Perioperative Nursing Concepts and Management

Practice flashcards covering the phases of perioperative nursing, surgical classifications, anesthesia, and postoperative complications based on NCM 112 Module 1.

What is the comprehensive care specialty dedicated to patients throughout the entire surgical experience?

Perioperative nursing

What are the three categories of the perioperative experience?

Preoperative, Intraoperative, and Postoperative phases

In surgical classification by urgency, what category is assigned to a patient requiring immediate attention for a life-threatening disorder like severe bleeding?

I. Emergent

Which surgical category describes a patient who requires prompt attention within $24$ to $30$ hours, such as for an acute gallbladder infection?

II. Urgent

What is the classification for surgery that improves appearance or restores function, such as a mammoplasty?

Reconstructive/Cosmetic

What type of surgery is performed to relieve symptoms without curing the underlying disease?

Palliative (e.g., gastrostomy for feeding)

Who is responsible for explaining the surgical procedure, its risks, benefits, and alternatives during informed consent?

The surgeon

What is the nurse's role in the informed consent process?

To witness the patient's signature and ensure the consent is voluntary and informed.

When does the preoperative phase officially begin and end?

Begins when the decision for surgery is made and ends when the patient is transferred to the OR table.

In the Preoperative Instructions, how many times should a patient repeat diaphragmatic breathing exercises?

$15$ times with a short rest after each group of five.

What position should the patient assume to practice diaphragmatic breathing and leg exercises preoperatively?

Semi-Fowler's position

What is the purpose of splinting an incision with hands or a pillow during coughing?

To provide support and minimize discomfort at the incisional site.

Which immediate preoperative intervention requires the patient to empty their bladder?

Letting the patient void before starting the procedure.

Who is the lead role in the OR responsible for managing the room, ensuring patient safety, and performing the 'time out'?

Circulating Nurse

Which OR zone allows the use of street clothes?

Unrestricted zone

What are the three components of proper attire in the restricted zone of the OR?

Scrub clothes, caps, shoe covers, and masks

What is the consideration for hair removal at the surgical site to maintain asepsis?

If hair needs to be removed, it is done with clippers rather than being shaved.

In maintaining surgical asepsis, which parts of a surgical gown are considered sterile?

The front from the chest to the level of the sterile field and the sleeves from $2$ inches above the elbow to the stockinette cuff.

Which stage of general anesthesia is known as the 'Excitement' stage, characterized by shouting, struggling, and dilated pupils?

Stage II

Stage IV of general anesthesia, which is a medical emergency, is known as what?

Medullary Depression

What is the most commonly used gas anesthetic agent administered via inhalation?

Nitrous oxide ($N_{2}O$)

Which anesthetic agent is more than $10$ times as potent as procaine and is commonly used in spinal or topical anesthesia?

Tetracaine (Pontocaine)

What form of anesthesia allows the patient to maintain a patent airway and respond to verbal stimuli while undergoing diagnostic or therapeutic procedures?

Moderate Sedation (Conscious Sedation)

Why is epinephrine often administered in combination with local anesthetic agents?

It constricts blood vessels to prevent rapid absorption and prolongs the local action of the anesthetic.

What is the earliest clinical manifestation of Malignant Hyperthermia?

Tachycardia (heart rate greater than $150\text{ bpm}$)

What is the primary medication administered to treat Malignant Hyperthermia?

Dantrolene

Inadvertent hypothermia is defined as a core body temperature lower than what threshold?

$36.6^\text{o}\text{C}$ ($98.0^\text{o}\text{F}$) or less

When does the intraoperative phase begin and end?

Begins when the patient is transferred to the OR table and ends when the patient is admitted to the PACU.

What are the five assessment areas included in the modified Aldrete score?

Activity, Respiration, Circulation, Consciousness, and $O_{2}$ Saturation

What Aldrete score is typically required for discharge from the PACU?

$8$ to $10$

Which type of hemorrhage is characterized by bright red blood that appears in spurts with each heartbeat?

Arterial hemorrhage

What category of hemorrhage occurs during the first few hours after surgery when a rise in blood pressure dislodges insecure clots?

Intermediary hemorrhage

Which wound healing mechanism involves an aseptic wound with minimum tissue destruction that is properly closed?

First-intention healing (primary union)

What is the term for the protrusion of wound contents, such as intestines, through a disrupted surgical incision?

Evisceration

What is the most common organism responsible for surgical-site infections (SSIs)?

Staphylococcus aureus

In elderly patients, what multifactorial condition is characterized by acute confusion, cognitive deficits, and disturbed sleep postoperatively?

Postoperative Delirium

How many air exchanges per hour are standard in OR ventilation to decrease airborne bacteria?

$15$ air exchanges per hour, at least three of which are fresh air.