perioperative nursing pt 2

describe PO restrictions prior to surgery

traditionally NPO after midnight if AM surgery

can have sip of water for necessary medication

no gum or hard candy

done to promote gastric emptying and decrease risk of aspiration

what needs to be done on the day of surgery?

confirm preop checklist completed

record baseline VS

check pt has ID and allergy wrist band on

pt in hospital gown, sometimes no underwear

remove nail polish, makeup, all jewelry

remove dentures and bridges

remove eyeglasses and hearing aids

pt should void prior to leaving for OR

why may some medications be order prior to an operation?

for anxiety or facilitate anesthesia, antiemetic to prevent nausea from anesthesia, eyes drops prior to eye surgery

what happens in the preop holding area?

2 identifiers are used to identify pt

verification of correct person, site, and procedure by preop holding area nurse

what is the protocol for preventing wrong site, procedure/ and or person?

pre-procedure verification, mark the procedure site and time out

wrong site surgery has to be reported in the state of PA

what are the three zones of the operating room?

unrestricted: can wear street clothes

semi-restricted: must wear scrubs and surgical hat

restricted: must wear scrubs, surgical hat, and mask

who is part of the surgical team?

surgeon, resident/fellow, anesthesiologist, nurse anesthetist, circulating nurse, surgical technician

who is sterile and who is non-sterile on the surgical team?

sterile: surgeon, resident, surgical technician

non-sterile: circulating nurse, anesthesiologist, nurse anesthetist

what are the types of anesthesia?

general: inhalation and monitored anesthesia care (MAC)

regional: epidural and spinal

local: blocks

what is some different positioning for pts on the operating room table?

depends on the surgery

types: supine, prone, lateral, lithotomy

complications: prevent hyperextension of extremities, pressure on nerve, present circulation occlusion, and padding to prevent pressure ulcers

what is a time out?

performed prior to starting the procedure

done to make sure everyone is on the same page and that the procedure is done properly

characteristics: all members of team there, lead by one member of team, verbal agreement between all members, express concerns when there, process for reconciling differences in response

why is it important to do a count of materials before and after a procedure?

this is done to make sure nothing has been left within the pt

sponges or other materials left in the pt can be life threatening

what is done to prevent surgical site infection?

maintain a normal body temperature

maintain normal glucose levels

do not shave surgical site

prophylactic antibiotic therapy

what is done in a PACU assessment?

ABC, LOC, VS, drains, dressings, fluids, pain, nausea

what is nursing care like in the PACU?

assessing the pt

maintaining a patent airway

maintaining cardiovascular stability

pain relief

readiness for discharge: stable VS, pain controlled, etc.