Podcast
Questions and Answers
Which type of surgery is characterized by its necessity to immediately save a life or preserve the function of a body part?
Which type of surgery is characterized by its necessity to immediately save a life or preserve the function of a body part?
What is the primary goal of reconstructive surgery?
What is the primary goal of reconstructive surgery?
In which surgical category would a cholecystectomy primarily fall?
In which surgical category would a cholecystectomy primarily fall?
Which of the following describes a procedure that is performed based on the patient’s choice?
Which of the following describes a procedure that is performed based on the patient’s choice?
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What distinguishes major surgery from minor surgery?
What distinguishes major surgery from minor surgery?
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Which surgical procedure is performed to relieve symptoms but does not aim for a cure?
Which surgical procedure is performed to relieve symptoms but does not aim for a cure?
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Which factor significantly increases the risk of adverse interactions for older adults taking multiple medications?
Which factor significantly increases the risk of adverse interactions for older adults taking multiple medications?
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What should nurses assess about a patient's medication history prior to surgery?
What should nurses assess about a patient's medication history prior to surgery?
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What special consideration must be taken for older adults undergoing surgery?
What special consideration must be taken for older adults undergoing surgery?
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What type of consent is obtained under specific conditions such as unconsciousness?
What type of consent is obtained under specific conditions such as unconsciousness?
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What is one of the main purposes of preoperative teaching?
What is one of the main purposes of preoperative teaching?
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What is the rationale behind allowing patients to consume clear liquids up to 2 hours before surgery?
What is the rationale behind allowing patients to consume clear liquids up to 2 hours before surgery?
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Why is splinting an incision important during coughing exercises post-surgery?
Why is splinting an incision important during coughing exercises post-surgery?
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Which of the following is a recommended practice to prevent venous stasis in postoperative patients?
Which of the following is a recommended practice to prevent venous stasis in postoperative patients?
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How should incentive spirometer exercises be structured for post-operative care?
How should incentive spirometer exercises be structured for post-operative care?
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What is one potential risk of prolonged NPO status before surgery?
What is one potential risk of prolonged NPO status before surgery?
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Which of the following statements about anti-embolism stockings is INCORRECT?
Which of the following statements about anti-embolism stockings is INCORRECT?
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What is a critical reason for teaching patients nonpharmacologic analgesic techniques prior to surgery?
What is a critical reason for teaching patients nonpharmacologic analgesic techniques prior to surgery?
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Which postoperative complication is frequently observed due to decreased bladder tone following general anesthesia?
Which postoperative complication is frequently observed due to decreased bladder tone following general anesthesia?
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What is the recommended action when applying Sequential Compression Devices (SCD) to a patient?
What is the recommended action when applying Sequential Compression Devices (SCD) to a patient?
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What is a potential risk when using pre-operative medications like barbiturates and tranquilizers?
What is a potential risk when using pre-operative medications like barbiturates and tranquilizers?
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Which population is at the GREATEST risk for developing latex allergies?
Which population is at the GREATEST risk for developing latex allergies?
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Why should nurses assess legs for pigmentation or edema when applying anti-embolism stockings?
Why should nurses assess legs for pigmentation or edema when applying anti-embolism stockings?
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Which of the following is NOT a common pain relief measure recommended for patients preoperatively?
Which of the following is NOT a common pain relief measure recommended for patients preoperatively?
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Which of the following patients would be at the highest risk for complications during surgery?
Which of the following patients would be at the highest risk for complications during surgery?
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In what situation should the nurse intervene regarding the preoperative patient's allergies?
In what situation should the nurse intervene regarding the preoperative patient's allergies?
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How can a nurse best address the psychosocial needs of a patient with surgical anxiety?
How can a nurse best address the psychosocial needs of a patient with surgical anxiety?
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Which dietary consideration is important for a patient to recover effectively after surgery?
Which dietary consideration is important for a patient to recover effectively after surgery?
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Which factor related to the physical condition of the patient can significantly affect recovery speed?
Which factor related to the physical condition of the patient can significantly affect recovery speed?
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Major surgery is characterized by minimal alteration in body parts and involves low risks compared to minor procedures.
Major surgery is characterized by minimal alteration in body parts and involves low risks compared to minor procedures.
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Palliative surgery aims to cure the condition and restore function to affected organs.
Palliative surgery aims to cure the condition and restore function to affected organs.
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Transplant surgeries involve the replacement of malfunctioning organs, like kidneys or corneas.
Transplant surgeries involve the replacement of malfunctioning organs, like kidneys or corneas.
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Older adults undergoing surgery have lower morbidity rates than younger patients.
Older adults undergoing surgery have lower morbidity rates than younger patients.
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Patients with diabetes mellitus experience accelerated wound healing due to strict control of blood glucose levels.
Patients with diabetes mellitus experience accelerated wound healing due to strict control of blood glucose levels.
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Study Notes
Preoperative and Perioperative Nursing Definitions
- Ambulatory: Outpatient surgery; patient enters, has surgery, and leaves the same day. (Examples: breast biopsy, cataract extraction)
- Same-day admit: Patient admitted to hospital, surgery on same day, stays for recovery. (Example: cholecystectomy)
- Inpatient: Patient admitted, surgery (possibly not on admission day), stays for recovery. (Examples: amputation, heart transplant)
- Major: Extensive reconstruction; high risk. (Examples: coronary artery bypass, colon resection)
- Minor: Minimal alteration; low risk. (Examples: cataract extraction, skin graft, tooth extraction)
- Elective: Performed at patient's choice. (Example: bunionectomy)
- Urgent: Necessary for patient health. (Examples: cancerous tumor removal, gallbladder removal for stones)
- Emergent: Immediate; life-saving or function-preserving. (Examples: perforated appendix removal, traumatic amputation repair)
- Diagnostic: Surgical exploration to confirm diagnosis. (Examples: exploratory laparotomy, breast mass biopsy)
- Ablative: Removal of diseased body part. (Examples: amputation, appendix removal, cholecystectomy)
- Palliative: Relieves disease symptoms; not curative. (Examples: colostomy, necrotic tissue debridement)
- Reconstructive: Restores function or appearance. (Examples: fracture fixation, scar revision, breast reconstruction)
- Curative: Cures the problem.
- Preventive: Prevents problems.
- Transplant: Replaces malfunctioning organs. (Examples: cornea, heart, joints, kidney)
- Constructive: Restores function lost due to a congenital anomaly. (Examples: cleft palate repair, atrial-septal defect closure)
- Cosmetic: Alters appearance. (Example: rhinoplasty)
- Common Surgical Settings: (Note: no specific settings listed).
Perioperative Nursing
- Perioperative period: Preoperative (before surgery), intraoperative (during surgery), and postoperative (after surgery) phases. Nurses provide continuous care using the nursing process.
- Delegation considerations: Nurses are responsible for skilled assessment. Unlicensed assistive personnel (UAP) may assist with vital signs, height/weight, and some post-op exercises, but not skilled assessments.
- Preoperative teaching: Done by the nurse; UAP may assist with post-op exercises and reviewing precautions.
- Coordination: Nurse coordinates pre-op preparation; UAP may assist with enemas, vital signs, stockings, and removing clothing/jewelry.
- Sterile procedures: Surgical technologists or skilled nurses perform sterile technique.
- Postoperative care: Initiating and managing post-op care requires critical thinking and nursing knowledge; UAP can assist with vital signs, comfort measures, and basic hygiene tasks.
Influencing Factors in Perioperative Patients
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Age: Young/old patients tolerate major procedures less well than middle-aged adults; older patients have higher morbidity/mortality; slower recovery; higher risk for complications (aspiration, atelectasis, pneumonia, embolus, infection).
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Physical condition: Assess for allergies, bleeding/clotting disorders, cortisone/steroid use, diabetes, emboli risk, immune status using ABCDEF mnemonic.
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Nutritional Factors: Diet history needed to understand nutritional intake; protein for tissue repair; carbohydrates/fats for energy.
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Psychosocial needs: Anxiety, financial concerns, mobility, living situation, death, anesthesia side effects, body image, fear of cancer detection.
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Patient Teaching: Preoperative tests, sequence of events, equipment, transfers, monitoring, mobility, IS, IVs, pain management.
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Socioeconomic and cultural needs: Cultural sensitivity; use interpreters, adjust for sensitivities of different cultures (eye contact, communication, etc).
Medications
- Polypharmacy: Common, especially in older adults; increased risk of adverse drug interactions.
- Herbal remedies: Important to inquire about herbal use as alternative or complementary therapy.
- Medication withholding: Certain medications may be stopped before surgery; nurses need medication knowledge.
- Medications taken on the day of surgery: Antiseizure and cardiac medications may be taken with water the morning before surgery.
Preoperative Assessment and Data Collection
- Thorough health assessment: Allergies, past surgeries, infection, and disease history.
- Medication list: Prescription, over-the-counter, vitamins, minerals, and herbal supplements crucial.
- Chemical, alcohol, and recreational substance use: Assists in medication selection and post-op care planning.
- Vital signs, height, and weight: Baselines for post-op comparisons; guide medication dosing.
Preoperative Teaching
- Reduce anxiety: Educate about the procedures, equipment, transfers, etc.
- Verify understanding: Use open-ended questions; accommodate reading abilities.
- Use interpreters: Ensure patients who do not understand English receive clear information.
- Involve family: If appropriate, include family members in teaching sessions.
Preoperative Preparations
- Laboratory tests and Diagnostic imaging: Complete blood count, blood chemistry, hepatic, cardiac, and renal functions, urinalysis, chest X-ray.
- Informed consent: Obtain consent; avoid if patient is disoriented, unconscious, etc; follow facility protocols. Emergency situations may require alternative consent.
- GI preparation: NPO (nothing by mouth) typically from midnight. Recent recommendations for clear liquids have been reviewed or updated. Anesthesia relaxes the bowel; bowel cleansing may be used (N/V). Oral care is possible, with fluid avoidance.
- Skin preparation: Hair removal at surgical site, as appropriate. Surgical area cleaned with antiseptic.
- Respiratory preparation: Incentive spirometry for atelectasis and pneumonia prevention. Coughing and splinting techniques. Early ambulation to improve respiratory function.
- Cardiovascular considerations: Leg exercises, early ambulation; anti-embolism stockings, sequential compression devices (SCD). Postoperative cardiovascular health is an important element of rehabilitation.
- Genitourinary considerations: Assess for urinary retention.
- Surgical wounds/tubes: Explain types of closures; monitor any drains, tubes, etc.
- Pain management: Educate about pain relief methods; non-pharmacologic, analgesics, PCA pumps.
- Preoperative medications: Reduces anxiety, and amount of anesthetic. Side effects, as well as safety measures, should be discussed.
- Latex allergy: Screen for latex allergies; prevent latex exposure during surgery, if possible.
Anesthesia
- Four categories: General, regional, local, conscious sedation.
- General anesthesia: Produces unconsciousness; used for major procedures. Stages include induction, maintenance, and emergence.
- Regional anesthesia: Loss of sensation in a specific area; no loss of consciousness. Includes epidural, nerve block, and spinal anesthesia.
- Local anesthesia: Loss of sensation at the site (e.g., biopsy, wisdom teeth).
- Conscious sedation: Depressed level of consciousness; used for procedures that do not require complete anesthesia. Requires careful monitoring and skilled nursing.
Preoperative Checklist and Transport to OR
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Verification process: Critical to ensure correct patient, procedure, and site.
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Preoperative checklist: Completed prior to pre-op medication and surgery. This includes patient identification, allergy bands, surgical site marking, removal of prosthetics, skin preparation completed, gowns, NPO time, lab results, current xrays and scans, and pre-op vital signs.
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Transport to OR: Personnel verification, patient identification checks, transport method considerations.
Post-op preparations
- Preparing for the Postoperative Patient:* Bedding, gowns, emesis basin, pillows for positioning. necessary equipment-IV pole, IV pump, oxygen equipment, PCA pump, sphygmomanometer
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Description
Test your knowledge of key definitions in preoperative and perioperative nursing. This quiz covers various types of surgery classifications, such as elective, urgent, and emergent procedures. Enhance your understanding of patient care practices in surgical settings.
