Perioperative Nursing Summary

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Questions and Answers

What is the primary purpose of turning patients every two hours?

To prevent skin breakdown and improve circulation.

What signs should a nurse observe to assess for fluid and electrolyte imbalances?

Signs include changes in blood pressure, respiratory function, and muscle function.

When can patients typically resume eating after surgery?

Patients remain NPO until gastrointestinal motility returns, which may take up to 48 hours.

How should a nurse assess urinary retention in a postoperative patient?

Assess for bladder distension and tenderness, and use a bladder scanner if necessary. Signup and view all the answers

What immediate action should be taken in the event of evisceration?

Cover the wound with a moist saline dressing and notify the surgeon immediately. Signup and view all the answers

Why is proper nutrition essential in postoperative care?

Proper nutrition promotes healing and recovery following surgery. Signup and view all the answers

What should be monitored during the first dressing change after surgery?

Monitor for excessive drainage or bleeding and circle the dressing to track any growth of drainage. Signup and view all the answers

What is the nurse's role in the process of obtaining consent for a surgical procedure?

The nurse's role is to witness the signing of the consent and ensure that the patient understands the procedure. Signup and view all the answers

List two diagnostic tests commonly performed preoperatively and their purposes.

CBC (Complete Blood Count) assesses hemoglobin, hematocrit, and platelets; PT/INR checks clotting ability. Signup and view all the answers

What are two primary goals of educating patients during the preoperative phase?

To prevent complications, like clot formation, and to teach wound care and management of drains and sutures. Signup and view all the answers

Why is deep breathing and using an incentive spirometer important for postoperative patients?

They help prevent atelectasis by ensuring adequate lung expansion and preventing fluid accumulation in the lungs. Signup and view all the answers

What must be done if a patient has literacy issues during the consent process?

Adjustments should be made to ensure the patient fully understands the procedure's details. Signup and view all the answers

What should you do if you notice visible blood on a dressing?

Circle and date the area to monitor for growth or saturation, and notify the physician if necessary. Signup and view all the answers

What happens to a patient's consent if they are given a psychoactive substance?

The consent becomes invalid because the patient is not in a clear state of mind to make informed decisions. Signup and view all the answers

What are the components that should be included in the consent for a surgical procedure?

Details of the procedure, the surgeon's name, the reason for surgery, expected benefits, and alternative options. Signup and view all the answers

Name two essential equipment items that should be available at the bedside during a postoperative handoff.

Suction devices and a cardiac monitor. Signup and view all the answers

What is one way to help prevent respiratory complications post-surgery?

Encourage the use of incentive spirometers. Signup and view all the answers

What specific anticoagulant is mentioned as likely prescribed for patients before surgery?

Lovenox, which is low molecular weight heparin. Signup and view all the answers

List one immobility risk associated with postoperative care.

Pressure ulcers. Signup and view all the answers

What should be monitored to prevent dehydration in postoperative patients?

Intake and output to ensure balance. Signup and view all the answers

Why is early mobility important for recovery after surgery?

It helps prevent complications like atelectasis or pneumonia. Signup and view all the answers

What are key indicators of delirium that should be assessed?

Confusion, withdrawal, or unexpected behavior changes. Signup and view all the answers

What should postoperative education include regarding wound care?

Teach patients and families how to care for surgical sites and manage drains. Signup and view all the answers

What vital signs should be stable before discharging a patient?

Blood pressure, heart rate, and oxygen saturation. Signup and view all the answers

What is a common postoperative complication related to mobility?

Blood clots. Signup and view all the answers

What are two major risks associated with fire hazards in the operating room?

Alcohol-based skin preps and surgical drapes. Signup and view all the answers

Why is instrument and material count performed in the operating room?

To ensure no foreign objects are left inside the patient after surgery. Signup and view all the answers

What precautions should be taken for patients with latex allergies during surgery?

Special precautions, like using latex-free materials, must be implemented. Signup and view all the answers

What are some potential reactions to anesthesia that healthcare providers should be aware of?

Trauma during intubation and burns from surgical equipment. Signup and view all the answers

How does aging affect the surgical risks faced by older adults?

It leads to decreased cardiac and pulmonary reserve. Signup and view all the answers

What is the purpose of using local anesthesia during surgical procedures?

To numb a specific area where the procedure is performed. Signup and view all the answers

What characterizes moderate sedation during a surgical procedure?

The patient remains conscious but has an elevated pain threshold. Signup and view all the answers

What is a significant consequence of significant volume loss during surgery?

It can cause drops in blood pressure. Signup and view all the answers

What is the difference between spinal anesthesia and epidural anesthesia?

Spinal anesthesia is delivered into the spinal cord while epidural anesthesia is delivered into the epidural space. Signup and view all the answers

Why is understanding pharmacokinetics especially important for older patients undergoing surgery?

Older patients often have impaired clearance of drugs, leading to prolonged effects. Signup and view all the answers

What is the role of the circulating nurse in the operating room?

The circulating nurse manages the OR environment, monitors aseptic techniques, ensures equipment functionality, and oversees documentation. Signup and view all the answers

Why is it important to have preoperative medications for patients?

Preoperative medications are administered to reduce patient anxiety and help prepare them mentally for surgery. Signup and view all the answers

What is the primary focus during patient care before surgery?

The primary focus is on airway, breathing, and circulation (ABC). Signup and view all the answers

What steps are included in the preoperative checklist?

The checklist ensures bowel and skin prep are complete, all preoperative orders are followed, and documentation is up to date. Signup and view all the answers

What types of preoperative cleaning might some patients undergo?

Some patients may be cleaned with chlorhexidine wipes while others may require a scrub, especially for certain surgeries like open-heart surgery. Signup and view all the answers

How do EHRs contribute to preoperative preparation?

Electronic Health Records (EHR) are used for documenting patient information and ensuring all necessary data is accessible and up to date. Signup and view all the answers

What is the importance of teaching patients preoperatively?

Teaching patients about the surgery and recovery helps them understand what to expect, reducing their fear and anxiety. Signup and view all the answers

What should be confirmed regarding preoperative orders before surgery?

It is essential to confirm that all preoperative orders, including bowel and skin preparation, are followed. Signup and view all the answers

Name two responsibilities of the anesthesia provider in the surgical team.

The anesthesia provider manages the airway and anesthesia, and addresses complications that may arise during surgery. Signup and view all the answers

Why is it important for family needs to be balanced with patient priorities?

While attending to family needs is important, the primary focus must remain on patient safety and care as per the ABC protocol. Signup and view all the answers

Study Notes

Perioperative Lecture Summary

Anesthesia, also known as paralytic agents, can prevent breathing and patients may still feel pain
Preoperative nursing measures aim to lower post-op complications
Discharge criteria and interventions are evaluated for effectiveness
Preoperative phase: Consent, medical history, and teaching are required before surgery; patients learn about breathing exercises, incentive spirometry, and coughing
Intraoperative phase: Begins when the patient is transferred to the OR bed
Postoperative phase: Begins when patient is in the PACU and ends after their follow-up evaluation
Discharge teaching is essential and must involve the patient and family. The teaching includes follow-up care, instructions on drains, sutures, and other items.
Emergency situations require immediate lifesaving measures. Pre-operative testing may include labs to identify risks like bleeding.
If patients are on anticoagulants, special management to prevent bleeding is needed during pre-op testing.
Patients' rights include the option of refusing procedures, even after consent.
Medical history includes past medical problems, allergies (including latex), medications, implants, piercings.
Age, obesity, and disabilities can affect surgical procedures and require accommodations
Surgical classifications can be categorized as Diagnostic, Curative, Palliative, Reconstructive/Cosmetic, and Emergent
Diagnostic testing often includes CBC, PT/INR, or PTT tests
Patient consent is vital before any procedure
Patients' concerns and any concerns reported to the surgical team must be documented
Preoperative teaching should cover the appearance of wound, how drains work, and what to expect during recovery
Preoperative medications may be used to reduce anxiety
EHR records are used for documentation
The OR maintains sterility for safety - including staff and patients; gowning, draping, and sterilization must be maintained. Procedures use a Universal Protocol involving confirming patient, site, and procedure
Skin preparation and antiseptic solutions are used to reduce infection risks
Patient valuables should be removed or secured
Instruments, fluids, and estimated blood loss (EBL) must be accounted for and documented
Potential complications include fire hazards, allergies, infections, and pain
Postoperative care and assessment includes monitoring of fluids, vital signs, blood pressure, and oxygen saturation
Postoperative delirium may occur due to medications, infections, sepsis, and fluid/electrolyte imbalances

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Description

This quiz covers the essential aspects of perioperative nursing, including anesthesia, preoperative measures, and postoperative care. It highlights the importance of patient education and the evaluation of discharge criteria. Key phases discussed are preoperative, intraoperative, and postoperative care.