Questions and Answers
Which nursing role is primarily responsible for maintaining a sterile field during surgery?
What is the primary purpose of the timeout procedure before surgery?
Which of the following zones in a surgical environment allows street clothes?
What is a crucial intervention for preventing surgical site infections according to the Surgical Care Improvement Project (SCIP)?
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What is an important aspect of surgical asepsis?
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Which member of the surgical team is primarily involved in ensuring the patient stays warm during the procedure?
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What is the primary function of a scrub role during surgery?
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How long after surgery should prophylactic antibiotics be continued according to SCIP guidelines?
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What is a possible nursing intervention during the intraoperative phase to monitor a patient's respiratory status?
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What should be assessed in a patient during the intraoperative phase to prevent complications?
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Which medication should ideally be tapered prior to surgery to avoid intraoperative complications?
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In the intraoperative setting, which action is least likely to help manage immediate postoperative nausea and vomiting?
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Which aspect of a patient's history is crucial to assess before the intraoperative phase to mitigate the risk of malignant hyperthermia?
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During the intraoperative phase, what is an important preoperative care step to ensure patient safety?
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What is an important nursing consideration when a patient is under anesthesia during the intraoperative phase?
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Which factor could increase the risk of bleeding during surgery, necessitating careful monitoring during the intraoperative phase?
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What should a nurse prioritize in preparation during the intraoperative phase for a patient at risk of aspiration?
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Which action is not focused on reducing the risk of patient injury during intraoperative care?
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What should be included in the verification process to ensure patient safety in the intraoperative phase?
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Which nursing intervention directly addresses the prevention of perioperative positioning injury?
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In which way can a nurse serve effectively as a patient advocate during the intraoperative phase?
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What is the priority nursing action to protect the patient during intraoperative care?
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What is a critical factor to consider when reducing latex exposure in the operating room?
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Which nursing responsibility is performed to maintain aseptic technique and prevent complications during surgery?
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What is the primary focus of a nurse when serving as a patient advocate in the intraoperative setting?
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Which behavioral intervention is critical for minimizing patient anxiety in the intraoperative period?
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What is a potential consequence of insufficient monitoring of the physical environment during surgery?
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Which nursing intervention is vital for ensuring patient safety immediately before anesthesia administration?
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What factor contributes to the increased significance of monitoring older adults during intraoperative care?
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Which nursing action is most effective in preventing postoperative confusion in older surgical patients?
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What should be done if a sterile barrier is breached during a surgical procedure?
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Which condition is characterized by the patient becoming aware of surgical procedures despite being under anesthesia?
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What complication is specifically associated with a rare inherited muscle disorder triggered by anesthesia?
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Which of the following statements about maintaining a sterile field is true?
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What is a potential adverse effect of general anesthesia related to the cardiovascular system?
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What is the primary cause of vision loss in patients with glaucoma?
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During the assessment of a patient with glaucoma, which diagnostic study is most crucial for measuring intraocular pressure?
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Which type of glaucoma requires immediate medical intervention to prevent permanent vision loss?
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Which of the following risk factors is NOT associated with the development of glaucoma?
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What symptom is typically NOT experienced by patients with glaucoma?
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What is the primary goal of glaucoma treatment?
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Which of the following best describes the surgical management of cataracts?
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Which postoperative instruction should be given to a patient who has just undergone cataract surgery?
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What common symptom is NOT associated with the presence of cataracts?
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Which of the following factors may not contribute to the increased risk for developing cataracts?
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What is the primary complication associated with anemia that affects cardiovascular function?
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Which of the following statements regarding miotics used in glaucoma treatment is true?
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What is the most significant concern patients should monitor for after cataract surgery?
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Which lab data is essential for evaluating iron deficiency anemia?
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In sickle cell disease, what characteristic of red blood cells primarily contributes to vascular occlusion?
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What is the likely visual impairment experienced by patients with cataracts?
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What is the main goal of medical management in patients with anemia?
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Which of the following symptoms may be more pronounced in older adults with anemia?
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Which intervention is vital when managing a patient experiencing a sickle cell crisis?
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Which dietary intervention is a primary recommendation for patients with iron deficiency anemia?
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What is a significant consequence of untreated anemia in older patients?
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What type of anemia is characterized by the presence of S-shaped hemoglobin?
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What is the most common reason for a blood transfusion in patients with anemia?
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What is a characteristic sign of Cushing's syndrome?
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What is the primary cause of Type 1 diabetes?
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What lifestyle change can prevent prediabetes from progressing to Type 2 diabetes?
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What is a likely complication of uncontrolled diabetes mellitus?
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What treatment is typically recommended for a pituitary tumor causing Cushing's syndrome?
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Which oral medication approach is recommended for diabetes treatment?
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What monitoring is essential for patients with diabetes to prevent acute complications?
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What is the effect of stress on blood glucose levels in diabetes management?
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Why is it important for diabetes patients to engage in resistance exercise?
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What dietary approach is recommended for diabetes management?
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What potential effect does hyperglycemia during pregnancy have on newborns?
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Which type of insulin requires administration 30 minutes before meals?
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What is a necessary precaution when using an insulin pump?
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What is the primary cause of diabetic ketoacidosis?
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Which of the following symptoms is least likely associated with hyperglycemic hyperosmolar syndrome (HHS)?
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What is a key distinguishing symptom of acute hemolytic transfusion reaction?
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What is the primary concern when administering blood transfusions to older adults?
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What is the most common complication in diabetes leading to renal failure?
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Which of the following nursing actions is essential during the first 15 minutes of a blood transfusion?
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What clinical sign is characteristic of foot and leg problems in diabetic patients?
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What complication is associated with diabetic retinopathy?
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What condition must be avoided in patients receiving blood products?
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In which situation is Kussmaul breathing most likely observed?
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What condition is characterized by the presence of high blood glucose levels and increased osmolality?
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Which symptom is NOT commonly seen in both DKA and HHS?
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What is a definitive management step for treating hypoglycemia?
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What layer of the retina is primarily responsible for the absorption of light?
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Which statement accurately describes the optic disc?
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In which condition are distorted retinal vessels commonly observed?
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What is the primary visual function of cones in the retina?
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Which treatment option is typically utilized for correcting strabismus?
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What is the recommended maximum infusion rate for PRBCs during the first 15 minutes?
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Which of the following is a possible cause of hypoproliferative anemia?
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What should be done post-transfusion to ensure the efficacy of the transfusion?
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Which blood types are compatible donors for a transfusion of PRBCs?
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Which laboratory results are important to assess the efficacy of a blood transfusion?
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What is the primary indication for a cochlear implant?
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Which of the following statements about preoperative nursing care is true?
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What dietary modification is recommended to manage symptoms that may worsen due to high salt intake?
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Which surgical classification is characterized as non-essential and primarily based on a patient's personal choice?
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Which factor is most likely to lead to an increased risk of a malignant hypothermia reaction during surgery?
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Which statement best describes the role of diuretics in surgical management?
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In which phase of perioperative care does the nursing process initiate with patient admission data collection?
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What is a common misconception about the effects of tranquilizers prior to surgery?
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Which suggestion is crucial for effectively communicating with a hearing-impaired person?
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What common preoperative risk factor must be assessed to mitigate the risk of aspiration during surgery?
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What is a common consequence of untreated Diabetes Mellitus that affects the nervous system?
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Which of the following symptoms is NOT typically associated with Cushing's syndrome?
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Which type of Diabetes Mellitus is characterized by the destruction of beta cells in the pancreas?
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What physiological change occurs due to increased mineralocorticoid secretion in Cushing's syndrome?
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Which treatment approach is indicated for managing a pituitary tumor in Cushing's syndrome?
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Which complication is a potential risk of insulin pump therapy?
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In managing diabetes, what is the main purpose of using sliding scale insulin?
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What dietary method is commonly recommended for patients with diabetes?
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Which of the following is a characteristic feature of Type 2 diabetes?
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What is the primary physiological effect of insulin on blood glucose levels?
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Which of the following physiological conditions is linked to the excessive secretion of androgens in Cushing's syndrome?
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What common symptom might indicate a diabetic patient is experiencing hyperglycemia?
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What should be monitored regularly in patients with diabetes to assess for potential complications?
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What is a common symptom associated with primary hyperparathyroidism?
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What is the most likely effect of walking on bone health in individuals with hyperparathyroidism?
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What is a possible treatment for hypoparathyroidism aimed at increasing calcium levels?
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Which of the following is NOT a classic symptom of acromegaly?
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What is the primary reason for the development of dehydration in patients with diabetes insipidus?
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Which physiologic change is most associated with SIADH?
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What is the treatment approach for severe cases of hyponatremia associated with SIADH?
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What laboratory finding is indicative of diabetes insipidus?
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Which hormonal environment is primarily affected in hypothyroidism?
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What is a significant consequence of untreated acromegaly?
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What laboratory test is critical for the diagnosis of nephrogenic diabetes insipidus?
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Which of the following is a classic early symptom of syndrome of inappropriate antidiuretic hormone (SIADH)?
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What is the main therapeutic goal in managing hypoparathyroidism?
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What effect does tight bedrest have on individuals with hyperparathyroidism?
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Study Notes
Intraoperative Team Roles
- Patient: Central focus of surgical care.
- Anesthesiologist/CRNA: Administer anesthesia, monitor patient during surgery.
- Surgeon: Performs the surgical procedure.
-
Nurses:
- Circulating Nurse: Ensures safety, maintains a sterile environment, documents events, assists with the timeout procedure.
- Scrub Role: Maintains sterile field, anticipates required supplies, conducts instrument counts to prevent retention in the patient.
- Registered Nurse First Assistant (RNFA): Assists the surgeon directly, recognized in 17 states.
- Surgical Technicians: Transport and prepare the operating room and equipment.
- Certified Surgical Technologists: Provide direct assistance to the surgeon.
Surgical Environment and Infection Prevention
-
Zones:
- Unrestricted Zone: Street clothes allowed.
- Semi-restricted Zone: Scrub clothes and caps required.
- Restricted Zone: Strict sterile protocols with caps, masks, and shoe covers.
- Surgical Asepsis: All items in the sterile field must be sterile.
- Surgical Care Improvement Project (SCIP): Aims to reduce surgical site infections through timely antibiotic administration and VTE prophylaxis.
Patient Safety and Advocacy
- Patient Verification: Continuous monitoring of identity, health history, allergies, and diagnostic tests.
- Safety Measures: Grounding of equipment, restraints, preventing patient from being left unsupervised while sedated.
- Patient Advocate Role of Nurses: Ensure patient welfare and safety before, during, and after surgery.
Post Anesthesia Care Unit (PACU) Management
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Assessment Responsibilities:
- Vital signs, motor and sensory function, orientation checks.
- Regular observations every 15 minutes until stable.
- Postoperative Care: Manage pain, assess for complications, and provide discharge education regarding care, medications, and activities.
Key Considerations for Postoperative Patients
- Airway Management: Maintain ventilation, provide supplemental oxygen, monitor respiratory status.
- Cardiovascular Stability: Monitor fluid status, heart rate, blood pressure, and assess for potential shock symptoms.
- Hypovolemic Shock Indicators: Pallor, rapid pulse, low blood pressure, and decreased urine output.
Managing Postoperative Symptoms
- Pain Relief: Environment control and administration of analgesics; address family concerns as well.
- Nausea/Vomiting Control: Use antiemetics and assess their effectiveness.
Special Considerations for Older Adults
- Increased susceptibility to anesthesia effects and postoperative complications.
- Regular monitoring for hypoxia, hypotension, and hydration status.
- Adjust pain management to a lower dosage ("go low and slow").
Wound Healing Factors
- Influenced by age, nutrition, medications, comorbid conditions, and surgical stressors.
- Management includes dietary modifications and medication assessments.
Hearing Impairment Treatment
- Hearing Aids and Cochlear Implants: Enhance auditory function for different levels of hearing loss.
- Vestibular Rehabilitation: Focuses on balance and stability improvement.
Communicating with Hearing Impaired Individuals
- Speak clearly and use gestures; reduce background noise to enhance understanding.
Perioperative Phases
- Preoperative: Begins with surgical decision, ends with OR transfer.
- Intraoperative: From OR transfer until PACU admission.
- Postoperative: Starts from PACU admission until follow-up evaluation.
Surgical Classification Types
- Procedural Categories: Diagnosis, cure, repair, reconstructive, cosmetic, or rehabilitative surgeries.
- Urgency Levels: Ranging from emergent to optional surgeries.
Preoperative Assessments
- Comprehensive health history, medication review, allergy checks, and psychosocial factors assessment.
- Environmental and physiological evaluations to minimize surgical risks.
Patient Care During Ambulation
- Allow the patient to hold the nurse's arm above the elbow while walking to provide support and stability.
- Encourage patient independence during meals instead of offering to feed them.
Glaucoma
- A condition characterized by optic nerve damage due to increased intraocular pressure (IOP).
- Imbalance in aqueous humor production and drainage leads to increased IOP, resulting in peripheral vision loss.
- Normal IOP ranges from 10 to 21 mmHg; increased IOP can cause irreversible damage to the optic nerve.
- Types include wide-angle (most common) and narrow-angle (emergency situation).
- Risk factors include cardiovascular disease, diabetes, older age, and previous eye trauma.
- Often referred to as the "silent thief," as patients may not be aware of the condition until significant vision loss occurs.
Wide-Angle Glaucoma
- Develops due to improper fluid drainage, leading to slow IOP increase and gradual vision loss.
- Outflow resistance occurs at the trabecular framework, resulting in slower progression.
Narrow-Angle Glaucoma
- Emergent condition where blockage occurs at the base of the iris and cornea, causing rapid IOP increase.
- Permanent vision loss can occur if untreated for more than 24-48 hours.
Diagnostic Studies for Glaucoma
- Tonometry measures IOP levels.
- Ophthalmoscopy examines the optic nerve and disc for pallor (indicating blood supply issues) and cupping (indicative of optic nerve damage).
- Central visual field testing helps assess peripheral vision loss.
Treatment of Glaucoma
- Aim to prevent further optic nerve damage and maintain safe IOP levels.
- Pharmacologic therapies include miotics (e.g., pilocarpine), beta-blockers, alpha2-agonists, carbonic anhydrase inhibitors, and prostaglandins.
- Treatment may also involve laser procedures and surgery.
Cataracts
- Defined as cloudiness of the lens, with higher incidence in aging populations; over half of Americans over 80 have cataracts.
- Symptoms include blurry vision, sensitivity to glare, and reduced visual acuity.
- Other manifestations include myopic shift, astigmatism, and color shifts.
Cataract Surgical Management
- Surgery is not necessary unless vision impairment affects daily activities.
- Outpatient procedure, usually completed within an hour, with local anesthesia.
- Potential complications during surgery include inflammation, infection, and light sensitivity.
Postoperative Care for Cataract Surgery
- Administer eye drops as prescribed to aid recovery.
- Educate patients on proper post-surgery care, including avoiding sleeping on the side of the affected eye and restricting heavy lifting.
Adverse Effects of Surgery and Anesthesia
- Complications can include allergic reactions, cardiac dysrhythmias, mood swings, and trauma from intubation.
- Special attention required for gerontologic patients who are at higher risk for complications.
Cushing's Syndrome
- Characterized by increased adrenal cortex hormones due to medications, hyperplasia, or pituitary tumors.
- Classic signs include central obesity, moon face, buffalo hump, hypertension, and skin changes.
- Treatment often involves medication adjustments or surgical intervention.
Diabetes Mellitus (DM)
- A chronic disorder marked by hyperglycemia due to inadequate insulin production (Type 1) or insulin resistance (Type 2).
- Types of diabetes include prediabetes, Type 1, Type 2, and gestational diabetes.
- Common symptoms are polyuria, polydipsia, polyphagia, fatigue, and slower healing wounds.
Consequences of Diabetes
- Long-term complications include neuropathy, nephropathy, and retinopathy.
- Management involves education, medication, dietary changes, and physical activity.
Diabetes Treatment Education
- Essential to understand diabetes pathophysiology, normal glucose ranges, and treatment approaches.
- Education also includes medication management, meal planning, and recognizing complications.
Diabetes Treatment Medications
- Oral medications require gradual dosing, while insulin can be administered through injections, pens, or pumps.
- Various types of insulin exist, including rapid-acting, regular, NPH, and long-acting.
Diabetes Diet and Nutrition
- Emphasizes a balanced plate method: half vegetables, a quarter protein, and a quarter carbohydrates.
- Collaboration with dietitians is encouraged to accommodate cultural preferences.
Diabetes Physical Activity Recommendations
- The American Diabetes Association suggests at least 150 minutes of moderate physical activity weekly.
- Resistance exercise should occur twice to three times weekly, with flexibility training recommended.### Diabetes Management and Complications
- Incorporating yoga and tai chi can improve flexibility, muscular strength, and balance for diabetics.
- Blood glucose levels should be monitored before and after engaging in physical activities.
Acute Complications of Diabetes
- Hypoglycemia: Symptoms include neurologic changes, hypotension, dehydration, and elevated BUN and creatinine levels.
- Diabetic Ketoacidosis (DKA): Characterized by metabolic acidosis and is primarily related to insulin deficiency.
- Hyperglycemia Hyperosmolar Syndrome (HHS): High levels of glucose cause severe hyperosmolality (>320 mOsm) and presents with prolonged polyuria and neurologic impairments.
Long-Term Complications of Diabetes
- Diabetes often accompanies metabolic syndrome, which includes cardiovascular disease, hypertension, and obesity.
-
Macrovascular Complications:
- Coronary Artery Disease (CAD) is 2-3 times more likely to result in heart attacks in diabetics.
- Cerebrovascular Disease leads to increased risk of transient ischemic attacks (TIAs) and strokes.
- Peripheral Vascular Disease is common in lower extremities.
-
Microvascular Complications:
- Retinopathy: Leading cause of blindness among individuals aged 20-74 in the USA due to damaged retinal blood vessels.
- Nephropathy: Nearly half of end-stage kidney diseases are attributed to diabetes harming kidney filtration.
- Diabetic Neuropathy: Symptoms include peripheral nerve damage leading to paresthesia and decreased sensation; increased risk of foot injuries.
Foot Care for Diabetics
- Prioritize diabetes management followed by daily foot inspections and care.
- Wash feet in warm water, apply lotion on top and bottom, and trim toenails straight across.
- Maintain good footwear practices and avoid going barefoot.
- Regularly check for injuries to prevent serious complications.
Composition of Blood
- RBC to plasma ratios: Males - 40-54%, Females - 37-47%.
- Hemoglobin levels: Males - 13-18 g/dL, Females - 12-15 g/dL.
- RBC Counts: Males - 4.6-6.2 million/mm³, Females - 4.2-5.4 million/mm³.
Blood Transfusion Protocols
- Transfusions involve RBCs, platelets, and plasma; require verification of order, type, and consent.
- Blood must be transfused within 4 hours to prevent infection; first 15 minutes critical for monitoring reactions.
- Monitor for adverse reactions: febrile, hemolytic, allergic, circulatory overload (TACO), and transfusion-related acute lung injury (TRALI).
Recognition of Transfusion Reactions
- Febrile Non-hemolytic Reaction: Common, typically minor; causes fever and chills.
- Acute Hemolytic Reaction: Life-threatening due to blood incompatibility, may result in severe symptoms including back pain and hypotension.
- Allergic Reactions: Potentially severe, manifesting as hives or respiratory distress; managed with epinephrine if severe.
- TACO: Caused by rapid transfusion; watch for symptoms like dyspnea and jugular vein distention.
- TRALI: Serious pulmonary reaction, often fatal; characterized by acute lung injury.
Management of Anemia
- Anemia often affects older adults, leading to decreased physical and cognitive function.
- Treatment involves correcting the cause, transfusions, or specific dietary supplementation (iron, folate, B12).
- Regular monitoring of vital signs and patient education are crucial.
Sickle Cell Disease Overview
- Inherited disorder resulting in sickle-shaped red blood cells (HbS), leading to occlusions and hemolytic anemia.
- The disease causes severe pain crises due to vessel blockage and poor oxygenation.
- The only cure is a bone marrow or stem cell transplant, reserved for severe cases with a matching sibling donor.
Assessment for Sickle Cell Disease
- Conduct thorough health history and pain assessment; evaluate for symptoms like swelling and fever.
- Laboratory assessment of sickle hemoglobin necessary for diagnosis and management.
Sensory Systems
- Visual cortex is located in the occipital lobe; auditory cortex is situated in the temporal lobe.
- Retina is an extension of the optic nerve, with a healthy pinkish-red color.
- Retina contains:
- Retinal Pigment Epithelium (RPE) for light absorption.
- Sensory retina with rods (night vision) and cones (color and detail).
- Optic disc characteristics: distinct outline, round/oval shape, yellow/orange to creamy pink in color.
- Retinal vessels:
- Four sets per quadrant (paired artery and vein).
- Arteries appear brighter red; vessels decrease in size away from the optic disc.
- Distorted vessels indicate poorly managed diabetes or hypertension.
Strabismus vs. Nystagmus
- Strabismus (lazy eye): ocular misalignment with correction possible through glasses, patching, or surgery.
- Nystagmus: involuntary eye oscillation.
Vision Assessment & Evaluation
- Obtain ocular history: symptoms like blurred vision, duration, visual acuity tests (Snellen for distance, Rosenbaum for near).
- Assess eye structures and conduct finger count or hand motion tests.
Eye Structure Examination
- External examination may reveal irritation or inflammation; symptoms can include nausea and a feeling of fullness.
- Lifestyle factors (smoking, high-salt diets) can worsen symptoms.
- Treatment includes a low-sodium diet, avoiding caffeine, and medications like Meclizine and diuretics.
- Surgical options available for persistent vertigo.
Hearing Impairment Treatments
- Hearing aids amplify sound.
- Cochlear implants assist those with profound sensorineural hearing loss.
- Vestibular rehabilitation focuses on balance improvement for inner ear conditions.
Communicating with Hearing Impaired Individuals
- Use a low-tone, clear voice; speak slowly.
- Minimize background noise; face the individual and use gestures to assist communication.
Perioperative Nursing
- The preoperative phase begins with the surgical decision and ends with transfer to the OR bed.
- Intraoperative phase spans from the OR bed transfer to admission in PACU.
- Postoperative phase begins upon PACU admission, concluding with follow-up evaluation.
Surgical Classifications
- Types include diagnostic, reconstructive, cosmetic, and rehabilitative.
- Urgency levels: emergent (immediate), urgent (24-30h), required (weeks), elective (non-critical), optional (personal choice).
Preoperative Care and Assessment
- Admission data should include demographics and medical history.
- Verify completion of preoperative tests, including labs.
- Comprehensive preoperative assessment covering health history, medications, allergies, nutritional status, and psychosocial factors.
Medications Affecting Surgical Experience
- Specific medications need careful management (e.g., corticosteroids, diuretics, anticoagulants) due to potential complications like bleeding or respiratory issues.
- Herbal and over-the-counter supplements may impact surgery (e.g., garlic lowering blood pressure, ginseng affecting heart rate).
Pituitary Disorders
- Disorders include acromegaly, diabetes insipidus, and syndrome of inappropriate antidiuretic hormone (SIADH).
Acromegaly
- Rare condition due to excess growth hormone, often from a pituitary tumor, leading to enlarged body parts (but not height).
- Symptoms include coarse facial features, enlarged hands and feet, and thickened skin.
- Treatment may involve surgery, medication, or radiation therapy.
Diabetes Insipidus
- Caused by deficient ADH, leading to extreme thirst and high urine output.
- Distinguished into central (brain-related) and nephrogenic (kidney-related) types.
- Assessment may show dehydration and lab results indicating dilute urine and concentrated blood.
SIADH
- Characterized by excess ADH leading to fluid retention and sodium dilution.
- Symptoms range from headache and muscle cramps to confusion and seizures due to fluid overload.
- Management focuses on fluid restriction, monitoring laboratories, and treating underlying causes.
Hypothyroidism
- Decreased thyroid hormone levels result in slowed metabolism.
- Causes include autoimmune conditions (Hashimoto's disease) and complications from hyperthyroid treatments.
- Symptoms include fatigue, weight gain, cold intolerance, and bradycardia.### Monitoring and Safety Precautions
- Severe cases may require prevention and treatment for circulatory shock, including restoring blood circulation and administering fluids/steroids intravenously.
- Monitor vital signs, and consider lying the patient flat and using vasopressors.
- Patients are susceptible to infections and may need antibiotics.
- Check laboratory results for hyperkalemia and hypoglycemia.
Cushing's Syndrome/Disease
- Characterized by an increase in adrenal cortex hormones.
- Causes include medications, adrenal cortex hyperplasia, and pituitary tumors, often in patients with asthma or arthritis.
- Classic assessment signs: central obesity, moon face, buffalo hump, weakness, and various systemic symptoms like hypertension and hyperglycemia.
- Treatment varies based on the cause; medication tapering or surgery (adrenalectomy or tumor removal) might be necessary.
- Risks include falls, fractures, and retention of sodium and water, leading to hypertension and heart failure.
Diabetes Mellitus (DM)
- A chronic metabolic disorder marked by hyperglycemia due to inadequate insulin production (Type 1) or insulin resistance (Type 2).
- Type classifications:
- Prediabetes: elevated blood sugar not high enough for type 2 diagnosis, affecting 1/3 of adults.
- Type 1: lack of insulin production, often juvenile diabetes, can lead to ketoacidosis.
- Type 2: characterized by insulin resistance, making up 95% of cases.
- Gestational diabetes: occurs during pregnancy and may require dietary changes or insulin.
- Insulin functions to transport glucose into cells and regulate liver glucose release.
Signs and Symptoms of DM
- Key symptoms include polyuria, polydipsia, polyphagia, fatigue, and recurrent infections.
- Long-term complications: neuropathy, nephropathy, retinopathy.
Diabetes Treatment
- Education covers basic diabetes understanding, glucose monitoring, and acute complication management.
- Medications include insulin injections and oral antidiabetic drugs, tailored to individual needs.
- Emphasis on diet, physical activity, and regular monitoring.
Diet & Nutrition for Diabetes
- The plate method: half vegetables, one-quarter proteins, one-quarter carbs.
- Collaboration with dieticians to respect cultural preferences.
Physical Activity Recommendations
- Engage in 150+ minutes per week of moderate to vigorous aerobic exercise.
- Include resistance training sessions 2-3 times a week for Type 1 and Type 2 diabetes.
- Interrupt prolonged sitting every 30 minutes to minimize sedentary behavior.
Infusion and Blood Transfusion Protocols
- Verify orders and patient identity; ensure consent and screening are complete.
- Use proper IV access and perform blood product verification with a two-person check.
- Monitor the patient closely during the first 15 minutes of transfusion for reactions.
- One unit of PRBCs is approximately 300mL and should be infused over 3-4 hours.
Hematologic Disorders Overview
- Anemias and blood disorders include hypoproliferative and hemolytic anemias, sickle cell disease, neutropenia, and polycythemia vera.
- Bleeding disorders to consider: thrombocytopenia and hemophilia, which affect coagulation processes.
Anemias
- Defined by lower hemoglobin levels and fewer circulating erythrocytes, indicating underlying issues.
- Most common blood disorder, categorized as hypoproliferative (due to nutrient deficiencies or cancer) or hemolytic (excess destruction of RBCs).
- Causes can also include blood loss from various sources.
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Test your knowledge on the roles of surgical team members and the importance of patient safety during surgery. This quiz also covers critical care practices to prevent falls and ensure patient comfort. Perfect for students studying surgical nursing and anesthesiology.
