Perioperative Nursing Care Overview

Questions and Answers

Which of the following is a key responsibility during the intraoperative phase?

Monitor the patient's intake and output

Administer postoperative analgesics

Conduct a preoperative education session

Ensure strict asepsis (correct)

What is the purpose of marking the procedure site during the intraoperative phase?

To enhance visibility for the surgical team

To prepare for wound closure

To confirm the site with the patient (correct)

To indicate potential complications

Which action is NOT part of the postoperative nursing interventions?

Provide pain management

Monitor oxygen saturation

Check dressings for type and amount of drainage

Conduct a full physical examination (correct)

What is the initial treatment for malignant hyperthermia in the operating room?

Dantrolene Sodium Signup and view all the answers

In the context of preoperative phase medications, which category is used to manage secretions?

Anticholinergics Signup and view all the answers

What does the 'time out' procedure ensure before surgery begins?

Confirmation of patient identity and procedure Signup and view all the answers

Which assessment is crucial for monitoring neurological function in the postoperative phase?

Evaluate the level of consciousness Signup and view all the answers

Withholding anticoagulants before surgery is essential to prevent what complication?

Excessive bleeding Signup and view all the answers

What is the focus of nursing care during the immediate recovery period in the PACU?

Monitoring vital signs and airway Signup and view all the answers

In preoperative assessments, which diagnostic test is typically ordered for female patients?

Pregnancy test Signup and view all the answers

What is one of the primary goals of preoperative nursing care?

To reduce potential complications and postoperative discomfort Signup and view all the answers

Which factor should be considered during a comprehensive preoperative assessment?

The patient's history of chronic illness Signup and view all the answers

What is an important consideration when obtaining informed consent for surgery?

Providing the patient with all necessary information regarding risks and benefits Signup and view all the answers

During the intraoperative phase, which role does nursing primarily focus on?

Safety and client advocacy Signup and view all the answers

What immediate action should a nurse take for a client unresponsive to verbal stimuli?

Place the client in a lateral position Signup and view all the answers

What is an adverse effect that can occur due to anesthesia?

Nausea and vomiting Signup and view all the answers

Which symptom is indicative of atelectasis in a postoperative patient?

Shallow respirations Signup and view all the answers

In postoperative care, which patient demographic may require special consideration?

Older adults Signup and view all the answers

What is a common intervention to address postoperative respiratory depression?

Regulate narcotics Signup and view all the answers

What intervention should be prioritized to prevent wound hemorrhage?

Monitor drainage device Signup and view all the answers

Which factor is crucial in affecting wound healing post-surgery?

Nutritional status of the patient Signup and view all the answers

Which complication is characterized by bradypnea and shallow respirations following surgery?

Respiratory Depression Signup and view all the answers

What distinguishes postoperative care in ambulatory patients from hospitalized patients?

Ambulatory patients typically do not stay overnight Signup and view all the answers

What specific action can help prevent urinary retention after regional anesthesia?

Perform a bladder scan Signup and view all the answers

Which symptom might alert a nurse to a possible postoperative urinary tract infection?

Cloudy urine with urgency Signup and view all the answers

In managing a patient with postoperative hypotension, which intervention is essential?

Give IV fluids Signup and view all the answers

What should be done first if a postoperative patient exhibits delayed wound healing?

Assess the incision site Signup and view all the answers

Which intervention is key for managing postoperative atelectasis?

Encourage use of an incentive spirometer Signup and view all the answers

Study Notes

Student Learning Outcomes

Conduct comprehensive preoperative assessments to identify health and surgical risks.
Consider special needs in preoperative care for older adults, obese patients, and those with disabilities.
Understand legal and ethical aspects of obtaining informed consent for surgeries.
Implement nursing teaching measures to reduce infection and complications post-surgery.
Collaborate with surgical teams to optimize care during intraoperative interactions.
Recognize adverse effects related to surgery and anesthesia.
Compare various anesthesia types and their implications for nursing responsibilities.
Utilize the nursing process for enhancing patient outcomes in the intraoperative setting.
Describe post-anesthesia care nurse responsibilities in preventing immediate complications post-surgery.
Differentiate between postoperative care for ambulatory and hospitalized patients.
Identify and assess common postoperative complications and their early detection indicators.
Consider gerontologic factors in postoperative management.
Understand factors affecting wound healing.

Perioperative Care Phases

Preoperative Phase: Involves procedures and education to minimize complications, enhance comfort, and encourage patient involvement.
Intraoperative Phase: Begins with the entrance to the surgical suite; nursing focus is safety, advocacy, and collaboration.
Postoperative Phase: Starts in the post-anesthesia recovery area and continues until discharge.

Preoperative Nursing Interventions

Obtain detailed patient history and assess for risk factors, including age, chronic illnesses, malnutrition, and obesity.
Verify informed consent with the patient.
Perform a baseline assessment including height and weight.
Confirm NPO (nothing by mouth) status.

Medications in the Preoperative Phase

Anesthesia Types: Inhalation, intravenous, regional (spinal, epidural), and topical.
Prophylactic Antibiotics: Administered to prevent infection.
Anticholinergics: Used to dry secretions.
Sedatives: May be given preoperatively.

Client Education Preoperative Phase

Address patient fears and anxieties.
Discuss medication protocols, especially regarding anticoagulants.
Explain diagnostic tests and procedures including ECG, chest X-rays, and pregnancy tests for females.
Provide instructions on post-surgical recovery techniques like using an incentive spirometer and performing leg exercises.

Intraoperative Phase

Nursing focus on safety (avoiding falls, maintaining airway), client advocacy, and effective communication with the health team.
Universal Protocol: Includes verification of procedures, marking surgical sites, and conducting a “time out” to confirm readiness.

Intraoperative Nursing Interventions

Maintain a sterile environment and ensure strict asepsis.
Apply grounding devices to prevent electrical burns.
Monitor for complications such as malignant hyperthermia and remain vigilant for surgical complications.

Postoperative Phase Monitoring

Conduct ongoing assessments in the PACU, focusing on:
- Pulmonary: Verify airway, assess breath sounds, encourage deep breathing.
- Circulatory: Compare vital signs to baseline and assess tissue perfusion.
- Neurological: Monitor consciousness levels and reflexes.
- Genitourinary: Track fluid intake/output and urinary status.
- Gastrointestinal: Check for bowel sounds and distention.
- Integument: Assess skin coloration, wound condition, and drainage.

Common Postoperative Complications

Atelectasis: Symptoms include tachycardia and shallow breathing; interventions involve early ambulation and deep breathing exercises.
Respiratory Depression: Monitor respiratory patterns and manage narcotic levels; use antagonists as needed.
Hypoxia: Monitor vitals, administer oxygen, and address underlying issues.
Nausea: Employ comfort measures, antiemetic therapy, and NG tube if necessary.
Urinary Retention: Commonly linked to anesthesia; encourage voiding and utilize bladder scans.
Hypotension: Manage with IV fluids and monitor for signs of shock.
Wound Complications: Assess and treat wound issues including infection, dehiscence, and delayed healing, utilizing splinting and proper wound care techniques.

Special Considerations

Thrombophlebitis: Symptoms include redness and tenderness; encourage ambulation and use compression devices.
Urinary Tract Infection: Promote hygiene, limit catheter use, and maintain hydration.
Wound Infection: Signs include purulent drainage; implement appropriate wound care and antibiotic therapy.

Nursing Responsibilities

Verify all IV fluids and drainage.
Facilitate pain management and thermoregulation.
Discharge instructions for ambulatory surgery patients are critical for successful recovery.

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Description

This quiz covers the essential aspects of perioperative nursing care, including preoperative assessments, considerations for special populations, and the legal and ethical implications of informed consent. It emphasizes understanding risk factors and teaching strategies to enhance patient safety before surgery.