PN 2003 MIDTERM EXAM 2024- 2025 Perioperative and nurses role - ANSWER pre-admission, health history, preparation for OR, diagnostics, pre-anesthetic medication before surgery ma y be ordered nurses role: teaching!!, stress reduction, history gathering, ensuring consent is signed, explaining pre and post-op procedures, explaining OR and po st-op care Preoperative - ANSWER Intraoperative - ANSWER Postoperative - ANSWER - receive client and report condition including relevan t preop stats (vitals, lab values, allergies) - medications given - estimated blood loss and replacement fluids - presence of tubes, drains, catheters, wound status, surgical complicatio ns Components of health history - ANSWER biological data, chief compl aint, history of present illness, systems assessment, lifestyle, psychological data, patterns of health Preoperative assessment checklist - ANSWER - vital signs - routine hygiene - allergy/ID band checked and on - hospital gown with no nail polish or jewelry, dentures out - consent form signed - charts prepared Factors of preoperative stress - ANSWER knowledge deficit causing anxiety, anger, anticipatory grieving (could be loss of limb), What do patients do with valuables during preop - ANSWER don't bring them, lock up or put away whatever is brought, could also leave items with family me mber Latex allergy risk factors - ANSWER - history of anaphylactic reaction of unknown etiology during medical procedure - multiple surgical procedures (especially from infancy) - allergies (particularly kiwi, bananas, avocado, chestnuts, poinsettia plants) - job with daily exposure to latex (medical, nursing, food handler, tire manufac ture etc) - asthma Crossmatch - ANSWER testing compatibility of the blood or tissues of a donor and a recipient by mixing them to determine the absence of agglutination reactions Can students act as a witnesses for a consent form - ANSWER No, the must ha ve a licensed buddy nurse with them to witness Who is required to ask the client to sign an informed consent form for surgery? Is anyone else present - ANSWER the surgeon the witness must be present, nurse can be it General anesthesia mode of delivery - ANSWER inhalation or IV Spinal anesthesia mode of delivery - ANSWER local anesthetic inserted betwee n L4/5, goes into the spinal fluid in (subarachnoid space) Epidural anesthesia mode of delivery - ANSWER local anesthetic injected in epidural space, around L5 Regional anesthesia mode of delivery - ANSWER nerve block to a specific area Local anesthesia mode of delivery - ANSWER local anaesthetic to a specific part of the body, injected or topical Caudal block - ANSWER local anesthetic injected into sacral hiatus (end bit of epidural) Surgical risks - ANSWE R - chronic resp or cardio disorders - diabetes - renal or liver disease - malnutrition or obesity - certain meds or drug abuse - nicotine or alcoholism Common post-op problems - ANSWER - airway compromise - breathing/respiratory insufficiency - cardiac compromise - neurological compromise - hypothermia - pain, nausea/vomiting - wound dehiscence and delayed healing - side effects of analgesia How often do you check vitals post op - ANSWER immediately after, then ev ery 15 minutes for the first hour or until stable, every 30 minutes the following 2 hours, and once an hour for the following 4 hours check every 4 hours for 24-48 hours (check orders) Post-op nursing care - ANSWER - maintain airway - encourage deep breathing and coughing - promote tissue perfusion