Peri-operative
When should patient teaching begin?
Upon admission
How can you prevent evisceration?
Splinting
Abdominal binder
Teaching limitations (lifting)
Laxatives
What is the textbook definition of shock?
Decreased tissue perfusion and impaired cellular metabolism
What is the pneumonic for pain and what does each letter stand for?
Provocation
Quality
Radiation or Relief
Severity
Time
What is the deadliest form of skin cancer?
Malignant melanoma
What causes malignant hyperthermia and what are the signs/symptoms?
Caused by inhalant anesthesia
S/S: muscle rigidity, rising temp., increased K+ & Ca+, rhabdomyolysis
Watch out for renal failure
What is the most common cause of post-op hypoxemia?
Atelectasis
What are the cardinal signs of all types of shock?
Tachycardia & hypotension
Identify and describe the 4 types of pain scales.
Numeric: 0-10 with 0 being no pain and 10 being the worst pain ever felt
Faces: for children or those who cannot understand the numeric scale
FLACC: non-verbal pain assessment tool
Comfort: functional pain goal for chronic pain
Differentiate between open angle glaucoma and closed angle glaucoma.
Open: no pain, gradual loss of vision, tunnel vision
Closed: emergency, pain, redness, blurred vision, halos around light, N&V
What teaching should be started/completed during the pre-op phase?
IS, Deep breathe & cough
Early ambulation
Enoxaprin
SCD's
Positioning
___ is a product of anaerboic metabolism in the tissues that are not being perfused
Lactate
What is the difference between acute and chronic pain?
Acute: lasts less than 3 months, as it heals the pain diminishes
Chronic: lasts longer than 3 months or longer than the anticipation of the normal/typical healing process
This type of skin infection is a type of skin infection occurring in the SQ tissue and is manifested as red, hot, tender and swollen. Patients may have fever or malaise.
Cellulitis
What test must you conduct on 50% of the population prior to surgery and why?
Pregnancy test; anesthetics depress the fetus
What are the signs and symptoms of hemorrhage?
Tachycardia
Decreased BP
Tachypnea
Cool, clammy skin
Identify and describe the 3 stages of shock.
Compensatory: tissue perfusion is maintained by vasoconstriction due to the body attempting to compensate for the cause
Progressive: the body cannot maintain compensation, HR increases, HR increases, BP decreases, RR increases, changes in LOC
Refractory (irreversible: organ tissue damage, multiple organ dysfunction, death
How is neuropathic pain described?
Numbing, hot, burning, shooting, stabbing, electric
This type of skin infection is described as honey crust usually on the face.
Impetigo
What are the different reasons why surgery is performed?
Cure
Palliative care
Preventative care
Exploratory
Cosmetic improvement
Emergency
What is the difference between dehiscence and evisceration?
Dehiscence: wound opens through superficial layers
Evisceration: abdominals content protrude through opening
Identify and describe the 4 different types of shock.
Cardiogenic: pump problem
Hypovolemic: loss of intravascular fluid volume
Neurogenic: hemodynamic phenomenon after spinal cord injury
Distributive: massive vasodilation and permeability
What are the side effects of opioid medications?
Respiratory depression, constipation, N/V, itching, over sedation, potential for dependence, tolerance
A patient has a severe burn on the right hand and forearm and reports severe escalating pain. The nurse anticipates pain medication administration via which route?
IV for fastest onset