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50 Cards in this Set
- Front
- Back
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What are the advantages of pre-op teaching?
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1
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What areas are addressed in pre-op teaching?
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1
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What is the purpose of pre-op labs?
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Hemoglobin - ability to oxygenate
Hematocrit - fluid overload or loss Glucose & A1C- impaired glucose metabolism WBC—infectious process Platelets & coagulation profile (PT, PTT)—clotting CO2—respiratory status Electrolytes especially K, Na, Cl; BUN, Creatinine |
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What diagnostic tests are done pre-op and why?
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1
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Which medications are given preoperatively and why?
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1
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What meds may be discontinued preoperatively and why?
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1
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What is the primary focus of care during immediate post-op care?
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1
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What are the criteria for discharge from PACU?
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1
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What are the special precautions associated with spinal anesthesia?
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1
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Why is oxygen given postoperatively?
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1
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What is the role of the nurse during the continuing post-op period?(assessment)
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General appearance
Level of consciousness Emotional Status Quantity of respirations Skin color & Temp Discomfort/pain Nausea/vomiting Type of IV fluid & flow rate Dressing site Drainage on dressing or bed linen Urinary output (catheter or self) Ability to move all extremities |
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What are the parameters for VS in the PACU post-op period
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Q 5 minute Vital Signs (P, R, BP, p02) until discharged to the clinical floor
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What are the parameters for VS once D/C'd to floor during post-op period?
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VS (P, R, BP):
15 min for 1st hour 30 min for next 2 hours Every hour for next 4 hours |
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How is pain managed in the post-operative client?
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1
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How is pain medication administered in the post-operative client?
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1
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How is pain medication timed in the post-operative client?
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1
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What are the drug choices for pain management in the post-operative client?
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1
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What are the side effects for comonly used pain meds in the post-operative client?
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1
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List some common post-op complications.
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Shock
Pulmonary Emboli Pneumonia Atelectasis Urinary Retention Dehiscence & Evisceration Gastric Dilation & Paralytic Ileus |
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What is the treatment for post-op hemorrage (blood loss)?
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early recognition!!
Bedrest: supine; Elevate feet 12 inches; Extra blankets; NPO; & aggressive IV Fluids (eg.1 liter over 10 min) + |
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List nursing interventions for urinary retention.
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Assess amount in bladder: Bladder Scanner, Order to catheterize if large volume retained, Assure adequate fluid replacement: may increase IV fluid to 2500-3000 ml / 24 hours
Monitor I & O; |
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List nursing interventions for DVT.
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1
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How do you assess for a DVT in a post-op pt?
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1
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List nursing interventions for pulmonary embolis in the post op pt.
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TREAT:
IMMEDIATELY notify physician; Bedrest with head elevated; O2 and pulse ox; Monitor symptoms and vital signs; With MD order, give prescribed: fluids, anticoagulants, analgesics |
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How do you assess for a PE in a post-op pt?
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ASSESS for Signs/Symptoms of:
Sudden dyspnea Chest pain (steady; worsen with exertion; does not go away) Cough, blood-tinged sputum Tachypnea, shallow Tachycardia and/or dysrhythmia Diaphoresis and/or clammy skin Anxiety & restlessness Light-headed and/or disoriented Cyanosis |
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List nursing interventions for atelectasis in the post-op pt.
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TREAT:
Head elevated; oxygen order; CTDB Q2 hrs; incentive spirometer; hydration ;ambulate |
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How do you assess for atelectasis in a post-op pt?
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ASSESS for Sign/Symptoms of:
Difficulty breathing (dyspnea) Rapid, shallow breathing Cough Anxiety & restlessness Lung sound Assessment Diminished breath sounds over area |
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List nursing interventions for pnuemonia in the post op pt.
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TREAT:
Head elevated; TCDB Q 2hrs; Incentive Spirometer Oxygen order; Hydrate (Encourage increased fluid intake-to liquefy secretions; proper disposal of tissues. Ambulate (chest expansion & deep breaths) |
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How do you assess for pnuemonia in a post-op pt?
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ASSESS for Signs/Symptoms of:
Hyperthermia (T up) Tachypnea and tachycardia (P up & BP up) Chills Productive cough Dyspnea and chest pain Lung Sound Assessment; Crackles "popping open" of small airways and alveoli collapsed by fluid, exudate, or lack of aeration during expiration Wheezes (a continuous, coarse, whistling sound produced in the airway) |
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How do you assess for urinary retention in a post-op pt?
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ASSESS for Signs/Symptoms of:
Bladder distention (palpate) If voiding only small , frequent amounts, Pain in the suprapubic area |
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How do you assess for a paralytic ileus in a post op pt?
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ASSESS for Signs/Symptoms of:
Inspect: abdominal distention Auscultate: no bowel sounds (listen for 5 minutes in each quadrant) Percuss: decreased tympany & increased resonance No bowel movement or flatulence Excessive belching; maybe nausea |
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How do you treat a paralytic ileus in a post op pt?
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NPO: food or drink should be avoided until peristaltic sound auscultated in all 4 quadrants
Intestinal decompression (Nasogastric tube to low intermittent suction) IV Fluids Auscultate for bowel sound Q 4 hrs |
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Define paralytic ileus.
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disruption of the normal propulsive ability of the GI tract; typically after abdominal surgery; the intestinal content of that portion of the bowel is unable to move forward
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Define pulmonary embolis.
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a dislodged blood clot (thrombi -> emboli); lodges in pulmonary artery; high risk in DVT patient
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Define atelectasis.
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Complete or partial collapse of lung; from mucus in the airways after surgery.
Unlike pneumothorax, which is air between the chest wall and lung, atelectasis develops when the alveoli become deflated. |
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Who is at increased risk for atelectasis?
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Confinement to bed, with infrequent change of position;
Obesity, which can elevate the diaphragm and hamper the ability to inhale fully |
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What is a normal urine output amount?
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30ml per hour.
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What are common post-op discharge teaching needs?
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1
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What should accompany all aspects of discharge teaching?
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1
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Define Dehiscence and Evisceration.
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Dehiscence: separation of wound edges
Evisceration: intestines or organs protrude |
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Identify lab and diagnostic tests used with infectious disorders and state their purpose and expected results.
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1
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What is the best preventive measure used with transmission of infectious organisms?
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Handwashing
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What is the key clinical manifestation of an infection?
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1
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How does the prodromal stage of an infection differ from the acute stage, including symptoms?
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1
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What clients are at higher risk to contract an infection?
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1
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What clinical manifestations (symptoms) are seen in the older adult with an infection?
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1
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What pharmacologic agents are used in the treatment of infection, including side effects and possible toxicities?
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1
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What is a nosocomial infection and what is the incidence by location?
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1
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What are characteristics of inflammatory vascular response?
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1
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Which diagnostic test(s) is (are) used to measure/monitor the inflammatory status of a client?
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1
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