44 Questions
What is the primary purpose of diagnostic surgery?
To confirm or establish a diagnosis
What type of surgery is performed to restore function or appearance to traumatized tissues?
Reconstructive surgery
What is the term for surgery that is necessary to preserve the client's life, body part, or body function?
Emergency surgery
What factor increases the risk of surgery?
Regular use of certain medications
What type of surgery involves a high degree of risk?
Major surgery
What type of surgery is performed when the client's symptoms are not immediately life-threatening?
Elective surgery
What is the primary role of the nurse in the perioperative phase?
To assess the patient's overall health status and provide education
What is a common challenge for patients with a history of substance abuse during the perioperative phase?
All of the above
What is a potential consequence of decreased renal function in the perioperative phase?
Decreased fluid and electrolyte balance
What is a key consideration for older adults undergoing surgery?
Increased incidence of post-op confusion
What is the purpose of laboratory and diagnostic testing in the perioperative phase?
To identify underlying health conditions that may impact surgery
What is a key aspect of patient education in the perioperative phase?
Teaching the importance of post-op DB+C and ambulation
What is a potential complication of surgery in patients with a history of smoking?
Increased risk of pulmonary complications
What is the primary purpose of pre-operative teaching?
To increase patient satisfaction and reduce anxiety
What is a key aspect of the physical assessment in the perioperative phase?
Conducting a thorough head-to-toe assessment
What is a potential benefit of having a support system in place for patients undergoing surgery?
Decreased anxiety
What is included in the pre-operative checklist?
Lab results, consent forms, and medication lists
What is the purpose of giving pre-operative medications?
To facilitate effective anesthesia and minimize respiratory tract secretions
What is a key consideration for patients taking certain medications, such as anticoagulants, in the perioperative phase?
They will need to be stopped pre-operatively
What is the role of the circulating nurse in the intraoperative team?
To maintain a safe and efficient environment during surgery
What is the purpose of the pre-operative survey?
To identify the patient's medical history and allergies
What is the primary responsibility of the nurse before transferring the patient to the OR?
To ensure all pre-operative orders are complete and verified
What is the purpose of removing nail polish before surgery?
To ensure accurate pulse oximetry readings
What is the purpose of the intraoperative team?
To implement the surgical plan and ensure a safe environment
What is the purpose of the post-anesthesia care unit (PACU)?
To provide ongoing care and monitoring after surgery
What is the primary goal of pre-operative preparation?
To prepare the patient for surgery and reduce complications
What is a primary goal of post-anesthesia care?
Achieving physiological equilibrium
What is assessed and managed in the Post-Anesthesia Care Unit (PACU)?
ABC's, vital signs, and motor functions
What is a critical aspect of post-operative care?
All of the above
What is included in post-operative unit preparation?
All of the above
What laboratory test is commonly performed post-operatively?
All of the above
What is a consideration for nutrition in post-operative care?
All of the above
What is a potential complication in the respiratory system post-operatively?
All of the above
What is a gerontologic consideration in post-operative care?
All of the above
What is the primary responsibility of the nursing team during surgery?
Maintaining a safe environment and reducing anxiety
Which of the following is NOT a potential intra-op adverse event?
Hypertension
What is the primary advantage of spinal anesthesia?
Mental status monitoring
What is the main purpose of wearing a surgical mask in the OR?
To prevent the spread of infection
What is the main consideration for gerontological patients in the OR?
Higher risk of excessive IV administration
What is the most important aspect of post-operative care?
Monitoring for potential complications
What is the primary role of the nursing team in the OR?
Maintaining the patient's safety and comfort
What is the main difference between general anesthesia and local anesthesia?
General anesthesia affects the entire body, while local anesthesia affects a specific area
What is the primary purpose of scrubbing, gowning, and gloving in the OR?
To maintain surgical asepsis
What is the most important consideration for the nursing team when preparing the surgical site?
Maintaining surgical asepsis
Study Notes
Types of Surgery
- Purpose: Diagnostic, Corrective, Reconstructive, Ablative, Palliative
- Urgency: Emergency, Urgent, Elective, Required, Optional
- Degree of Risk: Major, Minor
- Factors affecting risk: Age, General Health, Nutritional Status, Medications, Mental Status, Pregnancy
Surgical Settings
- Inpatient
- Ambulatory
- Outpatient
- Short-Stay Unit
- Extent of Surgery: Simple, Radical
- Anatomic Location
Perioperative Phase
- Interprofessional team: Physicians, Surgeons, Internist, Endocrinologist, Cardiologist, Respiratory, Anaesthetist, Nurses, Pharmacy, Speech Language, Dietician, Pastoral Care
- Nurses' major responsibilities:
- Patient Assessment
- Physical Challenges
- Emotional Aspects
- Understanding of Surgery/Consent
- Legal Requirements
- Read and Interpret Lab Results
- Perioperative Teaching
Patient Assessment
- Current Health Status
- Allergies
- Medications
- Previous Surgeries
- Understanding of Surgical Procedure and Anesthesia
- Smoking
- Increased Risk for Pulmonary Complications
- Teaching Importance of Post-Op DB+C and Ambulation
- Alcohol and Other Altering Substances
- Malnourished
- Coping
- Social Resources
- Cultural Considerations
Medication History
- Hazardous to Surgery: Anti-Depressants, Phenothiazines, Diuretics, Steroids, Anticoagulants, Antibiotics, Herbal (Garlic, Ginger, Ginkgo)
Physical Assessment/Clinical Manifestations
- General Survey
- Gestures and Body Movements
- Cardiovascular System
- Respiratory System
- Renal Function
- Neurologic System
- Musculoskeletal System
- Gastrointestinal System
- Head and Neck
- Immune Status
- Obesity
- Challenges
Gerontological Considerations
- Cardiovascular System
- Decreased Cardiac Output
- Decreased Heart Rate
- Respiratory System
- Decreased Static Lung Volumes
- Decreased Pulmonary Static Recoil
- Nervous System
- Increased Incidence of Post-Op Confusion
- Increased Incidence of Delirium
- Renal System
- Decreased Renal Blood Flow
- Decreased Renal Clearance
- Gastrointestinal System
- Decreased Intestinal Motility
- Decreased Liver Blood Flow
- Musculoskeletal System
- Decreased Mass, Tone, Strength
- Decreased Bone Density
- Integumentary System
- Decreased Elasticity
- Decreased Lean Body Mass
- Decreased Subcutaneous Fat
Psychosocial Considerations
- Levels of Anxiety
- Coping Ability
- Support Systems
Laboratory and Diagnostics
- Screening Tests
- Routine Screening Tests: CBC, Blood Grouping + X-Match, Electrolytes, Glucose, BUN & Creatinine, ALT, AST, Bilirubin, Serum Albumin, Total Protein, Urinalysis, CXR, ECG
Pre-Operative Nursing Diagnosis
- Knowledge Deficit
- Anxiety
- Risk for Ineffective Airway Clearance
- Fear
- Anticipatory Grieving
Pre-Operative Teaching
- Patient's Right to Know
- Increasing Patient Satisfaction
- Reducing Fear, Anxiety, Stress, Pain, and Vomiting
- Teaching + Evaluation
- Exercises: Deep Breathing, Coughing, Diaphragmatic Breathing, Incentive Spirometry, Leg Exercises, Turning/Moving/Alignment
- Pain Management
- Coping Strategies
- When to Stop Eating and Drinking
- Medications Information
- Tubes, Drains, Monitoring Devices, or Special Equipment
Legal Preparation
- Informed Consent
- Blood Transfusion
- Pre-Op Survey
- Pre-Op Checklist
- Code Status
- Must Include Adequate Disclosure of Diagnosis, Treatment, Risks, and Probability of Success
- Patient Must Demonstrate Clear Understanding and Comprehension
- Signed Before Any Pre-Operative Drugs Given
- Voluntary Consent
- Surgeon Responsible for Obtaining Consent
- Nurse May Obtain and Witness Signature
Day-of-Surgery Preparation
- Final Pre-Operative Teaching
- Assessment & Communication of Pertinent Findings
- Ensure Completion of Pre-Op Prep Orders
- Pre-Op Checklist
- Labs
- Verify Signed Consent
- History and Physical Exam
- Baseline Vitals
- Consultation Records
- Nurse's Notes
- Patient Should Not Wear Any Cosmetics
- Observation of Skin Color
- Remove Nail Polish for Pulse Oximeter
- Identification
- Allergies
- Valuables Returned
- Wedding Ring Taped to Finger
- Dentures, Contacts, Prostheses Removed
- Void Before Surgery
Pre-Operative Medications
- Purpose
- Facilitate Effective Anesthetics
- Minimize Respiratory Tract Secretions
- Relax and Reduce Anxiety
- Types: Opiates, Anticholinergics, Barbiturates, Prophylactic Antibiotics, Anticoagulants
- Given as Ordered
Transportation to the OR
- Inpatients Transported by Stretcher
- Side Rails Raised and Secured
- Family May Accompany to Holding
- Outpatients Transported by Stretcher, Wheelchair, or May Walk
Intraoperative Phase
- Begins with Transferring the Patient to OR
- Ends with the Transfer to the Recovery Area
- Implementation of Anesthesia
Intraoperative Team
- Surgeon
- Anesthesiologist
- Nurse Anesthetist
- Scrub Nurse
- Circulating Nurse
- OR Techs
Nursing Responsibilities before Surgery
- Meet the Patient in the Holding Area
- Psychosocial Assessment and Support
- Review Baseline Data and Perform Baseline Assessment
- Review Chart/Consents/OR Checklist
- Check All Pre-Op Orders
Nursing Responsibilities during Surgery
- Reducing Anxiety
- Psychosocial Support
- Maintaining Client Dignity
- Maintaining a Safe Environment
- Proper Positioning
- Injury Prevention
- Prevention of Infection
- Prevention of Pressure Ulcers
- Room Preparation
- Transferring and Positioning
- Scrubbing, Gowning, Gloving
- Preparing Surgical Site
- Ensuring Flow of Supplies and Equipment
- Maintaining Surgical Asepsis
- Hemodynamic Monitoring
- Collaboration Between Team Members
- Therapeutic Response to Anesthesia
Safety in the OR
- Surgical Asepsis Maintained
- Safety Straps Used
- Bed Locked in Place
- Heating or Cooling Pads
- Sterile Drapes
- Pressure Relieving Devices
- All Equipment, Gases, and Medications Checked
- Accurate Sponge Count
- Safety Procedures
Nursing Responsibilities after Surgery
- Charting
- Equipment Count
- Transferring Client
- Patent Airway
- Communication to PACU
- Psychosocial Support
Anesthesia
- General Anesthetics
- Inhalation
- Liquid
- Intravenous
- Onset Pleasant
- Powerful Respiratory Depressant
- Local, Regional, or Spinal Anesthetics
- Local
- Nerve Block
- Epidural
- Spinal
- Potential Headache
Post-Operative Phase
- Begins after Surgery
- Goals: Physiological Equilibrium, Alleviating Pain, Preventing Complications, Teaching Client and Family Self-Care
Post-Anesthesia Care
- Operating Room → Post Anesthesia Care Unit (PACU)
- Assess and Manage: ABC’s
- Resumption of Motor + Sensory Functions
- Stable Vital Signs
- No Hemorrhage
- No Complications
- Manageable Pain Control
- Surgical Site
Post-Operative Nursing Goals
- Pain Control
- Optimal CVS and Respiratory Functioning
- Patient Safety
- Increase Activity Tolerance
- Unimpaired Wound Healing
- Resumption of Bowel and Bladder Function
- Recognize & Manage Complications
- Knowledge of Self-Care Needs
Post-Operative Unit Preparation
- Assessment Equipment
- Telemetry
- Emesis Basin
- Clean Gown
- Washcloth/Towel
- Facial Tissues
- IV Pole
- Suction Equipment
- Oxygen Equipment
- Extra Pillows for Positioning the Client
Post-Operative Laboratory and Diagnostic Testing
- Complete Blood Count
- PT, PTT, INR
- Electrolytes
- BUN, Creatinine
- Glucose
- Pulse Oximetry
- ABG’s
- CXR
- Surgery Specific
Post-Operative Care - Nutrition
- What to Consider
- Sips
- Clear Liquids
- Full Liquids
- Soft
- Regular
Post-Operative Care - Complications
- Respiratory System
- Atelectasis
- Pneumonia
- Pulmonary Embolism
- Circulatory System
- Hemorrhage
- Hypovolemic Shock
- Deep Vein Thrombus and Pulmonary Embolus
- Gastrointestinal System
- Abdominal Distention
- Constipation
- Nausea and Vomiting
- Genitourinary System
This quiz covers the different types of surgery, including diagnostic, corrective, reconstructive, and ablative surgery. It also explores the reasons, degree of urgency, degree of risk, settings, and extent of surgery.
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