Patient Care

Pre-op information helps with what things? Lessens Anxiety Decrease amount of anesthesia needed Decrease post surgical pain Decrease corticosteroid production True or False? Avoid questions that can be answered yes or no? True Pre-op considerations for Ginger? Risk of prolonged clotting times Discontinue beofre surgery Assessment should include clotting studies When is pre-op teaching done? 1-2 days before surgery Pre-op considerations for Valerian Root? DOn't use with sedatives or anxiolytics May increase effects of CNS depressants Following surgery is called? Post-op Pre-op considerations of St. Johns Wart? DOn't use with psychoactive drugs, MOI's, or Seratonin Reuptake Inhibitors Discontinue before surgery, possible drug interactions Which latex allergy? Cell mediated response to the chemical irritaqnts found in latex products Type IV _____ & _____are the prophylactic treatments for latex allergies to pre-op patients? Glucocorticoid Steroids Antihistimines Risk factors for latex allergy include ______? Kiwi, bananas, avacodos, chestnuts, pointsetta plants, history of alergies and asthma Which latex allergy? True latex allergy Occurs after exposure to proteins in latex rubber IgE mediated systemic reaction that occurs when latex is touched, inhaled, or ingested. Type I What are the 3 classifications of latex allergies Irritant Type IV Type I When is GoLYTELY contraindicated? In patients with GI obstruction, gastric retention, bowel perforation, toxic colitis, mega colon During surgery is called ____? Intra-op _____nursing refers to the role of the nurse during the pre-op, intra-op, and post-op phase of surgery. Peri-op ____ is an amputation or excision of any part of the body or removal of a growth or harmful substance? Ablation Before surgery is called _____? Pre-op The 4 primary purposes of the Incentive Spirometer? Prevent / Treat Atelectasis Increase lung expansion Increase Oxygenation Prevent post-op pneumonia After removal of a cath post-op a nurse should teach the patient to drink ___oz of fluid per hour while awake? 8 Collapse of lung tissue is called _____? Atelectasis Which patients is reflexology contraindicated in? Heart problems BP problems Epilepsy Diabetes When is a cath removed post-op 1-2 days True or False? After general anesthesia the urinary bladder tone is increased? False - Decreased Which latex allergy? Most commonly seen Actually a non-allergic reaction Irritant reaction Pre-op considerations for Feverfew? Has anticoagulant factors Assessment should include clotting studies Discontinue before surgery A patient should void within ____hr after surgery? 6-8 Teaching coughing to post-op patient is contraindicated in which patients? WHY? Cranial & Spinal-related surgeries Cataract surgery patients Increases ICP (intracranial pressure) _____is a disorder in which the normal flow of fluid through a vessel of the body is slowed or halted. The underlying cause of thrombus formation. Venous Stasis How would a wound be covered when open (as in evisceration or dehiscence)? COver with sterile towel moistened with sterile saline (warm) BREAK TIME BREAK TIME BREAK TIME BREAK TIME BREAK TIME BREAK TIME Normally dressings are not changed but are reinforced during the first 24hr. To accuratley measure the amount of drainage the nurse would _____? Circle the drainage markings on the dressing and write time and date on it. _____is the separation of a surgical incision or rupture of a wound closure. Dehiscence NI for patients receiving Opioid Analgesics? MOnitor for Resp depression, N/V, Orthostatic hypotension, pruritis. _____is a localized area of necrosis. (without adequate blood supply) Infarct True or False? Surgery *cancels all orders* and must be rewritten? True When a thrombus is dislodged and begins to travel to the heart, lungs, or brain it is called a _____? Embolus If edema, aching, cramping, sensitivity, or pain occurs in the calf (+Homans sign) or leg, the pt. will complain of calf pain on dorsiflexion of the foot, and a _____should be suspected? Thrombus _____is a protrusion of an internal organ through a wound or surgical incision, especially in the abdominal wall? Evisceration _____is ill health, malnutrition, and wasting as a result of chronic disease? Cachexia _______is a core temp of less than 98.6 F & occurs in 60-80% of all post-op pt.'s? Hypothermia During recovery how often would vitals be taken? Every 15min _____is an accumulation of platlets, fibrin, clotting factors, and cellular elements of the blood attached to the anterior wall of a vessel, sometimes including the lumen? Thrombus Scrub Nurse or Circulating Nurse? Performs surgical hand scrub Dons sterile gown and gloves aspetically Arranges sterile supplies Checks instruments for proper function Counts sponges, needles, and instruments with other nurse Gowns and gloves surgeon upon entering OR Assists with surgical draping of pt. Maintains sterile field Observes progress of procedure Hands instruments to DR. Identifies and handles surgical specimens Maintains count of sponges, needles, etc.. Scrub Before ambulating pt. for the first time....what NI should nurse perform? Have pt. sit on side of bed (legs dangling) to become accustomed to upright position. How long would you listen for bowel sounds ____? One full minute in each quad. _____is an involuntary contraction of the diaphram followed by rapid closure of the glottis. Results from irritation of the phrenic nerve? Singultus (hiccups) Unless the pt. has other problems (decreased renal excretion r/t renal failure, or advanced age) encourage the pt. to drink _____ml of fluid in 24hrs. 2000-2400 What steps would the nurse take when a pt. appears to be going into shock? Admin O2 or increase rate of delivery Raise pt.'s legs above level of the heart Increase rate of IV fluids (unless contraindicated) Notify anesthesia provider & surgeon Provide meds ordered Continue to assess pt. & response to interventions AKA Singultus Hiccups