Subacute Care and Surgery Overview
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Questions and Answers

A subacute setting is a special unit for those who need more care than most long-term facilities can give.

True

Hospitals can provide subacute care, but skilled nursing facilities cannot.

False

People who have had surgery, have chronic illnesses, or require dialysis or complex wound care may need subacute care.

True

A mechanical ventilator is a machine that assists with or replaces breathing when a person cannot breathe on their own.

<p>True</p> Signup and view all the answers

What type of surgery must be performed for health reasons but is not an emergency?

<p>Urgent</p> Signup and view all the answers

______ surgery is unexpected and unscheduled and must be performed immediately to save a life or limb.

<p>Emergency</p> Signup and view all the answers

Which type of surgery is chosen by the patient and is planned in advance?

<p>Elective</p> Signup and view all the answers

Which type of anesthesia is injected directly into the surgical site or area and is used for minor surgical procedures?

<p>Local anesthesia</p> Signup and view all the answers

An epidural is an example of this type of anesthesia.

<p>Regional anesthesia</p> Signup and view all the answers

Before a person has surgery, the doctor will most likely not tell what to expect because it may frighten the person too much.

<p>False</p> Signup and view all the answers

People who are going to have surgery often experience anxiety, fear, worry, and sadness.

<p>True</p> Signup and view all the answers

A nursing assistant (NA) can help a person who is worried about surgery by avoiding the person until the surgery is over.

<p>False</p> Signup and view all the answers

If a person has an NPO medical order before surgery, this means that she cannot have food or anything to drink except for water.

<p>False</p> Signup and view all the answers

A NA's duties may include making sure that the person's identification bracelet is accurate and on the wrist or ankle prior to transport.

<p>True</p> Signup and view all the answers

What are three goals of postoperative care?

<p>To prevent infections, promote healing, return the person to a state of health.</p> Signup and view all the answers

What concerns and possible complications should a NA watch for after a person has surgery?

<p>Problems with breathing, mental status, pain, wound healing, urinary retention or infection.</p> Signup and view all the answers

What type of equipment might a NA be asked to gather while a resident is in recovery after surgery?

<p>Bed protector, towels and washcloths, vital signs equipment, emesis basin.</p> Signup and view all the answers

List a few postoperative care tasks that NAs may be required to do.

<p>Move furniture, assist with transferring, return dentures, measure/record vital signs, repositioning.</p> Signup and view all the answers

Pulse oximetry is commonly used for people who are?

<p>Returning from surgery.</p> Signup and view all the answers

A pulse oximeter measures?

<p>Blood oxygen level.</p> Signup and view all the answers

The pulse oximeter's sensor is usually clipped on a person's?

<p>Finger.</p> Signup and view all the answers

The sensor ______ to measure blood oxygen level.

<p>Light</p> Signup and view all the answers

A normal blood oxygen level is usually between?

<p>95% - 100%.</p> Signup and view all the answers

Which of the following should be reported to the nurse regarding pulse oximetry?

<p>The alarm sounds.</p> Signup and view all the answers

Telemetry is used to measure the heart ______ and ____ on a continuous basis.

<p>Rhythm, rate.</p> Signup and view all the answers

Wires are attached to the ____ with sticky pads or patches.

<p>Chest.</p> Signup and view all the answers

The nursing assistant should report to the nurse if the pads become ____ or soiled.

<p>True</p> Signup and view all the answers

If the _____ sounds, the NA should notify the nurse.

<p>Alarm.</p> Signup and view all the answers

The NA should check _____ signs as ordered.

<p>Vital.</p> Signup and view all the answers

The skin around the pads should be checked for sores, redness or _____ .

<p>Irritation.</p> Signup and view all the answers

List three situations in which an artificial airway might be necessary.

<p>Obstructed due to illness, injury, secretion/aspiration.</p> Signup and view all the answers

What is a tracheostomy?

<p>Is a surgically-created opening through the neck into the trachea.</p> Signup and view all the answers

What are four guidelines for NAs working with residents who have artificial airways?

<p>Observe residents closely, check vital signs, perform oral care, be supportive and reassuring.</p> Signup and view all the answers

A tracheostomy is always permanent.

<p>False</p> Signup and view all the answers

It may be difficult for the resident to talk after first having a tracheostomy inserted.

<p>True</p> Signup and view all the answers

Cancer, infection, and severe neck or mouth injuries are some reasons why a tracheostomy may be necessary.

<p>True</p> Signup and view all the answers

Gurgling sounds are normal due to the placement in the neck and do not need to be reported to the nurse.

<p>False</p> Signup and view all the answers

NAs do not perform tracheostomy care or suctioning.

<p>True</p> Signup and view all the answers

Shortness of breath or trouble breathing should be reported right away.

<p>True</p> Signup and view all the answers

Residents with tracheostomies are prone to respiratory infections.

<p>True</p> Signup and view all the answers

To help prevent infections when working with residents with tracheostomies, the NA should wash his hands often.

<p>True</p> Signup and view all the answers

Being on a ventilator has been compared to breathing through this.

<p>Straw.</p> Signup and view all the answers

Nursing assistants should answer these promptly.

<p>Call lights.</p> Signup and view all the answers

An agent or drug that helps calm and soothe a person is called a?

<p>Sedative.</p> Signup and view all the answers

Regular, careful skin care can prevent these types of wounds.

<p>Pressure injuries.</p> Signup and view all the answers

Something that a person will no longer be able to do while on the mechanical ventilator because air will no longer reach the larynx is to?

<p>Speak.</p> Signup and view all the answers

Mechanical ventilation inflates and deflates these.

<p>Lungs.</p> Signup and view all the answers

Suctioning is needed when a person cannot remove mucus and secretions from the lungs on his own.

<p>True</p> Signup and view all the answers

Suctioning is usually a non-sterile procedure.

<p>False</p> Signup and view all the answers

The nursing assistant is normally responsible for suctioning.

<p>False</p> Signup and view all the answers

A portable pump may be used to suction the resident.

<p>True</p> Signup and view all the answers

One sign of respiratory distress is a gurgling sound of secretions.

<p>True</p> Signup and view all the answers

If a person is flaring his nostrils, he may be in respiratory distress.

<p>True</p> Signup and view all the answers

Vital signs, especially respiratory rate, should be monitored closely.

<p>True</p> Signup and view all the answers

Chest tubes are inserted during a ______ procedure.

<p>Sterile.</p> Signup and view all the answers

Chest tubes drain air, blood, or fluid from?

<p>The pleural cavity.</p> Signup and view all the answers

Chest tubes may be required for?

<p>Trauma.</p> Signup and view all the answers

The drainage system must be?

<p>Airtight.</p> Signup and view all the answers

The drainage system must be kept ______ the level of the resident's chest.

<p>Below.</p> Signup and view all the answers

Study Notes

Subacute Care

  • A subacute setting provides more specialized care than typical long-term facilities.
  • Hospitals can provide subacute care; skilled nursing facilities can also offer it.

Patient Needs

  • Individuals post-surgery, those with chronic illnesses, or requiring dialysis or wound care may need subacute care.

Surgery Types

  • Urgent Surgery: Necessary for health reasons but not an emergency.
  • Emergency Surgery: Unscheduled, requires immediate action to save life or limb.
  • Elective Surgery: Planned in advance by the patient.

Anesthesia

  • Local Anesthesia: Injected into the surgical site for minor procedures.
  • Regional Anesthesia: Includes epidurals and affects a larger area.

Preoperative Communication

  • Surgeons typically inform patients about what to expect to alleviate anxiety and fear.

Patient Emotions

  • Anxiety, fear, worry, and sadness are common feelings before surgery.

NA Responsibilities Pre/Post Surgery

  • NAs ensure identification bracelets are accurate prior to transport.
  • Postoperative goals include preventing infections, promoting healing, and restoring health.
  • Common concerns post-surgery: breathing issues, mental status, pain, wound healing, urinary retention or infection.

Equipment in Recovery

  • Potential equipment for recovery includes bed protectors, towels, vital signs tools, and emesis basins.

Monitoring Vital Signs

  • Pulse oximetry used for monitoring blood oxygen levels during recovery.
  • A normal blood oxygen level is between 95% - 100%.

Telemetry Monitoring

  • Monitors heart rhythm and rate continuously with pads attached to the chest.

Artificial Airway Necessity

  • May be needed due to obstruction caused by illness, injury, or aspirated secretions.
  • A tracheostomy is a surgical opening in the neck to facilitate breathing.

Guidelines for NA Care with Artificial Airways

  • NAs observe residents closely, monitor vital signs, perform oral care, and provide emotional support.

Ventilation Considerations

  • Being on a ventilator can affect speaking ability as air cannot reach the larynx.
  • Regular skin care prevents pressure injuries for patients on ventilators.

Suctioning and Respiratory Care

  • Suctioning is performed when patients cannot clear respiratory secretions; it's a sterile procedure.
  • Signs of respiratory distress include gurgling sounds, flaring nostrils, and need for close monitoring of vital signs.

Chest Tubes

  • Inserted during sterile procedures to drain air, blood, or fluid from the pleural cavity.
  • The drainage system must be airtight and positioned below the resident's chest level to function correctly.

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Description

This quiz covers key concepts in subacute care, including patient needs and types of surgery. It also delves into anesthesia and the importance of preoperative communication to manage patient emotions. Ideal for nursing assistants and healthcare students.

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