Perioperative
Why are patients kept NPO before surgery?
Aspiration risk of gastric secretions
What is an appropriate treatment for type 1 diabetes?
Insulin
How is peptic ulcer disease diagnosed?
EGD (esophagogastroduodenoscopy)
Biopsy for H. pylori presence
What is a typical acceptable O2 saturation for someone with COPD?
88-92%
What is malignant hyperthermia?
Inherited life threatening complication of certain anesthesia drugs. Characterized by tachycardia, muscle rigidity, tachypnea, hypotension.
Treated by administering dantrolene sodium, a muscle relaxant
What are some symptoms of Cushing's disease?
Moon face
Buffalo hump
Truncal obesity
Increased hair
Hypertension
What treatment might you anticipate for a bowel obstruction?
Nasogatric tube placement for decompression
Bowel rest
Potential surgery
When administering a bronchodilator and a steroid, what order should the medications be administered in?
Bronchodilator, then steroid.
The bronchodilator opens up the airway and lets the following medications penetrate into the lungs more deeply.
What is DVT? How can it be prevented?
Deep vein thrombosis - blood clot in a vein
Encourage early ambulation after surgery
Leg exercises (ankle pumps, calf stretches)
SCDs, TED hose use as ordered
What are some treatments for Addison's disease?
Oral glucocorticoid medications
Hydrocortisone
Prednisone
Dexamethasone
What lab value might suggest a complication of bowel obstruction is occuring?
Lactic acid elevation
What are some signs/symptoms of COPD?
Wheezes in inspiration/expiration
Rapid, shallow respirations
Barrel chest
Cyanotic skin
Digital clubbing
What is dehiscence? What is evisceration? What nursing interventions are appropriate for these?
Dehiscence: the separation of surgical wound edges, exposing underlying tissues
Evisceration: protrusion of internal organs through a dehisced surgical incision site
Notify the provider immediately; cover wound with sterile nonadherent or saline dressing; instruct pt to limit movement and avoid coughing to limit wound stress
What is type 2 diabetes?
Insulin resistance, cells become resistant to effects of insulin causing hyperglycemia. Long term can cause pancreatic burnout and insufficient insulin production
What is a bowel obstruction?
Mechanical or nonmechanical blockage of intestines
Mechanical - Adhesions, tumors, hernias, strictures, foreign object ingestion, volvulus (twisting)
Nonmechanical - Ileus
What is aspiration pneumonia and its risk factors?
When someone inhales food, drink, vomit, saliva, or medication into the lungs instead of swallowing it
Risk factors include dysphagia, impaired gag reflex, oversedation, excessive alcohol/drug use
What is atelectasis? How can it be prevented?
Collapse of part of all of a lung due to alveoli deflating
Encouraging incentive spirometer use (Q1-2hr)
Coughing and deep breathing
Early ambulation
What are the hallmark symptoms of diabetes?
Polyuria
Polydipsia
Polyphagia
Hyperglycemia
What are some treatments for peptic ulcer disease?
PPIs
H2 receptor agonists
Antibiotics (H. pylori)
Avoiding NSAIDs
What are some nursing interventions to help manage COPD?
Pursed-lip breathing
Coughing and deep breathing
Administer oxygen as prescribed
Incentive spirometry
Tripod position for shortness of breath