions post-op include:
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-encourage and assist with early ambulation
-encourage TCDB -assess circulatory maintenance -monitor fluid balance and nutritional status -inspect wound and provide care -provide pain meds and assist with comfort |
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Preventive measures for a pulmonary embolism include:
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-turning
-ambulating early -TED hose, SCD's |
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S/Sx of a paralytic ileus are:
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-abdominal pain
-distention -percussed belly sounds like ripe melon -Vomiting and constipation -absence of bowel sounds |
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Tx of paralytic ileus includes:
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-pt is NPO until bowel sounds return
-NG tube dropped and on continuous suction for decompression of abdominal distention |
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A temperature over ____ post-op should be reported to the physician.
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100.4 degrees
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The most common surgical complication is _____.
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infection
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Surgical complications include:
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-infection (SEPS)
-Post-op N and V -altered body temp regulation -altered urinary/bowel elimination -pain -changes in sensory function -wound opening -shock/hemorrhage -deep vein thrombosis -pulmonary embolism -paralytic ileus |
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Once a catheter is Dc, be sure patient has urinated, if they have not you must get an order for _____.
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in and out cath
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____ is expected post op but should diminish with time. Sudden changes could indicate hemorrhage, wound opening up, PE, or DVT.
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Pain
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Acute change in sensory function unrelated to anesthesia could be signs of a _____.
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stroke
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____ and ____ often go together as surgical complications.
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Shock and hemorrhage
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Signs of shock include:
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pallor, poor color, thready pulse, hypotension
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_____ could be internal or external.
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Hemorrhage
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Deep Vein Thrombosis can be assessed by checking for ______.
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Homan's sign
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When assessing for Homan's sign, there should be no...
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redness, warmth, or pain in calf
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A _____ is a clot that has migrated from the original spot (usually calf) to the pulmonary artery.
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pulmonary embolism
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S/Sx of a pulmonary embolism include:
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-sudden onset of chest pain
-SOB -tachycardia -cyanosis -anxiety |
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A _____ is an intestinal obstruction caused by a lack of peristalsis.
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paralytic ileus
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The purpose of pain management is to avoid _____.
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sedation
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Non-pharmacologic pain control measures include:
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-position change
-early ambulation -imagery -distraction |
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_____ are great for break thru pain.
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Analgesic antipyretics
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____ looks like flu and occurs when aspirin is used to treat viral problems. It returns 2 weeks later and is often fatal.
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Reye's syndrome
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3 types of analgesic antipyretics are:
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-aspirin
-acetaminophen -NSAIDS |
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A major side effect of aspirin is ____.
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GI upset.
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_____ should not be given to infants, children, teens, or young adults because of the risk of Reye's syndrome.
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Aspirin
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____ and _____ are analgesic antipyretics that are safe for children, teens, and infants.
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Acetaminophen and NSAIDS
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Aspirin can be used for...
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-fever
-mild-moderate pain -anticoagulant -antiinflammatory |
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High doses of acetaminophen can cause ____ and _____.
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hepatotoxicity and nephrotoxicity
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Ibuprofen and Naproxen are types of ____.
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NSAIDS
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_____ and _____ are NSAIDs that are non-steroidal anti-inflammatory drugs tat inhibit prostaglandins. They are effective in menstrual cramps, more expensive than aspirin, can cause stomach upset but tend to be very effective.
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Ibuprofen and Naproxen
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_____ and ____ are often used in alternating doses in children to treat fever.
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Acetaminophen and Ibuprofen
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______ agents help to prevent N and V in post-op patients.
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Antiemetic
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_____ are antiemetic agents used primarily with chemo patients.
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Serotonin antagonists
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_____ is an antiemetic agents used often on the nursing floor.
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Dopamine Antagonists (Reglan)
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______ are antiemetic agents that are effective with vertigo and motion sickness. They are also sedating.
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Anticholinergics/Antihistamines
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_____ relax the GI tract and inhibit secretions.
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Antihistamines
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______ is an antiemetic agent that is medical marijuana.
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Cannaboids
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______ is an antiemetic agent that has an off label usage with chemo patients. It is not approved.
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Glococorticoids (cortisone)
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______ are a liquid form of an antiemetic agent often given to reduce nausea in pregnancy.
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Carbohydrates
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Different types of antiemetic agents include:
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-Serotonin antagonists
-Dopamine antagonists -Anticholinergics/ Antihistamines -Cannaboids -Glucocorticoids -Carbohydrates |
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Postoperative teaching should include teaching the patient to...
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-keep wound dry and clean unless told they may shower
-dressing change technique -clean suture line gently -report Sx of infection -address lifting and activity level -pain management at home |
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_____ can increase surgical risk because they increase blood coagulation time.
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Anticoagulants
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_____ can increase surgical risk because they may interact with anesthetics, increasing the risk of respiratory depression.
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Tranquilizers
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_____ can increase surgical risk because they may interfere with wound healing and increase the risk of infection.
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Corticosteroids
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____ can increase surgical risk because they may affect fluid and electrolyte balance.
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Diuretics
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