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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
what are the classes of surgery?elective, urgent or emergent
what are the two categories of surgery?Major and Minor
surgery is performed for various purposes, what are they?diagnostic ablative palliative reconstructive curative preventive transplant constructive and cosmetic
What are some common surgical settings?Inpatient one day outpatient short stay surgical center short stay unit mobile surgery unit
Anastomosissurgical joining of two ducts or blood vessels to allow flow from one to another. to bypass an area ( Billroth I, joins stomach and duodenum.)
-ectomysurgical removal of ( cholecystectomy, removal of gallbladder)
Lysisdestruction or dissolution of ( lysis of adhesions, removal of adhesions)
-orrhaphysurgical repair ( herniorrhaphy, repair of a hernia)
-oscopydirect visualization with a scope ( cystoscopy, direct visualization of the bladder and urethra by means of a cystoscope)
-ostomyopening made to allow the passage of drainage ( ileostomy, formation of an opening of the ileum onto the surface of the abdomen for passage of feces)
-otomyopening into ( thoracotomy, surgical opening into the thoracic cavity)
-pexyfixation of ( cecopexy, fixation or suspension of the cecum to correct its excessive mobility)
-plastyplastic surgery
What can the nurse have the UAP do during patient preparation for surgery?administer an enema or douche, obtain v/s , apply antiembolic stockings, and assist pt in removing clothing, jewelry and prostheses
ablativeexcision or removal of diseased body part. ( amputation or removal of something
palliativesurgery for relief or reduction of intensity of disease of symptoms, not cure
what are some common fears associated with surgery?fear of loss of control associated with anesthesia. fear of the unknown. fear of waking up during the operation. fear of pain. fear of death fear of change in body image fear of detection of cancer
what are some of the major problems younger and older patients have during surgical procedures.temperature variations, cardiovascular shifts, respiratory needs, and renal functions.
list a few risks the older adults have when undergoing surgery.Aspiration, atelectasis ( collapsed lung) pneumonia, thrombus formation, infection, altered tissue perfusion.
list what the perioperative nursing includespreoperative phase , intraoperative and postoperative phase.
what type of communication will the nurse need to use in the surgical process.nonverbal communication.
if the pt is showing signs of malnutrition what should you as then nurse do?tube feeding , IV therapy of total parenteral nutrition can be initiated,
what does the ABCDEF mnemonic device to ascertain serious illness of trauma in the preoperative pt stand for?A: allergy to medications, chemicals, and other including latex. B: bleeding tendencies of use of meds like aspirin, heparin, or warfarin sodium C: cortisone or steroid use D: diabetes mellitus E: embili any past hx. F: fighting ability any pt with immune system problems
What are a few common fears associated with surgery?loss of control fear of the unknown fear of the unknown fear of pain fear of death fear of separation ( kids are a big one for this) fear of disruption of life patterns fear of change in body image fear of detection of cancer
What are some of the perioperative meds and agents used?anesthethetives, antimicrobials, anticoagulants , hemostatic agents, steroids , diagnostic imaging dyes, diuretics, central nervous system agents, emergency protocol medications.
why do you need to ask about herbal remedies as alternative or complementary therapy.Most people do not think of them as medications and they may interact with or potentiate other medications and interfere with surgical procedures.
why do you need to know if your pt is on vitamine E?it may prolong bleeding times
meds that need to be given the day of surgery are to be given with a sip of water in the morning what might these meds be?antiseizure and cardiac drugs
who typically provides the teaching regarding preoperative instructions that maybe GI cleaning or assistive devices like crutchesthe surgeons nursing staff
what are some per op considerations for Echinaceaneg impact on liver, can interference with hepatic metabolism of anesthesia meds
what are some per op considerations for Ephedra sinicaincreased risk of cardiac dysrhythmias
per op considerations for feverfewhas anticogulation factors can increase bleeding
what are per op considerations for Garlic and Ginger and Ginkgo bilobaincreased bleeding and prolonged clotting times
per op considerations for Ginsengmay increase anesthetic agent requirments and potential for hypoglycemia in pt with DM
what are per op considerations for Gauranamay reduce the efficacy of Warfarin
what are some per op considerations for Kavamay increase effects of certin muscle relaxants
what are some pre op considerations for Licoricemay cause hpyertension
what are some per op considerations for St. John's wortshould not be used with other psychoactive drugs, momoamine oxidase inhibitors or serotonin reuptake inhibitors this needs to be discontinue before surgery bc of possible drug interactions
what are some pre op considerations for Valerian rootshould not be used with sedative or anxiolytice
what should the nurse explain to the family regarding what to expect right after surgery to the pt family?that V/S, dressings, and tubes are assessed every 10 to 15 min until the pt is awake and stable
what are some laboratory tests commonly reviewed before surgery?urinalysis CBC Blood chemistery profile to assess endocrine, hepatic and renal and cardiovascular functions. serum electolytes chest x-ray electrocardiogram BUN
What meds can be given over a period of days to detoxify and sterilize the GI tract for a bowel surgery ?neomycin sulfonamides erythromycin
once the pt is in the OR an antiseptic solution to kill adherent and deeper residing bacteria is used what are these calledpovidoneiodine or betadine and chlorhexidine
what are the ways latex allergy occur1. as irritant contact dermatitis 2. as a type IV allergic reactions 3. as a type I allergic reaction
true latex allergy is the type I allergic reaction and occures shortly after exposure to the proteins in lates rubber.this happens by touch inhaled or ingested
what might the OR surgeon order for a pt with latex allergy?prophylactic treatment with glucocorticoid steroids and antihistamines
why is it important to ventilate the lungs post opto prevent or treat atelectasis, improve lung expansion and improve o2 and prevent post op pneumonia
What is given to help the pt with improve lung expansion post surgeryincentive spirometer
what are to two types of incentive spirometerflow-oriented incentive spirometer volume-oriented spirometer
when is an inventive spirometer contraindicatedin cranial and spin- related surgeries
why should the pt not massage the legs after a surgery?because of the risk of dislodging a thrombus
how much fluid should you have your pt drink after awake post surgery?8 oz every hour unless contraindicated.
true or false urinary retention is a common postoperative complication.true
Benzodiazepinesmidazolam diazepam (Valium) lorazepam ( Ativan) decrease anxiety and produce sedation. monitor for resp depression, hypotension, drowsiness and lack of coordination
Opioid anglgesicsmorphine fentanyl citrate ( sublimaze) decrease anxiety and allow decreased anesthetics monitor for resp depression, n/v hypotension and pruritus
H2 receptor antagonistsfamotidin ( pepcid) ranitdine ( zantac) not on market as of now reduce gastric acid volume and concentration monitor for confusion and dizziness in older adults
antimeticsmetoclopramide ( reglan) droperidol ( inapsine) ondansetron HCI ( 5-HT3 receptor antagonist) Zofran enhance gastric emptying , tranquilizing effect , prevent postop n/v monitor for sedation and involuntary movement have pt report any problem breathing
Anticholingergicsatropine sulfate glycopyrrolate (robinul) reduce oral and resp secretion to decrease risk of aspiration decrease n/v monitor for confusion, restlessness and tachycardia pt my have dry mouth
Antibioticscefazolin sodium (ancef) cefotaxime sodium (claforan) ceftriaxone bactericidal minimizes risk of wound and infections monitor of s/s of abd pain, diarrhea severe anal or genital pruritus and severe mouth soreness
Adrenocortical steroidmethylperdisolone ( depo- medrol, solu- medrol ) decreases inflammation determin if pt had DM and anticipate and increase in antidiabetic drug regimen bc of raised blood glucose levels
nonsteroidal Antiinflammatory drugs NSAIDketorolac reduces intensity of pain and inflammations assess pt for pain onset location and have they respond to the drug.
medications for the perioperative anticoagulantsenoxaparin sodium ( Lovenox) heparin sodium ( Heparin) warfarin sodium (coumadin) prevent new clot formation of secondary embolic complications dont not give IM but subQ and tell the pt not to take OTC drugs like aspirin
Anticoagulantsare stopped several days before surgery, can cause prolonged clotting times which can lead to hemrrhage
antihypertensivescan cause hypotension when combined with anesthetic agents and narcotics
antiseizure drugscan interact with anesthetic agents
corticosteroidsmay prolong bleeding and hamper healing time. and may hamper body abilty to deal with stress of surgery
diureticscan cause hypotension after surgery and decreased serum potassium levels
herbal therapiesaffect clotting times, ginseng may increase hypoglycemia with insulin therapy
insulinpt with DM may need a decrease need for insulin after surgery bc nutritional intake is decreased and stress
NSAID'sinhibit platelet function and may prolong bleeding leading the possible hemorrhage
What do some common anesthetic agents include?propofol ( a nonbarbiturate IV anesthetic) nitrouse oxide gas and desflurane and sevoflurance vapors, muscle relaxants
what is done to establish and airwayintubation with and endotracheal tube or use of a laryngeal mask airway
what is the greatest risk from general anesthesia?cardiovascular depression of irritability, respiratory depression and liver and kidney damage
what is suctioned to decrease the risk of aspiration and laryngeal spasm after extubation?the oropharynx
if the pt is having difficulty maintaining a patent air way after extubation, what is used until the pt is fully consciousan oral airway