Chapter 31 Perioperative Nursing
preoperative phase - answer begins when the patient and surgeon mutually decide that
surgery is necessary and will take place; ends when the patient is transferred to the
operating room (OR) or procedural bed
intraoperative phase - answer begins when the patient is transferred onto the OR table
and ends with admission to the PACU
postoperative phase - answer Begins with admission to the PACU or other recovery
area; ends with complete recovery from surgery and the last follow-up health care
provider visit
postoperative phase I - answer close monitoring is required for management of airway,
ventilation, hemodynamic monitoring, fluid and electrolyte balance, and pain control
postoperative phase II - answer patient no longer requires acute care measures and is
prepared for self-care, for family/caregiver care, or for care in an extended care
environment
postoperative phase III - answerextended care; focused on providing ongoing care for
patients requiring extended observation or intervention after transfer or discharge from
phase I or II
elective surgery - answera procedure that is preplanned and based on patient's choice
and availability of scheduling; e.g., tonsillectomy, hernia repair, facelift, etc.
urgent surgery - answerprocedure that must be done within a reasonably short time
frame to preserve health; e.g., removal of a malignant tumor, amputation, removal of
gall bladder, etc.
emergency surgery - answerprocedure that must be done immediately to preserve life,
a body part, or function; e.g., control of hemorrhage, repair of trauma, intestinal
obstruction, tracheostomy, etc.
diagnostic surgery - answermeant to make or confirm a diagnosis; e.g., breast biopsy,
exploratory laparotomy, laparoscopy
ablative surgery - answerperformed to remove a diseased part; e.g., appendectomy,
colon resection, thyroidectomy, etc.
, palliative surgery - answerperformed to relieve or reduce intensity of an illness; is not
curative; e.g., colostomy, debridement of necrotic tissue, tumor debulking, arthroscopy
reconstructive surgery - answerperformed to restore function to traumatized or
malfunctioning tissue; may also improve self-concept; e.g., scar revision, plastic
surgery, skin graft, breast reconstruction
transplantation surgery - answerperformed to replace organs or structures that are
diseased or malfunctioning; e.g., kidney, liver, cornea, heart, joints
constructive surgery - answerperformed to restore function in congenital anomalies;
e.g., cleft palate repair, closure of atrial-septal repair
pre-anesthetic evaluation (PAE) - answerassesses medical readiness of a patient for
surgery; routinely includes an evaluation of the patient's airway, a review of any
laboratory or other diagnostic results, and a risk analysis
general anesthesia - answeradministration of drugs by inhalation or the IV route to
produce central nervous system depression; desired actions include loss of
consciousness, amnesia, analgesia, relaxed skeletal muscles, and depressed reflexes
phases of general anesthesia - answerinduction, maintenance, and emergence
induction - answerbegins with administration of the anesthetic agent and continue until
the patient is ready for incision
maintenance - answercontinues from the point of incision until near the completion of
the procedure
emergence - answerbegins as the patients begins to awaken from the altered state
induced by the anesthesia and usually ends when the patient is ready to leave the OR;
the length of time depends on the depth and length of anesthesia
regional anesthesia - answeroccurs when an anesthetic agent is injected near a nerve
or nerve pathway in or around the operative site, inhibiting the transmission of sensory
stimuli to central nervous system receptors
nerve blocks - answeraccomplished by injecting a local anesthesia around a nerve trunk
supplying the area of surgery such a the jaw, face, and extremities
spinal anesthesia - answerachieved by injecting a local anesthetic into the subarachnoid
space through a lumbar puncture causing sensory, motor, and autonomic blockage;
used for surgery of the lower abdomen, perineum, and legs