Nursing Interventions
Preoperative
Interoperative
Perioperative Care
Post Operative Care
100

How do SCD - Pneumatic Compression Devices work? What are we trying to prevent?

What is alternating compression (inflation) and deflation of leg stockings...to prevent venous stasis and DVT's

100
4 common diagnostic tests preoperatively
What are EKG, CBC, UA, PT/INR
100
What does "Time out" mean?
What is a safety measure- performed in the OR just before the initial cut...to make sure the right site will be operated on...Called by anyone in the care team (Circulating nurse)
100
Assessment priorities in PACU
What is Airway/Breathing, Circulation, LOC, Fluids - in this order
100
How do you prepare the room to receive a post-operative patient
What is bed up and open, blue pad on bed, all furniture moved out of way, obtain the following equipment for VS, O2, suction, emesis basin, tissues, pillow to splint...
200
Post operative temperature of ______ requires a call to the physician
What is >/= 101 F
200

Patients should be educated to do __________ in regards to pain medication post surgery.

What is call for a dose of medicine before the med completely wears off for better pain control.

200
Stage of Anesthesia- with heightened sense of hearing & muscle tension requiring a quiet environment
What is Stage II- excitement phase
200
"I want to keep my wedding ring on"
What is "That is fine, I will place tape over it"
200
Priority post operative assessment(s)
What is Airway (is there an airway in place, RR, lung sounds, skin color, pulse ox, cap refill), Cardiac with VS (heart sounds), LOC, surgical site, drains, remaining system assessment based on procedure & pain assessment
300
Interventions to prevent Ineffective breathing or ineffective airway clearance
What is side lying position to protect airway, C&BD, Incentive spirometry, splint incision, control pain, encourage fluids as tolerated, ensure gag reflex (and BS) before offering liquids
300

List 4 instructions to include in your patients pre-operative teaching

What is shower with antibacterial soap, NPO after midnight, when to arrive, what to bring, no makeup or jewelry, no acrylic nails, IV will be started, what medications to take, bring a driver if outpatient procedure

300
Wears sterile attire, prepares and assists surgeon with instruments, counts items
Who is the Surgical Technician or Scrub Nurse
300
Who obtains the surgical consent? What needs to be included in the discussion?
Who is surgeon. Procedure, desired & expected outcome, alternatives to procedure & outcomes, risks for procedure and anesthesia, time for questions
300
During your assessment the abdominal wound has a shadowing of blood, what are your next steps
What is mark the area with a pen, date, time and initial...if needed reinforce and notify physician.
400
Interventions to prevent GI upset, Nausea
What is check BS before any fluids / food, ambulate, anti-emetics, maintain IV, progressive diet...may take 48 hours to return
400
How do you perform C&DB exercises & how often? Who should not perform the cough?
What is splint incision, offer pain medication, deep breath in through nose, hold and cough 10x/hour every 2 hours Neurological or Eye surgery patients
400
Serves as the patient advocate, positions the client, handles the specimens, counts and documents the case. Hands of the patient to the PACU team
Who is the Circulating Nurse
400
Before I give you this pre-operative narcotic......
What is void
400
How often are post operative VS completed
What is Q15x4, Q30x4, Q1x4, Q2x4, Q4x4, then Q8
500
Interventions to prevent DVT
What is ambulate asap, ted hose, SCD, leg exercises
500
What is the most effective way to get out of bed after a major surgery?
What is elevate the HOB (high fowlers) first, turn onto one's side, splint and push to get up, then dangle, then stand, then get up...Stopping when not tolerated.
500
Anesthesia that produces loss of sensation, consciousness and reflexes.
What is General Anesthesia
500
After giving the narcotic in pre-op area your next steps include...
What is put up side rails, instruct not to get up without help
500
Absolute #1 priority
What is PATIENT SAFETY (Infection control, positioning, electrical safety, continuous monitoring, aspiration prevention...)