Pre-Op
The nurse may serve as a witness to the client's signature on this after the physician has explained the procedure, risks, benefits, & complications, before sedation is given and before surgery is performed.
What is an informed consent
This member of the surgical team remains in sterile gown and gloves and monitors sterile procedure throughout the surgery
What is the scrub nurse
Often used for minimally invasive procedures like colonoscopies.
What is moderate sedation
Medication that would be prescribed to prevent post-op VTE
Anticoagulant
Enoxaparin (Lovenox) or heparin
This classification of medication is often given pre-operatively for its anti-anxiety and sedative effects
What is a benzodiazepine
Hypotension, tachycardia, clammy skin, and hypothermia are s/sx of
What is shock
This type of surgery is necessary at some time, but the client has some choice as to when the procedure will be done.
What is Required/Nonelective
This member of the surgical team helps to get the operating room ready for the procedure, among other duties, and is not scrubbed in
What is the circulating nurse
Often used during childbirth and surgeries of the arm, leg, or abdomen. Numbs a large part of the body, but you remain aware.
What is regional anesthesia
Name at least 4 post-op complications
DVT, PE, infection, paralytic ileus, urinary retention, cardiac arrhythmias, hypovolemia, myocardial infarction, stroke
This med is given as a drying agent to reduce or eliminate secretions
What is atropine
A woman of childbearing age who has not had a hysterectomy must have this done before any surgery
What is a pregnancy test
A patient who is having abdominal surgery should always receive teaching on this in the pre-op stage.
What is coughing and deep breathing, splinting
In this step, the patient's identification, surgical site marking, and procedure to be done are all verified
What is a "time out"
In this stage of general anesthesia there are active reflexes, increased heart rate, irregular breathing, increased blood pressure and pupils are widely dilated.
what is Stage 2
PACU priorities
ABCs, Prevention of hypoxia, Prevention of hemorrhage, Prevention of injury
These medications should be discontinued prior to the day of surgery. (Identify 2 medication classes).
What are NSAIDs and Anticoagulants
This is the splitting open or separation of the surgical incision.
What is dehiscence
If a patient arrives for a scheduled surgery and says this, surgery will likely be cancelled (multiple options- give at least 2 options)
What is I don't have someone to drive me home, I had a smoothie this morning, I started antibiotics for a sinus infection yesterday, I'm having a panic attack because I know I'm going to die today
A patient with this type of problem will need extra precautions in positioning for surgery
What is a musculoskeletal problem
This is a normal effect of anesthesia in the immediate post-op period but must still be addressed
What is hypothermia
Criteria for PACU discharge
Anesthesiologist must sign out client before transfer to another unit or DC home, no excessive bleeding/ drainage, No respiratory depression, Stable vital signs, Return of gag reflex, Minimal to absent n/v, Wound drainage that is minimal- moderate, Urine output at least 30 mL/hr, Report given
These labs are monitored to assess kidney function
What is BUN/creatinine, GFR
The nurse would consider it a priority to report what type of allergies to the surgical team? (Identify at least 2).
What is latex, PCN/Antibiotics, iodine.
If a patient states that she drinks a liter of wine a day and takes kava and melatonin to help her sleep at night, the nurse should do this
What is notify the anesthesia care provider
This person is in charge of monitoring the patient throughout the surgery
Who is the anesthesia care provider
These medications are often used with moderate sedation
What is propofol, ketamine, etomidate, versed
Criteria for home discharge
•All PACU D/C criteria met, No IV narcotics for specified timeframe, Voided if applicable, Able to ambulate (age appropriate, not contraindicated), Responsible adult present (patient not to drive), D/C instructions given & understood
Alterations in this electrolyte, both high and low, put a patient at risk for cardiac arrhythmias
What is potassium Bonus: What is the normal range?
These factors would be a part of the Pre-Operative checklist (Name at least 4).
What is proper patient identification, allergy/blood product identification, skin preparation, bowel/bladder preparation, NPO, dentures/jewelry removed.