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34 Cards in this Set

  • Front
  • Back
As a nurse, what procedure can you call to avoid wrong site, wrong procedure, and wrong patient surgical errors?
time-outs

*also, can check consent form and Hx&P against what pt. says or the site marked. To ID patient, use arm band: look at name, DOB, and MR #
If the patient is unconscious, mentally incompetent, or a minor, who can sign the consent?
a court-appointed representative (power of attorney)
What are the 3 types of preoperative teaching?
sensory, process, and procedural teaching
What do you have to tell the patient for the patient to have clear understanding of informed consent?
- diagnosis (what's wrong and how to fix it)
- risks and consequences
- probability or success
- risks of alternative treatments
- prognosis without treatment
The nurse's role in informed consent for surgery may include:
obtaining the patient's signature on the consent form.

*Caution: if patient signs and all ahs not been explained to them, it is the nurse's fauly, so make sure they understand before they sign
Is asking the patient for informed consent, explaining the risks and consequences of proposed surgery, and informing the patient of the prognosis the role of the:

a. Doctor
b. Nurse
A. doctor
What percentage of patients have N/V post-op? What can you give preop to relieve this?
60%

antiemetics
What does a phase 1 initial assessment involve in the PACU after surgery?
- airway
- breathing
- circulation
- neurologic
- genitourinary
- surgical site
- pain
What can result from patients having only shallow respirations after surgery?
atelectasis
what can result due to unresolved atelectasis after surgery?
pneumonia develops due to fluid buildup
what can result from an ET tube irritating the trachea/bronchi?
bronchospasm
what complication can result from the tongue closing off the trachea?
airway obstruction, then later hypoxemia
what can reult from anesthesia slowing rate and depth or respirations, leading to decreased 02 in the blood?
hypoxemia
what can a nurse do to prevent DVT/ clot/ pulmonary embolism postoperatively?
- do passive ROM
- dangle on side of bed
- heparin (after MD order)
- lovenox (After MD order)
- TED hose
- ambulate ASAP
What can a nurse do to prevent aspiration of vomitous, leading to ineffective airway clearance, impaired gas exchange, and pneumonia?
- proper positioning
- elevate HOB
- deep breathing
- O2 therapy
- hold/maintain airway
What is the recovery position postoperatively?
lie flat on L side, so if they vomit they don't aspirate
What should a nurse look for postoperatively to check if a patient is breathing (#1 cause of not breathing is obstruction caused by tongue)?
-listen for breath sounds
- look for chest rise

*can lift and tilt head or insert oral airway if neither is present
What complication can blood loss, anesthesia, and hemorrhage lead to postoperatively?
hypotension
what complication can result from the fight or flight response of the sympathetic nervous system and fluid overload postoperatively?
hypertension
What complication can result from fluid and electrolyte embalances (especially K+ and Mg+) lead to postoperatively?
dysrhythmias
What complication can result secondary to hypotension and decreased cardiac output postoperatively?
Syncope
What is considered a normal rise in temperature up to 48 hours postoperatively? Is normal hyperthermia.
up to 100.4 (mild elevation)
what complications are expected from a moderate temperature elevation after surgery up to 48 hours?
(moderate elevation = >100.4)
- congestion
- atelectasis
- possibly dehydration

*be alarmed if it rises above 100.4 in first 48 hours
After 48 hours, temperature > ______ usually indicates infection.
99.9
What GI complication is a common side effet of anesthesia and narcotics?
N/V
What are common side effects due to decreased peristalsis or injected gas in abdominal surgery (ex. laparascopy)?
constipation

abdominal distention
what results from irritation of the phrenic nerve in abdominal surgery?
hiccups
what is a potential complication of increased release of aldosterone and ADH from the normal stress response postoperatively?
low urine output
what is a normal potential urinary problem immediately after surgery until about 3 days after surgery?
acute urinary retention
What can potentially cause urinary infection postoperatively?
- indwelling catheters

*as long epidural is in effect, must have catheter in place. After epidural effects wear off, remove catheter ASAP.
How long after a urinary catheter is removed postoperatively should a patient be able to urinate on their own?
6-8 hours
What are some potential causes of wound infection?
-invasion by normal flora on skin or in intestines, etc.
- immunocompromised are most at risk (diabetiivs, elderly, etc.)
What can result from the accumulation of drainage lying under the incision?
abscess.

*treated by manually draining or by oral/IV antibiotics.
How long should the dressing remain over the incision postoperatively?
24-48 hours, and usually not removed until physician gives the o.k.