Adult Health 1: Periop

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5 things that increase surgical risk.
- age (very young, very old)
- obesity & malnutrition
- preop dehydration/hypovolemia
- preop infection
- preop use of anticoagulants
Why is pt with liver disease at increased risk for operative complications?
- impairs ability to detoxify meds used during surgery
- impairs ability to produce prothrombin to reduce hemorrhage
Nursing axns to prevent dehiscence & evisceration.
- splint incision when coughing
- cough & deep breathe early when sutures are strong
- high-protein diet
Nursing interventions to prevent postop UTI.
- avoid catheterization
- increase fluid intake
- empty bladder every 4-6 hrs
- early ambulation
Nursing interventions to prevent paralytic ileus.
- early ambulation
- limit narcotic analgesics
- NG tube decompression
Nursing interventions to prevent postop thrombophlebitis.
- in-bed leg exercises
- early ambulation
- antiembolus stockings
- no pillows under knees
- no crossing legs at knees
Four types of consent.
- informed
- surgical
- signed
- witnessed
When should consent be obtained?

within 24 hrs
How long is consent good for?

45 days
Three rights?
- rt pt
- rt procedure
- rt anatomic site
Signs of shock & hemorrhage.
- hypotension
- narrow PP
- rapid, weak pulse
- cold, moist skin
- increased capillary refill time
Evisceration is more likely with what pts?
- elderly
- diabetic
- malnourished
- prolonged paralytic ileus