Care of the surgical patient
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Care of the surgical patient - Leaderboard
Care of the surgical patient - Details
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75 questions
| 🇬🇧 | 🇬🇧 |
| Why is it important to ventilate the lungs post op | To prevent or treat atelectasis, improve lung expansion and improve o2 and prevent post op pneumonia |
| H2 receptor antagonists | Famotidin ( pepcid) ranitdine ( zantac) not on market as of now reduce gastric acid volume and concentration monitor for confusion and dizziness in older adults |
| Opioid anglgesics | Morphine fentanyl citrate ( sublimaze) decrease anxiety and allow decreased anesthetics monitor for resp depression, n/v hypotension and pruritus |
| Benzodiazepines | Midazolam diazepam (Valium) lorazepam ( Ativan) decrease anxiety and produce sedation. monitor for resp depression, hypotension, drowsiness and lack of coordination |
| How much fluid should you have your pt drink after awake post surgery? | 8 oz every hour unless contraindicated. |
| Why should the pt not massage the legs after a surgery? | Because of the risk of dislodging a thrombus |
| When is an inventive spirometer contraindicated | In cranial and spin- related surgeries |
| What are to two types of incentive spirometer | Flow-oriented incentive spirometer volume-oriented spirometer |
| What is given to help the pt with improve lung expansion post surgery | Incentive spirometer |
| Antimetics | Metoclopramide ( reglan) droperidol ( inapsine) ondansetron HCI ( 5-HT3 receptor antagonist) Zofran enhance gastric emptying , tranquilizing effect , prevent postop n/v monitor for sedation and involuntary movement have pt report any problem breathing |
| What might the OR surgeon order for a pt with latex allergy? | Prophylactic treatment with glucocorticoid steroids and antihistamines |
| True latex allergy is the type I allergic reaction and occures shortly after exposure to the proteins in lates rubber. | This happens by touch inhaled or ingested |
| What are the ways latex allergy occur | 1. as irritant contact dermatitis 2. as a type IV allergic reactions 3. as a type I allergic reaction |
| Once the pt is in the OR an antiseptic solution to kill adherent and deeper residing bacteria is used what are these called | Povidoneiodine or betadine and chlorhexidine |
| What meds can be given over a period of days to detoxify and sterilize the GI tract for a bowel surgery ? | Neomycin sulfonamides erythromycin |
| What are some laboratory tests commonly reviewed before surgery? | Urinalysis CBC Blood chemistery profile to assess endocrine, hepatic and renal and cardiovascular functions. serum electolytes chest x-ray electrocardiogram BUN |
| What should the nurse explain to the family regarding what to expect right after surgery to the pt family? | That V/S, dressings, and tubes are assessed every 10 to 15 min until the pt is awake and stable |
| What are some pre op considerations for Valerian root | Should not be used with sedative or anxiolytice |
| Corticosteroids | May prolong bleeding and hamper healing time. and may hamper body abilty to deal with stress of surgery |
| If the pt is having difficulty maintaining a patent air way after extubation, what is used until the pt is fully conscious | An oral airway |
| What is suctioned to decrease the risk of aspiration and laryngeal spasm after extubation? | The oropharynx |
| What is the greatest risk from general anesthesia? | Cardiovascular depression of irritability, respiratory depression and liver and kidney damage |
| What is done to establish and airway | Intubation with and endotracheal tube or use of a laryngeal mask airway |
| What do some common anesthetic agents include? | Propofol ( a nonbarbiturate IV anesthetic) nitrouse oxide gas and desflurane and sevoflurance vapors, muscle relaxants |
| NSAID's | Inhibit platelet function and may prolong bleeding leading the possible hemorrhage |
| Insulin | Pt with DM may need a decrease need for insulin after surgery bc nutritional intake is decreased and stress |
| Herbal therapies | Affect clotting times, ginseng may increase hypoglycemia with insulin therapy |
| Diuretics | Can cause hypotension after surgery and decreased serum potassium levels |
| What are some per op considerations for St. John's wort | Should not be used with other psychoactive drugs, momoamine oxidase inhibitors or serotonin reuptake inhibitors this needs to be discontinue before surgery bc of possible drug interactions |
| Antiseizure drugs | Can interact with anesthetic agents |
| Antihypertensives | Can cause hypotension when combined with anesthetic agents and narcotics |
| Anticoagulants | Are stopped several days before surgery, can cause prolonged clotting times which can lead to hemrrhage |
| Medications for the perioperative anticoagulants | Enoxaparin sodium ( Lovenox) heparin sodium ( Heparin) warfarin sodium (coumadin) prevent new clot formation of secondary embolic complications dont not give IM but subQ and tell the pt not to take OTC drugs like aspirin |
| Nonsteroidal Antiinflammatory drugs NSAID | Ketorolac reduces intensity of pain and inflammations assess pt for pain onset location and have they respond to the drug. |
| Adrenocortical steroid | Methylperdisolone ( depo- medrol, solu- medrol ) decreases inflammation determin if pt had DM and anticipate and increase in antidiabetic drug regimen bc of raised blood glucose levels |
| Antibiotics | Cefazolin sodium (ancef) cefotaxime sodium (claforan) ceftriaxone bactericidal minimizes risk of wound and infections monitor of s/s of abd pain, diarrhea severe anal or genital pruritus and severe mouth soreness |
| Anticholingergics | Atropine sulfate glycopyrrolate (robinul) reduce oral and resp secretion to decrease risk of aspiration decrease n/v monitor for confusion, restlessness and tachycardia pt my have dry mouth |
| -ostomy | Opening made to allow the passage of drainage ( ileostomy, formation of an opening of the ileum onto the surface of the abdomen for passage of feces) |
| List a few risks the older adults have when undergoing surgery. | Aspiration, atelectasis ( collapsed lung) pneumonia, thrombus formation, infection, altered tissue perfusion. |
| What are some of the major problems younger and older patients have during surgical procedures. | Temperature variations, cardiovascular shifts, respiratory needs, and renal functions. |
| What are some common fears associated with surgery? | Fear of loss of control associated with anesthesia. fear of the unknown. fear of waking up during the operation. fear of pain. fear of death fear of change in body image fear of detection of cancer |
| Palliative | Surgery for relief or reduction of intensity of disease of symptoms, not cure |
| Ablative | Excision or removal of diseased body part. ( amputation or removal of something |
| What can the nurse have the UAP do during patient preparation for surgery? | Administer an enema or douche, obtain v/s , apply antiembolic stockings, and assist pt in removing clothing, jewelry and prostheses |
| -plasty | Plastic surgery |
| -pexy | Fixation of ( cecopexy, fixation or suspension of the cecum to correct its excessive mobility) |
| -otomy | Opening into ( thoracotomy, surgical opening into the thoracic cavity) |
| List what the perioperative nursing includes | Preoperative phase , intraoperative and postoperative phase. |
| -oscopy | Direct visualization with a scope ( cystoscopy, direct visualization of the bladder and urethra by means of a cystoscope) |
| -orrhaphy | Surgical repair ( herniorrhaphy, repair of a hernia) |
| Lysis | Destruction or dissolution of ( lysis of adhesions, removal of adhesions) |
| -ectomy | Surgical removal of ( cholecystectomy, removal of gallbladder) |
| Anastomosis | Surgical joining of two ducts or blood vessels to allow flow from one to another. to bypass an area ( Billroth I, joins stomach and duodenum.) |
| What are some common surgical settings? | Inpatient one day outpatient short stay surgical center short stay unit mobile surgery unit |
| Surgery is performed for various purposes, what are they? | Diagnostic ablative palliative reconstructive curative preventive transplant constructive and cosmetic |
| What are the two categories of surgery? | Major and Minor |
| Who typically provides the teaching regarding preoperative instructions that maybe GI cleaning or assistive devices like crutches | The surgeons nursing staff |
| What are some pre op considerations for Licorice | May cause hpyertension |
| What are some per op considerations for Kava | May increase effects of certin muscle relaxants |
| What are per op considerations for Gaurana | May reduce the efficacy of Warfarin |
| Per op considerations for Ginseng | May increase anesthetic agent requirments and potential for hypoglycemia in pt with DM |
| What are per op considerations for Garlic and Ginger and Ginkgo biloba | Increased bleeding and prolonged clotting times |
| Per op considerations for feverfew | Has anticogulation factors can increase bleeding |
| What are some per op considerations for Ephedra sinica | Increased risk of cardiac dysrhythmias |
| What are some per op considerations for Echinacea | Neg impact on liver, can interference with hepatic metabolism of anesthesia meds |
| What are the classes of surgery? | Elective, urgent or emergent |
| Meds that need to be given the day of surgery are to be given with a sip of water in the morning what might these meds be? | Antiseizure and cardiac drugs |
| Why do you need to know if your pt is on vitamine E? | It may prolong bleeding times |
| Why do you need to ask about herbal remedies as alternative or complementary therapy. | Most people do not think of them as medications and they may interact with or potentiate other medications and interfere with surgical procedures. |
| What are some of the perioperative meds and agents used? | Anesthethetives, antimicrobials, anticoagulants , hemostatic agents, steroids , diagnostic imaging dyes, diuretics, central nervous system agents, emergency protocol medications. |
| What are a few common fears associated with surgery? | Loss of control fear of the unknown fear of the unknown fear of pain fear of death fear of separation ( kids are a big one for this) fear of disruption of life patterns fear of change in body image fear of detection of cancer |
| What does the ABCDEF mnemonic device to ascertain serious illness of trauma in the preoperative pt stand for? | A: allergy to medications, chemicals, and other including latex. B: bleeding tendencies of use of meds like aspirin, heparin, or warfarin sodium C: cortisone or steroid use D: diabetes mellitus E: embili any past hx. F: fighting ability any pt with immune system problems |
| If the pt is showing signs of malnutrition what should you as then nurse do? | Tube feeding , IV therapy of total parenteral nutrition can be initiated, |
| What type of communication will the nurse need to use in the surgical process. | Nonverbal communication. |