Surgical Patient

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Author:
shannonm2003
ID:
147344
Filename:
Surgical Patient
Updated:
2012-04-13 18:14:15
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Description:
nursing school
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  1. What is the perioperative period
    Total surigcal period. Includes time before surgery, time spent in surgery and period after surgery. goal is for the client to come in well and leave well (want a positive outcome)
  2. What is the perioperative nurse
    Manages pt from the time they check in for surgery until they reach the PACU.
  3. What is the nurses role throughout the perioperative period
    client-centered role, partial defined by the practice setting
  4. What is the goal of perioperative nursing
    To assist clients and their significat others through the surgical episode, to promote positive outcomes, and to help clients achieve optimal level of functioning and wellness after surgery
  5. What should the nurse remember about the preoperative period
    • everyone responsds differently to surgery
    • identify potential risks and complications that may arise
    • identify the need for supportive services at home or in the hospital after surgery
  6. what is included in the preoperative assessment
    • medical/health history (physician responsible for completing this and needs to be done prior to surgery)
    • Alcohol/drug/nicotine use
    • current discomfots
    • chronic illnesses
    • advanced age
    • med history
    • psychological history
    • ability to tolerate perioperative stress
    • lifestyle habits
    • social history
    • physical exam
  7. What does the past medical history include and why is it performed
    • performed to determine operative risk and complete any missing links and to validate data
    • includes: Allergies, Bleeding tendencies, Cortisone or steriod use (impairs wound healing), diabetes mellitus (delays wound healing, increase risk of infection) and emboli (previous emboli events)
  8. What specific body system assessments need to be performed before client undergoes surgery
    • Cardiovascular assessment (increase in operative risk are MI w/in last 6 months, uncontrolled HTN)
    • Pulmonary function (high risk if have COPD)
    • musculoskeletal
    • GI function
    • skin integrity
    • renal function - increased BUN and creatine = dehydration, increase CO2 = renal failure
    • liver function - impaired liver can't detoxify meds
    • cognitive and neurologic
    • endocrine function - diabetes have bad outcome for surgery
  9. what two assesments are most important for anesthesiologist
    • pulmonary function
    • renal function
  10. what is an aesthetic procedure
    done to improve physical feature that is within "normal" range (breast augmentation)
  11. what is a constructive procedure
    repair of a congenitally defective body part (cleft palate)
  12. what is a curative procedure
    removal or repair of damaged or decreased tissue or organs (hysterectomy)
  13. what is a diagnostic procedure
    discovery or confirmation of a diagnosis (breast biopsy)
  14. what is an exploratory procedure
    estimation of extent of disease or confirmation of a diagnosis (laparotomy)
  15. what is an emergent procedure
    live-saving (repair of punctured lung)
  16. what is a pallative procedure
    relief of symptoms but w/o cure of disease (colostomy)
  17. what is a reconstructive surgery
    partial or complete restoration of body part (total joint replacement)
  18. what is an urgent procedure
    performed as soon as client is stable and infection is under control (appendectomy)
  19. what is the purpose of preparing the GI tract before surgery
    • to reduce the possibility of vomiting and aspiration
    • to reduce the risk of possible bowel obstruction
    • to allow visualization of the intestine during bowel surgery
    • to prevent contamination from fecal material in the intestinal tract during bowel or abdominal surgery
  20. what is pt NPO for 8 to 10 hrs prior to surgery
    so they don't aspirate b/c that would lead to pneumonia
  21. what are the components of preoperative teaching
    • sensory info (addresses the sights, sounds and feel of op room)
    • psychosocial info (coping abilities, what if i die)
    • procedural info (what is going to happen)
  22. what is clients role in post op care
    • deep breath (to expand collapsed alveoli in lungs and to prevent pneumonia and atelectasis. Faster clearance of inhalation agents from body)
    • cough (remove strained secretions from the bronchi and larger airways, may be painful, teach splinting)
    • turning exercises (need to practice turning and using bedside rails)
    • extremity exercises (prevent circulatory problems)
    • ambulation (prevents post op problems)
    • pain control (communicate pain)
    • postop equipment (tubes, drains, iv)
  23. what are the immediate pre op activities
    • ID band
    • allergies and allergy band
    • VS
    • consent form signed and procedure listed correctly
    • skin prep completed
    • hearing aids
    • dental work noted
    • special orders (enemas, iv)
    • NPO
    • client voided
    • dentures out
    • oral hygiene
    • storage of valuables
    • removed jewlery
    • wearing gown
    • make-up off
  24. why does a client need to C and DB
    • helps expand collapsed alveoli in lungs and prevents post op pneumonia and atelectasis (partial or complete collapse of lung) coughing removes retained secretions from bronchi and larger airways
    • tell pt to do this 5 to 10 times per hour
  25. what is the nurses role during the intraoperative period
    to protect client's emotional well-being, safety, positioning, maintaining asepsis, and controlling the surgical environment
  26. What are the 3 phases of the post op period
    • initial period in PACU (pt arrives, VS must be stable, alert, dressings, C/DB, able to talk about pain)
    • time from discharge from PACU to the first day or two after surgery (back to room or home)
    • postop phase the time of healing, may last weeks, months, or years after surgery
  27. what is the immediate assessment of the client in the PACU
    • airway (patency, presense of tubes)
    • breathing (respiratory rate and depth, wheezes, stay at bedside until gag reflex returns)
    • circulation (pulse rate and strength, BP, wound and dressings)
    • Also look at LOC, muscle strength, IV dressings, drains
  28. what are nursing diagnoses for PACU
    • risk for injury
    • risk for aspiration
    • acute pain
    • disturbed thought process
    • hypothermia
  29. what position is the pt in in the PACU
    lateral sims position

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