NCM 112 – Pre-operative Nursing Care & Surgical Fundamentals

A comprehensive set of flashcards covering historical context, terminology, classifications, legal aspects, risk factors, assessments, interventions, and medications relevant to pre-operative nursing care and surgical management.

During which historical period was ether first used publicly as an anesthetic, and by whom?

In 1846 (19th century) Dr. William Morton, a dentist in Boston, publicly used ether as an anesthetic.

What three chronological phases are encompassed by the term “perioperative”?

Pre-operative, intra-operative, and post-operative phases.

Define the pre-operative period in perioperative nursing.

The time from the patient’s decision for surgical intervention until transfer to the operating-room table.

What does the surgical root word “nephro” refer to?

The kidney.

Which suffix means “surgical removal of” an organ or structure?

-ectomy.

Give the meaning of the term 'cystoscopy'.

Direct visualization (scopy) of the bladder (cysto) with a scope.

What four major pathologic processes commonly require surgical intervention?

Obstruction, perforation, erosion, and tumors.

Which surgical classification according to purpose involves removal of an organ to treat a disease condition?

Curative (ablative) surgery.

Provide two examples of reconstructive surgery.

Plastic surgery after severe burns and breast reconstruction (mammoplasty).

What differentiates minor from major surgery in terms of risk?

Minor surgery is short with few serious complications; major surgery is extensive, prolonged, with greater blood loss and risk to vital organs.

Within how many hours must urgent (imperative) surgery generally be performed?

Within 24–48 hours.

Name two examples of elective surgeries.

Simple hernia repair and non-bleeding hemorrhoid excision.

List three physiologic effects of surgical stress on the client.

Elicits the HPA stress response (↑ catecholamines), lowers immune defense, and disrupts vascular and organ functions (e.g., paralytic ileus).

Why is smoking a significant surgical risk factor?

Tar and nicotine impair alveolar gas exchange, decreasing oxygenation needed during and after anesthesia.

Which two age groups are considered highest risk for surgery?

Very young children and the elderly.

What are the four legal criteria that make an informed consent valid?

Voluntary, competent subject, adequately informed, and obtained before sedation.

Who is legally responsible for explaining the surgical procedure and alternatives to the patient?

The surgeon (primary provider).

In a life-threatening emergency with no available family, may a surgeon operate without consent?

Yes; every effort must be made to contact family, but the physician may operate to save life.

Name three common patient fears that can produce pre-operative anxiety.

Fear of the unknown, fear of death, and fear of anesthesia or disfigurement.

State two nursing interventions to reduce pre-operative anxiety.

Allow verbalization of fears and provide thorough pre-operative teaching (e.g., what to expect post-op).

Why should smokers ideally stop 4–8 weeks before surgery?

To improve pulmonary function and wound healing, thereby reducing peri-operative complications.

Which laboratory values are part of a routine Complete Blood Count (CBC) ordered pre-operatively?

Hemoglobin, hematocrit, platelet count, and white blood cell count.

What minimum NPO fasting time is recommended for clear liquids before anesthesia (ASA guideline)?

At least 2 hours.

Explain the purpose of bowel preparation before abdominal surgery.

To empty and cleanse intestines for better visualization, reduce contamination, and prevent trauma.

Which hair removal method is preferred immediately before surgery to reduce infection risk?

Clipping (shaving is discouraged by CDC unless absolutely necessary).

List two vital nursing actions immediately after administering ‘on-call to OR’ pre-anesthetic medications.

Keep the patient in bed with side rails up and ensure the call light is within reach.

Give one example of each category of common pre-operative medication: benzodiazepine, opioid, and anti-emetic.

Midazolam (benzodiazepine), morphine (opioid), and metoclopramide (anti-emetic).

What does the acronym TURP stand for in surgical procedures?

Trans-Urethral Resection of the Prostate.

Why must corticosteroid use be reported in the pre-operative assessment?

Chronic steroids risk adrenal insufficiency and impair wound healing, requiring peri-operative stress dosing.

What diagnostic test is mandatory for patients older than 40 before major surgery to assess cardiac status?

An electrocardiogram (ECG) and often cardiopulmonary clearance.

Identify three medications that may increase surgical bleeding risk and thus are reviewed pre-operatively.

Anticoagulants, NSAIDs, and MAO inhibitors.

Which two organs are crucial for metabolizing anesthetic agents and drugs given during surgery?

The liver and the kidneys.

How is anxiety physiologically manifested that nurses should monitor pre-operatively?

Elevated pulse and respiratory rates, inability to concentrate, restlessness, or insomnia.

What teaching should be provided regarding coughing and deep breathing exercises?

Instruct patient to splint the incision, inhale deeply, cough to clear secretions, and repeat regularly post-operatively.

Describe the correct patient positioning when transported on a stretcher to the OR.

Feet first, side rails up, to enhance safety and minimize dizziness or nausea.

Which laboratory values assess renal function before surgery?

Blood Urea Nitrogen (BUN) and creatinine levels.

State two indicators that would prompt postponement of elective surgery related to respiratory status.

Active respiratory infection or uncontrolled asthma/COPD exacerbation.

What is the purpose of an indwelling urinary catheter ordered pre-operatively for long abdominal surgeries?

To keep the bladder empty, monitor urine output, and prevent bladder injury.

Which root word refers to the uterus in surgical terminology?

Hystero-.

What does the suffix “-plasty” indicate in a surgical term?

Plastic repair or reconstruction.

Define 'colostomy'.

Creation of an opening (-ostomy) of the colon onto the abdominal surface for fecal diversion.

Why is obesity a significant intra-operative risk factor?

Fats obstruct airways, increase surgical time, impair wound healing, and complicate positioning.

Which electrolyte imbalances are most critical to correct before anesthesia?

Sodium (Na⁺) and potassium (K⁺) imbalances.

What coping strategy involves focusing on a pleasant scene to reduce surgical anxiety?

Guided imagery.

Name two possible cardiovascular complications during or after surgery in patients with heart disease.

Dysrhythmias and myocardial infarction.

Under what circumstances may an emancipated minor sign their own surgical consent?

If legally emancipated, married, or the parent of a child undergoing an invasive procedure.

What are two key items that must accompany the patient to the OR besides the consent form?

Completed pre-operative checklist and all pertinent laboratory/diagnostic reports.

Which endocrine disorder increases the risk of thyrotoxicosis during surgery if uncontrolled?

Hyperthyroidism.

How long should a patient fast from meat or fried foods before anesthesia, according to ASA guidelines?

At least 8 hours.

What is the role of H2-receptor blockers as pre-operative medication?

To reduce gastric acidity and decrease risk of aspiration pneumonia.

Why must contact lenses be removed before anesthesia?

To prevent corneal injury and because eyelid reflexes are absent under anesthesia.

Which suffix means 'instrument for cutting'?

-tome.

What does 'salpingectomy' refer to?

Surgical removal (-ectomy) of a fallopian tube (salping-).

Identify two signs that a patient may be experiencing alcohol withdrawal peri-operatively.

Agitation/tremors and hallucinations 48–72 hours after last intake.

What is the standard nursing action if a patient has unresolved major questions about surgery while completing consent?

Contact the surgeon to provide further explanation before the patient signs.

List two respiratory complications that good post-operative deep-breathing exercises aim to prevent.

Atelectasis and pneumonia.

For what reason might a GIA stapler be used during abdominal surgery?

To create a gastrointestinal anastomosis quickly and securely.

What does the abbreviation 'TAH BSO' describe in gynecologic surgery?

Total abdominal hysterectomy with bilateral salpingo-oophorectomy.

Explain why the first and third trimesters of pregnancy carry greater surgical risk.

First trimester: teratogenic risk; third trimester: increased uterine size and risk of preterm labor.

Which laboratory tests evaluate coagulation status pre-operatively?

Prothrombin Time (PT), Partial Thromboplastin Time (PTT), and Activated PTT.

After pre-operative teaching, what two actions indicate the patient is ready for surgery?

The patient verbalizes understanding of the procedure and signs the informed consent.

What intra-operative advantage does clipping hair (vs. shaving) provide?

Reduces skin micro-abrasions and lowers surgical site infection rates.

Which opioid-sparring technique can be taught pre-operatively to aid post-operative pain control?

Splinting the incision while coughing or moving.

Why should dentures be removed prior to anesthesia induction?

To prevent airway obstruction or damage to dentures during intubation.

What is the primary goal of turning the patient side-to-side every two hours post-operatively?

To improve circulation, prevent pressure ulcers, and allow skin cooling.