Surgery Art and science of treating diseases, injuries, and deformities by operation and instrumentation Can be elective or emergent Can be inpatient (admitted) or outpatient (ambulatory)
Surgery performed for Diagnosis Cure Palliation Prevention Exploration Cosmetic improvement
Nurses role preop...
NURS 334 Exam 1 Questions and
Solutions
Surgery ✅Art and science of treating diseases, injuries, and deformities by operation
and instrumentation
Can be elective or emergent
Can be inpatient (admitted) or outpatient (ambulatory)
Surgery performed for ✅Diagnosis
Cure
Palliation
Prevention
Exploration
Cosmetic improvement
Nurses role preop ✅Have knowledge of the nature and disorder requiring surgery
Identify the individual patient's response to the stress of surgery
Have knowledge of the results of the preoperative diagnostic tests
Identify potential risks and complications associated with surgery
Nursing assessment ✅Determine psychological and physiological factors that may
contribute to risk with surgery
Possible surgical fears ✅Death
Pain
Anesthesia
Mutilation
Disruption of life
Additional subjective date to be gathered for preop nursing assessment ✅Allergies
Current Medications (prescription, OTC, vitamins, herbs, recreational drugs, alcohol,
tobacco)
Which supplements/drugs affect platelet aggregation/ thin blood ✅Fish oil
Vitamin E
St. Johns Wort
NSAIDs
Health history for preop nursing ✅Diagnosed medical condition
Previous surgeries and problems
Menstrual/obstetric history
Familial diseases/Conditions
,Reactions/problems to anesthesia (patient or family)
Cardiovascular hx ✅hx of hypertension, MI, CHF
Respiratory hx ✅Increased risk for laryngospasm, bronchospasm, SOB, chronic cough
Nervous system hx ✅Evaluation of neurological functioning, fine motor skills, gross
motor skills
Urinary system hx ✅Hx of frequent UTI, risk for fluid and electrolyte imbalance
Integumentary system ✅Risk for skin breakdown, weight, activity
GI hx ✅hx of constipation, GI motility concerns
Endocrine system hx ✅If diabetic, watch blood glucose levels
Immune system hx ✅Compromised patients have an increased risk for infection and
wound healing
Fluid and electrolyte status ✅NPO before surgery
Obesity in relation to surgery ✅Over 2/3 of US adults are overweight or obese (BMI
>25)
1/3 of adults age 20 and above are obese (BMI >30)
Estimated 16.9% of children and adolescents age 2-19 are obsese
Obesity stresses cardiac and pulmonary systems
The larger the neck circumference the more they are at risk for complications and
airway complications
They are predisposed to wound dehiscence and infection
Slows recovery
Adipose tissue absorbs and stores anesthesia
Preoperative teaching ✅Patients has right to know what to expect and how to
participate
The Joint Commission requires an H&P- increases patient satisfaction, reduces fear,
anxiety, stress, pain, and vomiting
Legal preparation for surgery ✅Each institution have its own informed consent form
Must include adequate disclosure of diagnosis, treatment, risks, and probability of
success
Surgeon is responsible for obtaining consent
Nurse may obtain and witness signature
Verify patient has understanding
Permission may be withdrawn at any time
, Day of surgery preparation ✅Final preoperative teaching
Assessment
Communication of pertinent findings
Verify signed consent
Preoperative checklist
Set of vitals right before hand off to surgical tema
Labs
History and physical exam
Baseline vitals
Consultation records
Nurse's notes
Marking of surgical site
Who can sign a consent form if the patient is unable? ✅Medical emergency overrules
needing a signature
Parent can sign for a child
POA
Preop medications ✅Benzodiazepines-sedative and amnesic effect
Anticholingergics- reduces secretion in mouth
Opioids- pain
Antiemetics- decreases nausea and vomiting
Antibiotics- reduces risk of infection
BP medication
Insulin
Eye drops
Time Outs/ Pause for Cause ✅Done prior to staring and intraoperative check
Intraoperative care ✅Nursing care requires an understanding of surgical procedures
Nurse must keep current on technologies
Maintain asepsis in surgical environment
National Patient Safety Goals
Surgical Care Improvement Project
Surgical suite ✅Infection control
Temperature controlled
Equipment is check for electrical safety
Patient privacy
Operating Room ✅Filters and controlled airflow ventilating systems provide dust
control
Positive air pressure in the rooms prevent air from entering the OR from the halls and
corridors
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