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?
Early ambulation helps reduce these three potential problems after surgery.
What is atelectasis, DVT and constipation?
List the normal range for blood glucose levels.
What is a 70-120 mg/dL?
You are sending Ms. McGonalgall home on a new insulin regimen. As the nurse, you want to discuss the importance of regular blood sugar check so as to avoid this complication; which can cause hunger, sweating, clammy skin and pallor, and confusion.
What is a hypoglycemia?
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?
These are your 3 priority assessments for any patient in post-anesthesia care.
What is ABC: Airway, Breathing, Circulation?
List the steps if you were going to teach a patient how to utilize an incentive spirometer.
What is:
Breathe out and put the mouthpiece in your mouth and close lips tightly.
Inhale slowly and deeply through the mouthpiece to raise the indicator.
When you can't inhale any longer hold your breath for 3-5 seconds keeping the indicator at the same level.
Exhale.
Repeat.
Mr. Potter, a Type I diabetic, had to be admitted to the hospital due to recurrent hypoglycemic episodes. When coming on shift to perform your assessment, you find that he is minimally responsive, drooling and diaphoretic. After assessing his airway, circulation and breathing, you then find that his blood glucose is 43. This medication would be your 1st drug of choice to administer for this severe and life-threating occurrence.
What is a D50% IVP?
A patient who is having surgery should always receive teaching on this in the pre-op stage to prevent atelectasis.
What is coughing and deep breathing?
In this step, the patient's identification, surgical site marking, signed consent and procedure to be done are all verified.
What is a time out for safety?
This is one of the most common respiratory problems after surgery and can be due to patients weak or shallow breathing, pain and inactivity.
What is atelectasis?
You are sending Ms. McGonalgall home on a new insulin regimen. As the nurse, you want to discuss the importance of regular blood sugar check so as to avoid this complication; which can cause hunger, sweating, clammy skin and pallor, and confusion.
What is hypoglycemia?
Ms. Granger is admitted to the ER complaining of nausea and vomiting for the last 24hrs, abdominal pain, frequent urination and thirst. Upon assessment you find that she has Kussmaul breathing is tachycardic, and her breath has a sweet fruity smell to it. As you wait to obtain a glucometer you suspect that these are all symptoms of this condition.
What is diabetic ketoacidosis (DKA)?
During preadmission testing, your patient informs you that she currently taking this medication. You need to inform the doctor immediately because as the pre-op nurse you know that this medication can increase infection, delay wound healing, and increase hemorrhage.
What is a corticosteroid?
List 3 signs of malignant hyperthermia beginning with the most common.
What is a tachycardia, muscle rigidity, fever, hypercapnia, diaphoresis, hyperkalemia?
Rapid position changes and motion in patients with vestibular disturbances can trigger this and can be a profound problem in any PACU setting, but especially in the ambulatory care setting.
What is post operative vomiting?
These labs are monitored to assess kidney function.
What is BUN and creatinine?
List 3 important "sick day rules" you will educate your diabetic patient on.
What is:
Take diabetic meds as usual.
Test BG and urine ketones every 3-4 hours.
Supplement with insulin if BG is elevated.
Eat small, frequent meals.
Stay hydrated.
Call MD if unable to keep fluid/food down.
A patient in the Pre-op setting has an order for Valium 2.5 mg IV. The nurse should direct the patient to do this prior to administration of the medication.
What is void?
This is the medication choice for malignant hyperythermia.
What is Dantrolene IV?
This score determines when a patient may safely be discharged from PACU.
What is Aldrete?
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?
List 3 available sources in the hospital of 15 grams of carbohydrates that you would administer your awake patient that has a low blood glucose.
What is:
4 ounces of juice
6 ounces of soda (not diet)
4-6 hard candies
2-3 glucose tablets