med surg chpt 16

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Dasefx10
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179124
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med surg chpt 16
Updated:
2012-10-22 23:26:44
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PREOPERATIVE PATIENTS
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CARE OF PEROPERATIVE PATIENTS
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  1. 3 PHASES OF PERIOPERATIVE
    PEROPERATIVE

    INTRAOPERATIVE

    POSTOPERATIVE
  2. Number one priorty for perioperative period.
    SAFETY
  3. DEFINE PERIOPERATIVE PERIOD.
    The preoperative period begins when the patient is scheduled for surgery and ends at the time of transfer to the surgical suite.
  4. PERIOPERATIVE NURSING PLACES SPECIAL EMPHASIS
    SAFETY

    ADVOCACY

    PATIENT EDUCATION
  5. DEFINE TERMS OUTPATIENT AND AMBULATORY
    outpatient and ambulatory refer to a patient who goes to the surgical area the day of the surgery and returns home on the same day  (SDS is same day surgery)
  6. WHAT ARE THE INHIBITORS THAT MAY AFFECT ANESTHESIA TO THE PATIENT.
    The use of tobacco increases the risk for pulmonary complications because of changes it causes to the lungs and chest cavity.

    Excessive alcohol and illicit substance use can alter the patient's responses to anesthesia and pain medication.

    Withdrawal of alcohol before surgery may lead to delirium tremens. 
  7. WHAT DRUGS ARE PRESCRIBE TO A PATIENT WITH CARDIAC IN PERIOPERATIVE THERAPY.
    Beta-blocking drugs as recommended by core measures for SCIP CARD 2.
  8. DEFINE CARBOXYHEMOGLOBIN
    Carbon monoxide on oxygen-binding sites of the hemoglobin molecule, which decreases oxygen delivery to organs.
  9. DEFINE ATELECTASIS.
    Collaspe of alveoi.  Atelectasis reduces gas exchange and causes intolerance of anesthesia.  It is a common problem after general anesthesia.
  10. DEFINE AUTOLOGOUS
    Autologous blood donation for sergery can be made by the patient is made a few weeks before surgery. 

    The last donation cannot be made within 72 hours before surgery

    Patients may wish to have family and friends donate blood exclusively for their use directed blood donation
  11. WHEN DO DISCHARGE PLANNING START?
    Before surgery
  12. DEFINE MORBIDITY
    The number of serious problems
  13. DEFINE MORTALITY
    Death during and after surgery
  14. DEFINE VENOUS THROMBOEMBOLISM
    Is a disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE).  is common. lethal disorder


    is a blood clot (thrombus) that forms within a vein.  Thrombosis ia term for a blood clot occuring inside blood vessel

    Venous thrombi are caused mainly by a combination of venous stasis and hypercoagulability
  15. INDICATIONS OF POOR FLUID OR NUTRITIONAL STATUS
    Brittle nails

    Muscle wasting

    Dry or flaky skn, decreased skin turgor, and hair changes (dull, sparse, drry)

    Orthostatic (postural) hypotension

    dcrease serum protein levels and abnormal serum electrolyte values
  16. WHY OBESE PATIENTS HAVE RISK FOR POOR WOUND HEALING.
    Obesity increases the risk for poor wound healing because of excesive adipose (fatty) tissue.  Fatty tissue has few blood vessels, little collagen, and decreased nutrients, all of which are needed for wound healing.

    Obesity stresses the heart and reduces the lung volumes, which can affect the surgery and recovery.
  17. THE MOST COMMON TEST BEFORE SURGERY
    Urinalysis

    Blood type and screen

    Complete blood count or hemoglobin level and hematocrit

    Clotting studies (prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (PTT), platelet count

    Electrolytes levels

    Serum creatine and blood urea nitrogen levels

    Depending on a female patient's age and the nature of the planned procedure, a pregnancy test may also be needed.




  18. DEFINE HPOKALEMIA
    Decreased serum potassium level) increases the risk for toxicity if the patient is taking digoxin, slows recovery fro anesthesia, and increases in cardiac irritability.

    must be treated before surgery
  19. DEFINE HYPERKALEMIA
    (Increased serum potassium level) increases the risk for dysrhythmias, especially with the use of anesthesia.

    must be treated before surgery
  20. CONSENT IMPLIES THAT THE PATIENT HAS SUFFICIENT INFORMATION TO UNDERSTAND:
    The nature of and reason of surgery

    Who will be performing the surgery and whether others will be present during the procedure

    All available options and the risks associated with each option

    The risks associated with the surgical procedure and its potential outcomes

    The risk associated with the use of anesthia



  21. WHEN A PATIENT STATES THEY FEEL THE SURGEON DID NOT INFORMED THEM THOROUGHLY ABOUT THE SURGERY AS A NURSE WHAT IS THE ROLE OF THE NUSE.
    If you believe that the patient has not been adequately informed, contact the surgeon and request that he or she se the patient for further clarification.  Document this action in the medical record.

  22. BEFORE SURGERY IS PERFORM WHAT MUST BE VERIFIED?
    At minimium the patients identity, correct side and site, correct patient position, and agreement on the proposed procdure must be writted by all members of the surgical team.
  23. NPO MEANS:
    No eating, drinking, (including water), or smoking (nicotine stimulates gastric secretions). 

    the American Society Anesthesiologist recommeds a reducd NPO time 6 or more hours for easily digested solid food and 2 hours for clear liquids

    Failuree to adhere can result in cancellation of surgery or increase the risk for aspiration during or after surgery.

  24. WHAT IS THE MAJOR BARRIER BETWEEN SURGEONS AND NURESE
    The major barrier inguideline implementation is failure of surgeons and nurses to communicate during preoperative teaching both the shorter duration fasting and the importance of taking some oral medication during the fast.
  25. EXPLAIN INCNTIVE SPIROMETRY FUNCTIONS AND BREATHING EXERCISES THE PURPOSE FOR THIS DEVICE.
    Incentive spirometry is another way to encourage the patient to take deep breaths.  Its purpose is to romote complete lung expansion and to prevent pulmonary problems.

    Breathing exercises include deep breathing to enlarge chest cavity and expand the lungs
  26. INTERVENTIONS TO MINIMIZING ANXIETY
    Preoperative teaching

    Encouraging communication

    Promoting rest

    Distraction

    Teaching family members

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