Perioperative Nursing Overview

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Questions and Answers

Which factor is NOT associated with increased surgical risk?

Nutritional status of the patient

Economic status of the patient

Gender of the patient (correct)

Age of the patient

What can excessive use of diuretics during the preoperative period lead to?

Enhanced anesthetic effects

Electrolyte imbalance (correct)

Improved nutritional status

Increased infection risk

Which population is particularly at risk during surgery?

Middle-aged adults

Healthy individuals

Elderly persons (correct)

Teenagers

Why should corticosteroids be assessed preoperatively?

They can trigger cardiovascular collapse if stopped suddenly Signup and view all the answers

What is a common risk factor that increases surgical complications?

Malnourishment Signup and view all the answers

What defines the preoperative phase of surgery?

From the decision for surgery until the patient is transferred into the operating room. Signup and view all the answers

Which of the following types of surgery is aimed at estimating the extent of a disease?

Exploratory surgery Signup and view all the answers

What is the main distinction between major and minor surgery?

Major surgery generally leads to more serious complications than minor surgery. Signup and view all the answers

Which category of surgery is categorized as 'must be performed immediately without delay'?

Emergency surgery Signup and view all the answers

What type of curative surgery involves the removal of diseased organs?

Ablative surgery Signup and view all the answers

In which type of surgery is the intention to relieve pain without curing the underlying condition?

Palliative surgery Signup and view all the answers

What is a characteristic of minor surgery?

It typically leads to few serious complications. Signup and view all the answers

Which of the following statements pertains to the intraoperative phase of surgery?

Includes the time from patient transfer to PACU admission. Signup and view all the answers

What is the purpose of diaphragmatic breathing before surgery?

To improve lung expansion and oxygenation Signup and view all the answers

Which of the following is a recommended preoperative instruction to prevent circulatory problems?

Extremity exercises Signup and view all the answers

Which of the following is NOT required to be included in the informed consent document?

Description of patients' past medical history Signup and view all the answers

What is a prerequisite for valid voluntary consent?

The patient must be cognitively competent Signup and view all the answers

What action should be taken regarding skin preparation on the night of surgery?

Shaving against the grain of the hair shaft Signup and view all the answers

Which of the following individuals would be considered unable to give consent?

A cognitively impaired older adult Signup and view all the answers

What is a contraindication for performing coughing exercises?

Surgeries involving the eye, nose, or throat Signup and view all the answers

What should be done to prepare the gastrointestinal tract before surgery?

Be NPO after midnight and possibly receive an enema Signup and view all the answers

What is one of the psychosocial interventions mentioned for general preoperative nursing?

Reducing anxiety and decreasing fear Signup and view all the answers

Which activity is part of immediate preoperative nursing interventions?

Transporting the patient to the surgical area Signup and view all the answers

What benefit does incentive spirometry provide in the preoperative phase?

Prevents or treats atelectasis Signup and view all the answers

Which patient teaching intervention is typically included for those undergoing ambulatory surgery?

Deep breathing and coughing exercises Signup and view all the answers

Which of the following measures can promote rest and sleep before surgery?

Offering a warm beverage if fluids are not contraindicated Signup and view all the answers

What is the main reason for withholding food before surgery?

To prevent aspiration Signup and view all the answers

Which of the following are patients advised to do every 2 hours postoperatively?

Turn, cough, and take deep breaths Signup and view all the answers

Who is responsible for obtaining informed consent?

Physician Signup and view all the answers

What is the primary purpose of administering pre-operative medications?

To allay anxiety Signup and view all the answers

Which action should be taken regarding the patient’s clothing before entering the OR?

Leave the gown untied and open at the back Signup and view all the answers

What is one of the effects of administering sedative medications before surgery?

Decreased anxiety and lower blood pressure Signup and view all the answers

Which of the following medications is an example of a narcotic analgesic used pre-operatively?

Morphine sulfate Signup and view all the answers

When should a patient be asked about their last meal prior to surgery?

One hour before entering the OR Signup and view all the answers

What is a potential consequence of overdosing on vagolytic agents administered before surgery?

Severe tachycardia Signup and view all the answers

Which procedure is recommended for a patient before entering the OR regarding oral hygiene?

Provide oral hygiene care Signup and view all the answers

What is typically recorded on the pre-operative checklist?

Final preparations and emotional responses Signup and view all the answers

Study Notes

Perioperative Nursing Phases

Preoperative phase: Time from decision for surgery until transfer to operating room.
Intraoperative phase: Time from operating room transfer to admission to postanesthesia care unit (PACU).
Postoperative phase: Time from admission to PACU until follow-up evaluation.

Classifications of Surgery

According to Purpose

Diagnostic: Used to confirm a suspected diagnosis (e.g., biopsy).
Exploratory: Determines the extent of disease (e.g., exploratory laparotomy).
Curative: Removal or repair of damaged or diseased organs or tissues.

Types of Curative Surgery

Ablative: Removal of diseased organs (e.g., appendectomy, hysterectomy).
Reconstructive: Restoration of damaged organs (e.g., plastic surgery after burns).
Constructive: Repair of congenitally defective organs.
Palliative: Relief of pain and distressing symptoms.

According to Degree of Risk

Major surgery: High risk, prolonged duration, significant blood loss, vital organs involved.
Minor surgery: Lower risk, shorter duration, few serious complications.

According to Urgency

Emergency: Requires immediate action (e.g., gunshot wound).
Urgent: Needs to be done within 24-48 hours (e.g., appendectomy).
Required: Necessary within weeks to months (e.g., addressing chronic alcohol use).

Factors Affecting Surgical Risk

Age: Infants and elderly at higher risk.
Nutritional status: Both malnourishment and obesity increase risk.
Fluid and electrolyte balance: Dehydration and hypovolemia can complicate surgery.
General health: Ongoing infections increase operative risks.
Mental health and economic status also play a role.

Preoperative Considerations

Informed Consent: Must be in writing; includes procedure explanation, risks, benefits, alternatives, opportunity for questions, withdrawal rights, and any deviations from standard protocol.
Valid Consent: Given freely, by those over 18 unless an emancipated minor, obtained by a physician, and witnessed.

Patient Teaching and Interventions

Important preoperative teachings: deep breathing, coughing, incentive spirometry, mobility exercises, and pain management strategies.
Psychosocial interventions aimed at reducing anxiety and respecting cultural beliefs.
Preoperative interventions: administering medications, maintaining records, supporting family needs.

Immediate Preoperative Interventions

Administer preanesthetic medications and transport patients to presurgical areas.
Focus on patient safety, nutrition, fluid management, skin preparation, and bowel preparation.

Preoperative Instructions

Withholding food before surgery is primarily aimed at preventing aspiration.
Encouragement of diaphragmatic breathing, coughing, and leg exercises to prevent complications.

Physiological Preparation

Incentive spirometry recommended for lung expansion and prevention of atelectasis.
Turn, cough, and deep breathe exercises every two hours, avoiding in some types of surgery.

Night Before and Day of Surgery

Skin preparation may include shaving against hair growth.
Patients instructed to be NPO after midnight and may require enemas.
Comfort measures to promote rest include a well-ventilated room, cleanliness, and potential sleep medications.

Pre-Operative Medications

Administered 60-90 minutes pre-anesthesia, addressing anxiety, secretions, and reducing anesthesia needs.
Types include:
- Sedatives: To lower anxiety and consistent blood pressure (e.g., Phenobarbital).
- Tranquilizers: Lowers anxiety (e.g., Thorazine).
- Narcotic analgesics: Reduces anxiety and required narcotics during surgery (e.g., Morphine sulfate).
- Vagolytic agents: Reduces respiratory secretions (e.g., Atropine sulfate).

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Description

This quiz covers the three critical phases of perioperative nursing: the preoperative phase, intraoperative phase, and postoperative phase. Each phase outlines crucial responsibilities and care provided to patients across the surgical process, from decision-making to recovery.