Preoperative
What is the minimum time a client must remain NPO prior to surgery?
At least 8 hours prior to surgery, to prevent the risk of aspiration during sedation creating the possibility of aspiration pneumonia.
The nurse who remains in the unsterile field and whose intraoperative duties include facilitating the progress of the procedure and documentation.
Circulating Nurse
The nurse is providing discharge teaching to a 51-year-old female patient who has had a laparoscopic partial hysterectomy at an ambulatory surgery center. Which statement, if made by the patient, indicates the need for further education?
A.“I have someone here to drive me home because I had general anesthesia.”
B “I will wait until my pain is severe before taking my prescribed medication.”
c.” I will call my care provider if I experience a temperature over 100.4”
“I will wait until my pain is severe before taking my prescribed medication.” This isn't the smartest action right after surgery because effective pain management needs to be established and if you wait to treat it, then the pain because easily unmanageable and then could require more drastic intervention.
This type of drug is used for severe or sometimes chronic pain. They include oxycodone, hydrocodone, fentanyl, and tramadol. Also known as narcotics and can become extremely addictive.
Opioids
The purpose of this type of surgery is not to cure or diagnose, but to manage and reduce symptoms including pain.
Palliative
T/F After the Informed consent is signed, the patient may not change or withdraw the consent?
F, Consent must be freely given and can be freely changed or withdrawn at any time.
Medical asepsis reduces the number of pathogens and includes handwashing, but this technique used in surgical procedures eliminates ALL pathogens.
Surgical Asepsis
After surgery, your patient is semicomatose with vital signs within normal limits. As the nurse, what position would be best for this patient?
Lateral
A pre-op antibiotic used to prevent post-op infection
Cefazolin
This type of surgery may be recommended when the person has signs that something may be wrong – for example, they may report unusual symptoms or have a positive test result. An example is a breast lump biopsy.
Diagnostic surgery
T/F The nurse should instruct the client to void prior to surgery?
T, It can be very uncomfortable for a client to have a full bladder during the postoperative period.
This type of anesthesia uses multiple agents, is used for procedures of significant duration that require ventilation, and may require uncomfortable operative patient positions.
General Anesthesia
Encouraging the use of the incentive spirometer device 10 times every 1-2 hours while awake along with early ambulation and encouraging the client to sit up to eat meals in beside chair are nursing interventions to help prevent what postoperative complication?
Atelectasis
This class of drugs is used to reduce anxiety, induce sedation, and have an amnesic effect. Examples include diazepam, lorazepam, and Midazolam
Benzodiazepines
Surgeons can reshape the appearance of body parts through this type of surgery. Some of the most common body parts people want to improve through surgery include breasts, eyes, face, nose, and tummy.
Cosmetic surgery (plastic surgery)
The nurse recognizes the value of leg exercises in the prevention of postoperative thrombophlebitis. When should the nurse teach the correct technique for leg exercises to a patient?
a. upon transfer from post-anesthetic care unit to the post-surgical unit
b. prior to surgery
c. when early signs of venous stasis are evident
B. Prior to surgery, because post-surgery the patient may be cognitively impaired from the medication so the teachings would be less effective.
This type of anesthesia involves the injection of a local anesthetic, which blocks sensory pathways but allows for motor function. It does not enter the CSF
Epidural Block
At the morning assessment of your post-operative patient you observe that they have removed their SCDs saying, "I had surgery yesterday I don't need to wear these anymore." Does this comment and action by your patient need intervention or teaching? If so, what do they need to know?
Yes, as the Nurse we need to inform/teach the patient the purpose of the SCDs and why they should stay on until the patient is discharged to go home or have received an order from their attending. (the SCDs are important to where to prevent blood clots/thrombosis in the legs. VTE)
Benzodiazepines, opioids, barbiturates, hypnotics, neuromuscular blocking agents, and volatile gases (desflurane, servoflurate, nitrous oxide) are used intra-op to produce this effect
Induction and maintenance of anesthesia
This type of surgery is done as same-day, outpatient surgery and not usually in a hospital setting.
Ambulatory surgery
Which of the following patients most likely requires special preoperative assessment and treatment as a result of his or her existing medication regimen?
a. a 62-year-old man who takes daily anticoagulants to treat atrial fib.
B. A 32-year-old woman taking daily Vitamin c, magnesium, and Metamucil
C. A 46-year-old man taking an SSRI and anti-anxiety medication
a. a 62-year-old man who takes daily anticoagulants to treat atrial fib.
A careful preoperative assessment can alert the nurse to the risk of this severe reaction which occurs in response to certain medications used during general anesthesia and has symptoms including tachycardia, tachypnea, and high fever
Malignant Hyperthermia
When assessing the surgical wound after surgery you see that the lower 4 stitches on the knee have separated and the wound was open on the knee. How could you chart the status of the knee wound?
Small dehiscence of the distal portion of the wound
This type of drug class is used to reduce oral and respiratory secretions
anticholinergics
This type of surgery uses manual and instrumental means of investigating an area of the body suspected of disease when a specific diagnosis is not possible through noninvasive or simple biopsy techniques. An example of this type of surgery is an abdominal laparotomy
Exploratory surgery