Surgery and Anesthesia Basics

Perioperative Phases

• The perioperative period consists of three phases: preoperative, intraoperative, and postoperative.

Classification of Surgical Procedures

• There are different classifications of surgical procedures, which include:

Types of Anesthesia

• There are four types of anesthesia:
  • General anesthesia
  • Moderate sedation/analgesia
  • Regional anesthesia, which includes nerve blocks, spinal anesthesia, and epidural anesthesia
  • Topical and local anesthesia

Informed Consent and Advanced Directives

• Informed consent is a legal document that protects patients, providers, and facilities.
• A nurse witnesses the patient's signature on the informed consent document.
• Advanced directives are legal documents that include living wills and durable power of attorney.

Preoperative Care

• Preoperative assessment includes:
  • Health history and physical assessment
  • Identifying risk factors and allergies
  • Identifying medications and treatments
  • Determining teaching and psychosocial needs
  • Determining postsurgical support and referral needs
• Usual presurgical screening tests include:
  • Chest x-ray
  • Electrocardiography (ECG)
  • Complete blood cell count (CBC)
  • Electrolyte levels
  • Urinalysis

Preoperative Health History

• Developmental level
• Medical and surgical history, including allergies
• Medication history, including prescription and over-the-counter medications
• Nutritional status
• Use of alcohol, illicit drugs, or nicotine
• Activities of daily living and occupation
• Coping patterns and support systems
• Sociocultural needs

Surgical Risks of Medications

• Anticoagulants can precipitate hemorrhage
• Diuretics can cause electrolyte imbalances and respiratory depression
• Tranquilizers can increase hypotensive effects of anesthetic agents
• Adrenal steroids can cause cardiovascular collapse if withdrawn abruptly
• Antibiotics in the mycin group can cause respiratory paralysis when combined with certain muscle relaxants

Surgical Risks of OTC or Herbal Medications

• Aspirin and ginkgo can increase bleeding risk
• Echinacea and kava can cause liver damage
• Garlic supplements can lower blood pressure
• Ginseng can raise blood pressure and heart rate
• Ephedra can raise blood pressure and cause abnormal heart rhythms
• St. John's Wort can make it harder to recover from anesthesia effects
• Valerian can make it harder to wake after anesthesia and cause abnormal heart rhythms

Nursing Process: Preoperative Care

• Identify patient strengths and factors that increase risk for surgical and postoperative complications
• Develop an individualized care plan for the surgical patient during the preoperative phase

Nursing Process: Intraoperative Care

• Conduct a patient identification/verification process
• Continuously assess the patient during the procedure
• Monitor supplies used to maintain safety
• Identify patient risks and develop a plan to prevent complications

Nursing Process: Postoperative Care

• Assess respiratory, cardiovascular, central nervous system, fluid, wound, gastrointestinal, and pain status
• Identify patient risks and develop a plan to prevent complications
• Develop an individualized care plan for the surgical patient during the postoperative phase

Test your knowledge of the perioperative period, classification of surgical procedures, and types of anesthesia. This quiz covers the basics of surgery and anesthesia.