Pre-Op
Who is to provide consent in an emergency situation?
Which member of the intraoperative team is designated the role of documenting.
Circulatory Nurse
Which type of anesthesia is the patient not arousable, even to painful stimuli
General Anesthesia
When does the post-op phase begin?
When the patient is admitted to the PACU
Separation of one or more layers of an incision before it heals due to strain on the suture line.
Wound Dehiscence
Older adults and pediatric patients are at higher risk of what during the intraoperative period?
Hypothermia
Why?
What 3 steps must be addressed during a “Time Out”
1. Name of patient
2. Procedure
3. Surgical Site
Which type of anesthesia causes a depressed LOC and is typically used for painful diagnostic procedures, such as a fracture reset?
Moderate Sedation
What assessment piece is of highest priority to the PACU nurse?
Airway
This postoperative complication is caused by inadequate lung expansion
Atelectasis
List 3 parts of the pre-op checklist.
Education
Informed Consent
Skin Prep
Documentation/Checklist of valuables
H&P (Including Meds)
Vital Signs
Allergy Band
ID Band
Pre Op meds given
Which members of the intraoperative team are considered sterile (must list all)?
Surgeon, Scrub nurse, First Assist
List two types of Regional Anesthesia
Epidural
Spinal
Nerve Block
Topical Anesthesia
Local anesthesia (injection)
Provide 2 nursing interventions to prevent or treat intraop/postop hypothermia
- Warm fluids
- Warm blankets
- Bear hugger
Provide 3 nonverbal cues that correlate with post-op pain
Hypertension
Tachycardia
Tachypnea
Restlessness
Grimacing
Guarding
List the order in which consent can be given (unless a minor or developmental delay).
1. Self
2. spouse
3. Adult children
4. Parents
List two roles of the Scrub Nurse.
- Works within & maintains sterile field
- Sets up sterile equipment and sterile field
- Assists the surgeon and the surgical assists
- Counts all needles, sponges, and instruments used during procedure (along with circulatory nurse)
What is the purpose of administering general anesthesia (provide 2)?
Provide the following:
- Amnesia
- Analgesia
- Decreased Reflexes
- muscle relaxation
- Manipulation of physiologic systems and functions
List two things the nurse can educate the patient to reduce the risk of developing post-op atelectasis or pneumonia.
Cough and deep breathing
Incentive Spirometry
Provide 3 assessment findings that correlate with the development of a pulmonary embolus (PE).
- Sudden chest pain
- Dyspnea
- Absent breath sounds in affected area of the lung
- Hemoptysis
List 3 important topics that the preoperative nurse must educate the patient on to optimize post-op recovery?
- Coughing and deep breathing
- Incentive Spirometry
- Turning
- Leg exercises
- Pain management
- Physical prep
List 3 roles of the circulatory nurse
-Document
-Maintain privacy of the patient
-Emotional Support
-Positions the patient
-Monitors sterile field
-Assist others with donning
-Assists with opening sterile packages
-counting number of sponges, needles, instruments, etc.
-Monitor’s patients and provides safety
-Provides report to PACU nurse
Which type of anesthesia requires intubation?
Why?
General Anesthesia
Patients who undergo general anesthesia require a mixture of anesthetic agents and paralytics. Intubation is required for proper ventilation during the procedure.
Educate: You may wake up with a sore throat. This is normal!
What are the criteria that a patient must meet before being discharged from the PACU?
Must list two.
- Stable Vital Signs
- Effective ventilation
- Easy arousal
- Absence of complications
List 3 signs & symptoms that correlate with hypovolemic shock
Hypotension
Tachycardia
Cool, moist skin
Pale
Decreased urine output