Exam week 13

Card Set Information

Exam week 13
2013-11-18 00:15:05
nur 103

breast and testicular exam
Show Answers:

  1. Assessment of female reproductive includes
    • assessment of inguinal lymph nodes and inspection of external genitals
    • PAP for sexually active adolescent to adult women
  2. what is the position for female
  3. what are the nurses responsibilities when assisting with an examination of internal female genitals
    • assembling the equipment (drapes, gloves, speculum, warm water and lubricant, supplies for cyctology and culture studies)
    • Preparing the client (explain, lithotomy position, drape)
    • Supporting the client (encourage, deep breaths)
    • Monitor/Assist after
    • Document Procedure
  4. What are the purposes of surgery?
    • Diagnostic
    • Palliative
    • Ablative
    • Constructive
    • Transplant
  5. Diagnostic Surgery
    • confirms or establishes a diagnosis
    • example: Biopsy of a mass in a breast
  6. Palliative Surgery
    Relieves or reduces pain or symptoms of a disease, It DOES NOT CURE
  7. Ablative Surgery
    • Removes diseased body part
    • removal of gallbladder
  8. Constructive Surgery
    Restores function or appearance that has been lost or reduced

    example breast implant
  9. Transplant Surgery
    Replaces malfunctioning structure

    example kidney or liver
  10. Preoperative Phase
    begins with the decision to have the surgery is made and ends when client is transferred to the operating table
  11. intraoperative phase
    begins when the client is transferred onto the operating table and ends when client is admitted to the postanesthesia care unit
  12. postoperative phase
    begins with the admission to the postanesthesia care unit and ends when healing is complete
  13. degree of urgency for surgery
    • Emergency - NOW
    • Urgent- TODAY
    • Elective- client chooses time and date
  14. degree of risk for surgery
    Major- involves high degree of risk

    Minor-involves little risk
  15. reasons for Major Risk during surgery
    • large blood loss
    • vital organs involved

    • organ transplant
    • open heart
    • removal of kidney
  16. the degree of risk during surgery is affected by ....
    • Age
    • General Health
    • Nutritional Status
    • Medications
    • Mental Status
  17. lifespan considerations for elderly
    • decreased Metabolic rate + toxicity
    • Dcd fluid reserve = Fluid Volume Deficit
    • Dcd Kidney Funct= cannot concentrate urine and flush things out as quickly
    • Dcd thirst= fluid volume deficit
    • Dcd Liver Func= can affect response to anesthia and other meds
  18. lifespan considerations
    infants and  neonates
    • high metabolic rate
    • blood volume is small, fluid reserves are limited= risk of depletion in surgery and inadequate oxygenation of body tissues
  19. malignant hyperemia
    • family genetic disorder
    • reaction to inhaled anesthesia

    ask if family H/O high fever during surgery or died during surgery
  20. client has anxiety before surgery what happens
    gi juices build up
  21. risk impacted by mental status
    • anxiety
    • cognitive ability (mental illness, development delays)
    • Ability to cope with stressors is decreased
  22. Nursing Management
    • Assessing
    • Physical Assessment
    • Screening Tests
    • Diagnosing
    • Planning
    • Planning For Home Care
    • Implementing
  23. Routine Preoperative Screening tests
    • CBC
    • Blood grouping and Cross match
    • Serum Electrolytes
    • Fasting Blood Glucose
    • Blood Urea Nitrogen (BUN) creatinine
    • ALT, AST, LDH and bilirubin
    • Serum Albumin and total protein
    • UA
    • Chest X RAY
    • EKG (over 40 or pre cardiac condition)
    • preg Test
  24. universal donor
  25. Universal Recipiant
  26. Na (Sodium)
  27. K (potassium)
  28. fasting blood glucose
  29. UA normals
    • Specific Gravity 1.010-1.025
    • pH 4.5-8
    • color Straw, transparent
    • odor fragrant aromatic
  30. WBC
  31. why do we check WBC, Hbg and Hct before surgery
    • immune system function
    • oxygen carrying capacity
  32. why do BUN and Creatinine needed to be checked before surgery
    to check renal sufficiency
  33. RBC normals
    • 4.6-6.0 MEN
    • 4.0-5.0 WOMEN
  34. Hgb
    • MEN 13.5-18
    • WOMEN 12-15
  35. Hct normals
    • MEN 40-54%
    • WOMEN 36-46%
  36. when are postop exercises taught
  37. TCDB
    turn cough deep breath
  38. Safety Alert
    safety protocols
    • 2 identifiers
    • mark site with YES before pt is sedated
    • call time out, all questions have to be answered be for proceding

    • box in book
    • Conduct preprocedure verification process
    • Mark the procedure site
    • A time out is performed before precedure
  39. Atelectasis
    • dyspnea
    • tachycardia
    • tachypnea
    • anxiety
  40. Hypovolemia
    tachycardia, decreased urine output, decreased BP
  41. Hemorrhage
    • Bright red, free flowing blood into tubes, drains ....
    • Happens 24 hours after surgery
  42. Hypovolemic Shock
    rapid, thread pulse, restlessness, anxiety

    "I just don't feel right."
  43. Postoperative ileus
    Recall, normal absence of sounds 24-48 hrs post op