Sx Hx & ORNAC
Which nurse, famous for her work in the Crimean War, is credited with founding modern nursing through her focus on cleanliness and sanitation?
Flo Nightingale
What is the main purpose of diagnostic surgery?
To determine or confirm a diagnosis (find the cause of symptoms).
Why are older adults generally at higher risk for surgical complications?
Age-related decline in organ function and multiple comorbidities, leading to slower recovery and more complications.
What is the primary concern during the preoperative phase?
Preparing the patient physically and emotionally for surgery to promote a safe outcome.
Which type of anesthesia makes the patient completely unconscious and unaware during the surgery?
General anesthesia.
Which surgeon is known for introducing the antiseptic technique, significantly reducing infection rates in surgery?
Joseph Lister
What is the main goal of palliative surgery?
To relieve symptoms (e.g., pain) without curing the underlying disease.
Give one example of a comorbid condition that increases surgical risk.
Cardiovascular disease, pulmonary disease (COPD/asthma), diabetes, renal or liver disease.
What is usually the first step in a preoperative nursing assessment?
Reviewing the patient’s medical history (including past surgeries, medications, allergies).
Which type of anesthesia numbs a small, specific area without affecting consciousness?
Local anesthesia.
How did World Wars I and II change surgical nursing practice?
The wars created massive numbers of casualties, which led to development of specialized surgical nursing and training in trauma and postoperative care.
In the ASA Physical Status classification, how would you describe an ASA I patient?
A normal, healthy patient with no systemic disease.
Smoking increases the risk of which broad group of complications during and after surgery?
Respiratory complications and poor wound healing (e.g., pneumonia, atelectasis, infection).
Why are preoperative blood tests, such as a CBC, electrolytes, and coagulation studies, important?
To assess organ function, oxygen-carrying capacity, clotting ability, and electrolyte balance to identify risks.
Give an example of regional anesthesia and a type of surgery it might be used for.
Spinal or epidural anesthesia for C-section or hip replacement, or a nerve block for limb surgery.
In Canada, what does ORNAC stand for, and what is its main focus?
Operating Room Nurses Association of Canada promotes excellence and professional growth in perioperative nursing practice.
In the ASA Physical Status classification, what does ASA III indicate about a patient’s health?
A patient with severe systemic disease that limits activity but is not immediately life-threatening.
How can obesity negatively impact surgical outcomes?
It increases the risk of respiratory problems, wound infection, DVT, and technical difficulty with positioning and anesthesia.
Name two key teaching points the nurse should cover with the patient before surgery.
Explain the procedure in simple terms, fasting/NPO instructions, preop medication instructions, what to expect on the day of surgery and in recovery.
State one advantage of regional anesthesia over general anesthesia in high-risk patients.
Fewer systemic effects (less impact on the whole body), which can be safer for patients with severe comorbidities.
Name two core values promoted by ORNAC for perioperative nursing practice.
Any two of: Knowledge (education & research), Collaboration, Respect, Professionalism, Continuous quality improvement.
Describe one limitation of the ASA Physical Status classification system.
It doesn’t account for factors like the type/complexity of surgery or a patient's psychological state, and it varies somewhat between providers.
Why do emergent or urgent surgeries carry higher risk compared with well-planned elective procedures?
They are riskier because there is little/no time for preoperative optimization, less information, and the body is already under acute stress.
Describe one way the nurse acts as a patient advocate in the preoperative phase?
Ensuring informed consent is obtained/understood, speaking up about patient concerns, and communicating significant findings to the surgical/anesthesia team.
Name the rare, life-threatening reaction triggered by certain anesthetic agents that causes rapid hyperthermia and muscle rigidity.
Malignant hyperthermia.