Podcast
Questions and Answers
What is the primary focus when prioritizing post-operative interventions?
What is the primary focus when prioritizing post-operative interventions?
- Maximizing surgical outcomes
- Ensuring the patient's comfort level is high
- Managing the patient's dietary needs
- Prioritizing airway, breathing, and circulation (correct)
Which acronym represents the nursing process steps in order?
Which acronym represents the nursing process steps in order?
- SMART
- PEARL
- ADPIE (correct)
- AIDET
What type of interventions should be used for managing mild to moderate pain in post-operative patients?
What type of interventions should be used for managing mild to moderate pain in post-operative patients?
- Only pharmacological interventions
- A combination of non-pharmacological and pharmacological interventions (correct)
- Non-pharmacological interventions should be avoided
- Surgical interventions are preferred in all cases
Which of the following describes a properly formatted patient outcome?
Which of the following describes a properly formatted patient outcome?
In the nursing diagnosis structure, how should the problem statement be formatted?
In the nursing diagnosis structure, how should the problem statement be formatted?
Which medication should be avoided in patients with liver failure?
Which medication should be avoided in patients with liver failure?
What is a common side effect associated with opioid use?
What is a common side effect associated with opioid use?
Which of the following is classified as an adjuvant therapy for neuropathic pain?
Which of the following is classified as an adjuvant therapy for neuropathic pain?
Non-pharmacological interventions are considered appropriate for which level of pain?
Non-pharmacological interventions are considered appropriate for which level of pain?
Which of the following medications is NOT typically used for somatic pain?
Which of the following medications is NOT typically used for somatic pain?
Which stakeholders should be involved in patient education for perioperative nursing?
Which stakeholders should be involved in patient education for perioperative nursing?
When should patient education ideally begin in the perioperative process?
When should patient education ideally begin in the perioperative process?
What is included in the baseline data for a perioperative nursing assessment?
What is included in the baseline data for a perioperative nursing assessment?
What is a key responsibility during the preoperative assessment?
What is a key responsibility during the preoperative assessment?
In perioperative nursing, which of the following should not be considered part of patient assessment?
In perioperative nursing, which of the following should not be considered part of patient assessment?
What is the biggest sign of hypophosphatemia?
What is the biggest sign of hypophosphatemia?
Which characteristic is commonly associated with Anorexia Nervosa?
Which characteristic is commonly associated with Anorexia Nervosa?
Which of the following is a significant risk factor for electrolyte imbalances?
Which of the following is a significant risk factor for electrolyte imbalances?
What are the most common electrolyte abnormalities associated with Bulimia Nervosa?
What are the most common electrolyte abnormalities associated with Bulimia Nervosa?
Which non-pharmacological intervention is recommended for better sleep?
Which non-pharmacological intervention is recommended for better sleep?
Which symptom is more commonly associated with Anorexia Nervosa compared to Bulimia Nervosa?
Which symptom is more commonly associated with Anorexia Nervosa compared to Bulimia Nervosa?
What is a possible adverse outcome of severe electrolyte imbalances?
What is a possible adverse outcome of severe electrolyte imbalances?
Which behavior is characteristic of Bulimia Nervosa?
Which behavior is characteristic of Bulimia Nervosa?
What is a primary concern for a patient receiving only IV fluids for an extended period?
What is a primary concern for a patient receiving only IV fluids for an extended period?
Which type of nutrition is appropriate for a patient unable to use their GI tract?
Which type of nutrition is appropriate for a patient unable to use their GI tract?
What is the maximum duration that a nutritional solution for parenteral feeding is considered good?
What is the maximum duration that a nutritional solution for parenteral feeding is considered good?
Which enteral feeding route is considered long-term?
Which enteral feeding route is considered long-term?
What should nurses particularly monitor for in patients receiving enteral nutrition?
What should nurses particularly monitor for in patients receiving enteral nutrition?
What is a characteristic of parenteral nutritional formulas?
What is a characteristic of parenteral nutritional formulas?
Which condition might require special formulas in enteral nutrition?
Which condition might require special formulas in enteral nutrition?
What is a type of enteral feeding route that may be used for short-term nutrition?
What is a type of enteral feeding route that may be used for short-term nutrition?
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Study Notes
Perioperative Nursing
- Involve patient, family, and care team in patient education
- Start patient education as early as possible
- Collect baseline data, including vital signs, assessments, health history, medications, allergies and medical history (including tobacco use)
- Pre-operative assessment findings must be communicated to the surgical team, such as medications, illness, abnormal lab values, medical history
- Fever is a contraindication to surgery
- Post-operative concerns and priorities include ABCs, pain, and complications
- Interpret assessment data and orders to determine appropriate treatments, including oxygen administration and medication adjustments
Nursing Process
- Diagnosis structure should be correct
- Problem related to (etiology) as evidenced by (symptoms or signs)
- Prioritize interventions using ABCs (airway, breathing, circulation) and hierarchy of needs
- Use AIDET (acknowledge, introduce, duration, explanation, thank)
- Use ADPIE (assessment, diagnosis, planning, implementation, evaluation)
- Outcomes should be SMART: specific, measurable, attainable, realistic, and timed
- Evaluate the effectiveness of interventions/outcomes to adjust care
Pain Management
- Manage pain in post-operative patients using non-pharmacological and pharmacological interventions
- Non-pharmacological interventions (heat/cold therapy, relaxation techniques) can be effective for mild to moderate pain
- Pharmacological interventions are necessary for more severe pain or when non-pharmacological approaches are insufficient
- Non-opioids are good for mild to moderate pain. Be aware of side effects: avoid NSAIDs in renal failure or bleeding disorders, avoid Tylenol in liver failure, dose adjustments may be needed based on comorbidities
- Opioids are for moderate to severe pain. Side effects: decrease HR, BP, RR, N/V, sedation, constipation
- Adjuvant therapies are used for neuropathic pain: anesthetics (lidocaine, bupivocaine), antidepressants (bupropion, duloxetine), antiseizure medications (pregabalin, gabapentin), cannabinoids
- Adjuvant therapies for somatic pain: benzodiazepine (diazepam), muscle relaxants (cyclobenzaprine)
- Educate patients on pain management plan, potential side effects, and proper medication usage
Nutrition and Obesity
- Concerns with baseline health - functional health patterns and metabolic and nutrition assessment questions
- Provide dietary education for patients with metabolic syndrome or special diets
- Monitor patients for signs of malnutrition, such as weight loss, muscle wasting, and decreased energy levels
- Educate patients about the importance of proper nutrition and its role in overall health
Sleep
- Non-pharmacological sleep interventions include avoiding alcohol, caffeine, and nicotine 4-6 hours before bed, limiting daytime naps, avoiding strenuous exercise 6 hours before bed, keeping a regular sleep schedule, maintaining a dark, quiet, and cool room, and avoiding sleeping pills unless absolutely necessary
- Encourage patients to maintain a regular sleep schedule, practice relaxation techniques, and avoid caffeine and alcohol before bed
Nutritional Support Types
- Enteral: tube feeds directly into the stomach or intestine
- Special formulas available for chronic diseases
- Administered via continuous or bolus infusions
- Parenteral: nutritional formulas delivered directly to the bloodstream via peripheral IVs or central lines
- Solutions are carefully customized to the patient on a daily basis
- Electrolytes, proteins, calories, and vitamins/minerals adjusted regularly
- Given to maintain or improve nutritional status
Enteral Feed Routes
- Short Term: Orogastric (OG), Nasogastric (NG), Nasoduodenal (ND), Nasojejunal (NJ)
- Long Term: Gastrostomy tube (GT), Jejunostomy tube (JT)
Enteral and Parenteral Nutrition Complications
- Enteral: monitor for aspiration, aspiration pneumonitis
- Parenteral: infection, electrolyte imbalances
Malnutrition
- Anorexia Nervosa: restricted caloric intake & types of foods, intense fear of gaining weight, assessment findings: extremely skinny, low body temps, weak
- Bulimia Nervosa: episodes of binge eating followed by vomiting, excessive laxative use, or overexercising to avoid gaining weight. Monitor for metabolic alkalosis and electrolyte imbalances, such as hypokalemia
Electrolyte Abnormalities with Anorexia Nervosa:
- Hypoglycemia
- Hyponatremia
- Hypomagnesemia
- Hypophosphatemia
Electrolyte Abnormalities with Bulimia Nervosa
- Hypokalemia
- Metabolic alkalosis
Differences between Bulimia Nervosa vs Anorexia Nervosa:
- Bulimia: Broken blood vessels, salivary gland enlargement, enamel erosion, esophagitis, dysrhythmias, diarrhea, callus, edema
- Anorexia: Dizziness, confusion, dry brittle hair, hair loss, low blood pressure and pulse, loss of menses, stool retention, muscle wasting, osteoporosis, dry skin, edema
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