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34 Cards in this Set
- Front
- Back
As a nurse, what procedure can you call to avoid wrong site, wrong procedure, and wrong patient surgical errors?
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time-outs
*also, can check consent form and Hx&P against what pt. says or the site marked. To ID patient, use arm band: look at name, DOB, and MR # |
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If the patient is unconscious, mentally incompetent, or a minor, who can sign the consent?
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a court-appointed representative (power of attorney)
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What are the 3 types of preoperative teaching?
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sensory, process, and procedural teaching
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What do you have to tell the patient for the patient to have clear understanding of informed consent?
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- diagnosis (what's wrong and how to fix it)
- risks and consequences - probability or success - risks of alternative treatments - prognosis without treatment |
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The nurse's role in informed consent for surgery may include:
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obtaining the patient's signature on the consent form.
*Caution: if patient signs and all ahs not been explained to them, it is the nurse's fauly, so make sure they understand before they sign |
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Is asking the patient for informed consent, explaining the risks and consequences of proposed surgery, and informing the patient of the prognosis the role of the:
a. Doctor b. Nurse |
A. doctor
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What percentage of patients have N/V post-op? What can you give preop to relieve this?
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60%
antiemetics |
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What does a phase 1 initial assessment involve in the PACU after surgery?
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- airway
- breathing - circulation - neurologic - genitourinary - surgical site - pain |
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What can result from patients having only shallow respirations after surgery?
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atelectasis
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what can result due to unresolved atelectasis after surgery?
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pneumonia develops due to fluid buildup
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what can result from an ET tube irritating the trachea/bronchi?
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bronchospasm
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what complication can result from the tongue closing off the trachea?
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airway obstruction, then later hypoxemia
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what can reult from anesthesia slowing rate and depth or respirations, leading to decreased 02 in the blood?
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hypoxemia
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what can a nurse do to prevent DVT/ clot/ pulmonary embolism postoperatively?
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- do passive ROM
- dangle on side of bed - heparin (after MD order) - lovenox (After MD order) - TED hose - ambulate ASAP |
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What can a nurse do to prevent aspiration of vomitous, leading to ineffective airway clearance, impaired gas exchange, and pneumonia?
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- proper positioning
- elevate HOB - deep breathing - O2 therapy - hold/maintain airway |
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What is the recovery position postoperatively?
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lie flat on L side, so if they vomit they don't aspirate
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What should a nurse look for postoperatively to check if a patient is breathing (#1 cause of not breathing is obstruction caused by tongue)?
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-listen for breath sounds
- look for chest rise *can lift and tilt head or insert oral airway if neither is present |
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What complication can blood loss, anesthesia, and hemorrhage lead to postoperatively?
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hypotension
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what complication can result from the fight or flight response of the sympathetic nervous system and fluid overload postoperatively?
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hypertension
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What complication can result from fluid and electrolyte embalances (especially K+ and Mg+) lead to postoperatively?
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dysrhythmias
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What complication can result secondary to hypotension and decreased cardiac output postoperatively?
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Syncope
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What is considered a normal rise in temperature up to 48 hours postoperatively? Is normal hyperthermia.
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up to 100.4 (mild elevation)
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what complications are expected from a moderate temperature elevation after surgery up to 48 hours?
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(moderate elevation = >100.4)
- congestion - atelectasis - possibly dehydration *be alarmed if it rises above 100.4 in first 48 hours |
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After 48 hours, temperature > ______ usually indicates infection.
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99.9
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What GI complication is a common side effet of anesthesia and narcotics?
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N/V
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What are common side effects due to decreased peristalsis or injected gas in abdominal surgery (ex. laparascopy)?
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constipation
abdominal distention |
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what results from irritation of the phrenic nerve in abdominal surgery?
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hiccups
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what is a potential complication of increased release of aldosterone and ADH from the normal stress response postoperatively?
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low urine output
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what is a normal potential urinary problem immediately after surgery until about 3 days after surgery?
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acute urinary retention
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What can potentially cause urinary infection postoperatively?
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- indwelling catheters
*as long epidural is in effect, must have catheter in place. After epidural effects wear off, remove catheter ASAP. |
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How long after a urinary catheter is removed postoperatively should a patient be able to urinate on their own?
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6-8 hours
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What are some potential causes of wound infection?
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-invasion by normal flora on skin or in intestines, etc.
- immunocompromised are most at risk (diabetiivs, elderly, etc.) |
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What can result from the accumulation of drainage lying under the incision?
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abscess.
*treated by manually draining or by oral/IV antibiotics. |
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How long should the dressing remain over the incision postoperatively?
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24-48 hours, and usually not removed until physician gives the o.k.
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