Podcast
Questions and Answers
What is the primary purpose of communication and documentation of preoperative assessment findings?
What is the primary purpose of communication and documentation of preoperative assessment findings?
What is the recommended treatment for malignant hyperthermia?
What is the recommended treatment for malignant hyperthermia?
What should be included in the informed consent process?
What should be included in the informed consent process?
Which of the following supplements is known to increase bleeding risk?
Which of the following supplements is known to increase bleeding risk?
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What should be reported to the operative team during the preoperative assessment?
What should be reported to the operative team during the preoperative assessment?
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What is the purpose of assessing the patient's respiratory system?
What is the purpose of assessing the patient's respiratory system?
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Why should smokers be encouraged to quit 6 weeks before surgery?
Why should smokers be encouraged to quit 6 weeks before surgery?
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What is the purpose of assessing the patient's genitourinary system?
What is the purpose of assessing the patient's genitourinary system?
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Why should the patient's musculoskeletal system be assessed?
Why should the patient's musculoskeletal system be assessed?
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What is the purpose of the joint commission's H&P?
What is the purpose of the joint commission's H&P?
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Study Notes
Preoperative Assessment
- Communication and documentation of important preoperative assessment findings are essential to the continuity of care.
Malignant Hyperthermia Treatment
- Stop triggering agents
- Hyperventilate with 100% oxygen
- Administer dantrolene (2.5 mg/kg)
- Provide bicarbonate
- Give glucose and insulin
- Use iced IV fluids and cooling blanket
- Monitor fluid output and administer furosemide if necessary
Informed Consent
- Include the patient's name
- Specify the type and reason for surgery
- Identify the surgeon performing the surgery
- Explain how the surgery will benefit the patient
- Discuss anesthesia options
- Obtain consent for anesthesia
- A legally appointed representative may consent for minors, unconscious, or mentally incompetent patients
Supplements and Bleeding Risk
- Gingko biloba, garlic, ginseng, fish oil, and dong quai may increase bleeding risk
Nursing Assessment
Allergies
- Assess for drug and non-drug allergies
- Screen for latex allergy, which may be indicated by banana or kiwi allergy
Cardiovascular Assessment
- Report any cardiac problems to the operative team
- Note the use of cardiac drugs
- Perform a 12-lead EKG and coagulation studies
- Consider prophylactic antibiotics
Respiratory System
- Inquire about recent airway infections, which may lead to procedure cancellation
- Report dyspnea, coughing, or hemoptysis to the operative team
- Note COPD, asthma, or high risk for atelectasis and hypoxemia
- Smokers should quit 6 weeks before the procedure to decrease complications
- Consider sleep apnea, obesity, and airway deformities affecting respiratory function
Genitourinary System
- Perform renal function tests
- Note problems voiding and inform the operative team
- Assess women for the possibility of pregnancy
Hepatic System
- The liver detoxifies many anesthetics and adjunctive drugs
- Hepatic dysfunction may increase the risk of postoperative complications
Integumentary System
- Assess for skin and musculoskeletal problems
- Consider a history of pressure ulcers and provide extra padding during the procedure
- Note body art, tattoos, and piercings
- Assess mobility restrictions that may affect positioning and ambulation
Musculoskeletal System
- Identify joints affected by arthritis
- Note mobility restrictions that may affect positioning and ambulation
- Consider hip replacement, neck injuries, and report problems affecting the neck or lumbar spine to the ACP
Endocrine System
- Patients with diabetes mellitus are at risk for hypo/hyperglycemia
- Cardiovascular alterations, delayed wound healing, and infection may occur
- Fluid and electrolyte status may require additional fluids and electrolytes before surgery if dehydration occurs
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Description
Test your knowledge on nursing care in various surgical settings such as the operating room (OR), postanesthesia care unit (PACU), and surgical intensive care unit (SICU). Focus on communication, documentation, preoperative assessments, and important treatments like malignant hyperthermia protocol.
