Perioperative Nursing Flashcards

Flashcards for Perioperative Nursing Review

Surgical Nursing

The nurse's responsibility to be attentive and active in providing safety in all phases of the perioperative experience.

Nursing process and clinical judgment models

Tools nurses apply to ensure individualized and family-centered strategies are utilized throughout the perioperative experience.

EDNX item container

Antibiotics per protocol, pressure point padding, maintaining sterile technique, surgical time-out to verify patient and procedure, continuous patient monitoring, instrument and sponge count

Surgical Risk Factors

Smoking, age, nutrition, obesity, obstructive sleep apnea (OSA), immunosuppression, fluid and electrolyte imbalance, postoperative nausea and vomiting (PONV), venous thromboembolism (VTE)

Allergies in Preoperative Surgical Phase

Medications, topical agents, latex, food

Preoperative Phase

Begins with the decision to have surgery and lasts until transfer to the operating suite.

Risks during surgery for individuals at each end of the age spectrum

Inability to regulate body temperature and fragile skin.

Pregnancy Test

May delay or cancel surgery if positive.

Importance of advocating for the patient

Communicate how they currently feel and if there have been any changes over the last 24 hours.

Preoperative Instructions

Physical preparation for surgery and expectations

Minimizing risk for surgical wound infection

Antibiotics, skin antisepsis, clipping instead of shaving hair

Maintaining normal fluid and electrolyte balance

Fasting before surgery and IV fluid replacement

Preparation on the day of surgery

Hygiene, preparation of hair and removal of cosmetics, removal of prostheses, safeguarding valuables, preparing the bowel and bladder, vital signs, prevention of DVT, administering preoperative medications, documentation and hand-off

Pre Op Checklist Day of Surgery

Preoperative Education Completed, Informed Consent Signed, NPO - Bowel Prep, Skin Prep - Shower or Bath in Anti-microbial Soap, Documentation / Checklist of Valuables

Intraoperative Phase

Extends from admission to the surgical department to transfer to the postanesthesia care unit (PACU).

Circulating Nurse role

Observe environment for hazards. Does not scrub in.

Scrub Nurse role

Assist with surgical procedure. Ability to anticipate each instrument & supply needed by the surgeons

Detailed information reported to PACU RN

Unusual happenings (malignant hyperthermia), anesthesia, vials, body system review, reactions, drains, dressings, IV Fluid, medications, urine output, airway, oxygenation

Postanesthesia Care Unit (PACU) phase

Begins with transport to the PACU and continues with recovery, which can be a long-term recovery

Education for Safety

Knowledge deficit provides individualized teaching and emotional support measures.

Identification of the Individual

Two patient identifiers to improve the reliability of the patient identification process

Wrong Surgery or Wrong Site Prevention

The site should be clearly marked with a permanent marker preoperatively.

Preoperative Checklist

The checklist helps nurses identify specific items that could negatively affect the patient along with verifying the patient is ready for surgery.

Items on checklist

Review of medical history, signed history and physical, lab work, provider orders, removal of metals, consents, allergies confirmed, ID bands placed, and nothing-by-mouth (NPO) status of the patient.

Power of Attorney

Gives a person designated by the patient permission to make medical and end-of-life decisions.

Informed Consent

Signed by physician and anesthesiologist to indicate all risks of surgery and anesthesia fully explained to patient.

Informed Consent requirements

Must have date and time correlating with signature and must be signed prior to administration of narcotics or any mind-altering medication

Communication for surgical clients

Continuity of care is pertinent when caring for surgical clients, and a smooth communication—“hand-off”—between caregivers is needed.

ISBAR

Identify, Situation, Background, Assessment, and Recommendation.