Show:
Labs
Perioperative
Postop
Periop Misc 1
Periop Misc 2
100
Purpose of preoperative lab and diagnostic tests?
What is Provide baseline info
100
Nurses role in obtaining informed consent?
What is Witnessing signature
100
CDB, use of incentive spirometer and ambulation prevents?
What is Atelectasis, Pneumonia. Lung infections
100
What does the nurse need to know from the surgeon’s post-op orders?
What is Foods and fluids permitted by mouth IV solutions and IV medications Position in bed Medications ordered (antibiotics, pain meds) Laboratory tests I & O orders Activity permitted including ambulation
100
Conscious sedation
What is minimal depression of the level of consciousness in which the client is able to maintain a patent airway and respond to commands
200
Diagnostic test ordered for people undergoing general anesthesia, over 40 or have a history of cardiovascular disease?
What is ECG
200
Person responsible for obtaining client’s informed consent?
What is Surgeon performing procedure
200
Leg Exercises(WHY)(WHAT)
What is Perform every 1-2 hours while awake Muscle contractions compress veins and help blood to return to heart Prevents stasis of blood in veins which may lead to thrombus, thrombophlebitis, and emboli (a blood clot that moved) Also promotes arterial blood flow
200
List medications which may affect a client undergoing surgery and explain their effects?
What is Antibiotics - may potentiate affects of anesthetic agents (aminoglycosides: gentamycin, tobramycin Antidysrhythmics – reduce cardiac contractility and cardiac conduction during anesthesia Anticoagulants – increase risk for hemorrhage (ASA, NSAIDS, coumadin); d/c 48 hours before surgery Anticonvulsants – may alter metabolism of certain anesthetic agents Antihypertensives – may interact with anesthetic agens and cause bradycardia, hypotension and impaired circulation Corticosteroids – cause adrenal atrophy and decrease body response to stress of surgery, before and during surgery dosages may be temporarily increased; immunosuppression - risk for infection Insulin – need may be increased or decreased after surgery Diuretics – potentiate fluid and electrolyte imbalances after surgery Anticholinergics – increase potential for confusion
200
Hemorrhage
What is loss of large amount of blood internally, or externally in a short period of time. CAN cause SHOCK. Increase serosanguinous drainage can cause SHOCK.
300
PT/INR, PTT
What is – screen for clotting disorders, anticoagulant therapy, if decreased levels there is increased risk for DVT. PT/INR: Coumadin PTT/APTT: Heparin
300
Where client is transferred after surgery?
What is PACU
300
Moving and ambulation(WHY)(WHAT)
What is Turn side to side Q 2 hours Helps increase lung expansion Ambulate ASAP after surgery Early ambulation prevents respiratory, circulatory, urinary, GI complications and muscle weakness Start gradually, dangle on side of bed first
300
If a patient has this disease they will need corticosteriods for LIFE?
What is Addison Disease
300
Shock
What is loss of circulatory volume usually caused by hemorrhage.
400
Serum electrolytes (Na +, Ca+, Mg+, Cl-, HCO3-
What is evaluates fluid and electrolyte status. Dehydration may lead to hypovolemia.
400
What is the first assessment performed in the PACU
What is Respiratory Assessment
400
Urinary elimination(WHY)(WHAT)
What is Assist client with voiding Notify MD if no void within 8 hours Anesthetic agents temporarily depress bladder tone which usually return 6-8 hours after surgery
400
What is usually included in a preop checklist?
What is ID bracelet List allergies Consents signed- surgery, anesthesia, blood transfusions, disposal of limbs, surgical sterilizations H&P in chart Consults completed and documented in chart Labs, EKG, CXR reports on chart Blood T&C Last void Remove jewelry, makeup, dentures, hairpins, nail polish, glasses, prothesis Valuables applicable Last time client ate or drank
400
How do You assess for SHOCK
What is Vitals Signs.The main symptom of shock is low blood pressure. Other symptoms include rapid, shallow breathing; cold, clammy skin; rapid, weak pulse; dizziness, fainting, or weakness
500
Serum albumin and total protein –
What is Evaluates nutritional status which is important for healing.
500
Separation of the surgical incision?
What is Dehisence; Evisceration (organs protrude), both cover with moist sterile drsg
500
Positioning: (WHY)(WHAT)
What is Spinal anesthetics lie flat 8-12 hours Unconscious or semi conscious on side with head slightly elevated Elevate affected extremities
500
General anesthesia
What is the loss of all sensation and consciousness, cough and gag reflexes lost
500
Paralytic ileus
What is failure of appropriate forward movement of bowel contents secondary to anesthesia or bowel manipulation during surgery