Nursing Interventions
How do SCD - Pneumatic Air Stockings work? What are we trying to prevent?
What is alternating compression (inflation) and deflation of leg stockings...to prevent venous stasis and DVT's
True or False: All preop orders are automatically discontinued when a patient goes to surgery.
What is True.
______ Anesthesia would be administered for procedures such as dental work, suturing, lacerations and biopsies.
What is Local Anesthesia
The insertion of an endotracheal tube into the patient's trachea to maintain an open airway an administer inhalant anesthesia and oxygen.
What is Intubation.
How do you prepare the room to receive a post-operative patient
What is bed up and open, draw sheet and blue pad on bed, all furniture moved out of way so gurney can be positioned parallel to the bed and the heads of the gurney and bed are aligned with each other, obtain the following equipment for VS equipment, O2, suction, emesis basin, tissues/towels/gown, pillow to splint...
Post operative temperature of ______ requires a call to the physician
What is >/= 101 F
4 common diagnostic tests preoperatively
What is CBC, UA, ECG, and CXR
Is responsible for sustaining the patient's life an ensuring that the patient remains comfortable during surgery.
What is the Anesthesia provider
Extubation
First Priority post operative assessment(s)
What is complete an initial assessment with vital signs to determine the patient's condition and establish a baseline for subsequent comparision. Start with number one priority: Airway (is there an airway in place, RR- depth, and pattern, lung sounds, skin color, pulse ox, cap refill)
Interventions to prevent Ineffective breathing or ineffective airway clearance
What is prepare suction equipment and suction patient PRN, monitoring RR, depth and patten at lease every 15 minutes or mor often, if necessary, until patient is stable, applying supplemental oxygen at the appropriate liter flow and with appropriate device, monitor breath sounds, elevate HOB, TCDB
Together, these two tests serve as a primary determinant of anemia.
What is Hgb and Hct
What does a "Time out" include upon entering the OR?
What is verify and document verification of :
Patients identify and DOB
Presence of signed consent in the chart.
Correct site of surgery and verifying it is marked accordingly.
Correct procedure
Presence of correct x-ray or other films
Presence of needed special equipment.
-Initiated by the circulating nurse, this process is designed to prevent the risk of wrong patient, wrong site, and wrong surgery.
What is Reconstruction: Reconstructive (corrective) Surgery
During your assessment the abdominal wound has a shadowing of blood, what are your next steps
What is mark the area with a pen, date, time and initial...if needed reinforce and notify physician.
Interventions to prevent GI upset, Nausea
What is administer antiemetic medicaions. Auscultalte bowel sounds at least every 4 hours. Apply a cool wet cloth on forehead or neck. Keep patient NPO or restricted to ice chips (or clear liquids if ordered and bowel sounds are presents)
How do you perform TCDB exercises & how often?
What is splint incision if needed and deep breath in through nose and hold breath for 3-5 seconds. Slowly exhale through your mouth with the lips in the "whistle position". (pursed breathing) Repeat deep breathing in this manner 3 times, on the fourth inhalation, cough during exhalation. To be most effective, you should cough three times during one exhalation. This helps bring the mucus up from deep in the airways and move it up and out. This is referred to as " huff coughing".
Turn from side to side every 1-2 hours to prevent secretions from pooling in one area of the lungs, known as stasis.
TCDB every 2 hours to help prevent hypostatic pneumonia and works to prevent atelectasis.
What variables need to be considered when positioning the patient on a surgical table?
What is:
Access to the surgical site
Access to the patient's airway
Monitoring of vital signs
Maintaining patient body alignment
Patient Safety
Patient Comfort
A voluntary surgery scheduled a week or more in advance intended to improve a patient's quality of life, either physically or psychologically.
What is Elective Surgery
How often are post operative VS completed
What is :
Every 15 min x4
Every 30 min x4,
Every 1 hour x4,
Every 2 hours x4,
Every 4 hours x24 hours postop
Interventions to prevent DVT
What is apply TED hose or SCD if ordered. Perform postop leg exercises to stimulate venous circulation and prevent stasis. Ambulate and/ Administer anticoagulant if ordered.
List the 8 steps to obtain the patient's history.
What are the 5 objectives of General Anesthesia?
1. Loss of consciousness
2. Amnesia regarding the procedure
3. Pian relief
4. Skeletal muscle relaxation
5. Blocking reflexes such as coughing and gagging, in addition to endocrine and autonomic responses
What does AE hose stand for?
How do you measure thigh high and knee high hose?
What is Antiembolism hose.
For thigh high: Measure the length of the leg from the gluteal fold to the bottom of the heel. Then measure the circumference of the calf and thigh at the largest diameters.
For Knee-high: Measurements are taken below the knee. Cross-reference these measurement on the TED hose chart to determine which size of hose to select.
Absolute #1 priority
What is PATIENT SAFETY (Infection control, positioning, electrical safety, continuous monitoring, aspiration prevention...)