Comprehensive Guide to Perioperative Nursing: Phases, Risks, and Safety

What are the three perioperative phases?

Preoperative, Intraoperative, and Postoperative.

What occurs during the preoperative phase?

Initial care before surgery involving physical and psychological preparations.

What is the intraoperative phase?

The period from when clients are moved onto the operating bed until they are transferred to recovery.

What happens during the postoperative phase?

The final phase immediately after surgery, which can include rehabilitation and recuperation.

What should be confirmed during preoperative assessment?

Client's name, medical record, age, date, medical diagnosis, chief complaint, and source of information with two identifiers.

Why is it important to screen for conditions that increase surgical risk?

To promote safety by identifying clients at high risk for complications.

What allergies should be noted during the perioperative phase?

Allergies to medications, foods, and intolerances to medications.

What is the recommendation for smokers undergoing surgery?

They should be advised to stop smoking as soon as possible.

What additional surgical risk factors should be considered?

Age, nutrition, obesity, obstructive sleep apnea, immunosuppression, fluid and electrolyte imbalance, and venous thromboembolism.

What is informed consent?

A client's full understanding and choice to undergo a treatment or procedure, including risks, benefits, and alternatives.

Who is responsible for obtaining informed consent?

The provider or doctor, while nurses may assist in ensuring understanding.

What is the role of the circulating nurse during surgery?

Coordinates care, verifies consent, provides support, ensures client safety, and maintains sterility.

What is the purpose of the 'time out' procedure in surgery?

To ensure all team members agree on the procedure and verify the correct patient and site before surgery begins.

What should be documented in the electronic medical record (EMR) during the perioperative phase?

Client's allergies, medical history, consent, and any other relevant information.

What is the significance of a pregnancy test before surgery?

To assess potential risks as anesthesia can cross the placenta.

What factors can affect postoperative recovery?

Glycemic control, infection risk, and pressure injury prevention.

What is the importance of hand-off communication in surgical care?

To ensure continuity of care and transfer of critical information between healthcare providers.

What is the expected outcome of preoperative education?

To prepare the client for surgery and set expectations for the procedure and recovery.

What should be included in preoperative teaching?

Information about the procedure, recovery expectations, and any necessary preparations.

What is the role of the scrub tech during surgery?

To maintain sterility and assist with instruments and supplies during the procedure.

What is the impact of obesity on surgical risk?

It can affect skin integrity and respiratory function, increasing the risk of complications.

Why is fluid and electrolyte balance important before surgery?

To ensure proper heart function and reduce the risk of complications.

What is the significance of premedication for postoperative nausea and vomiting (PONV)?

To reduce the likelihood of nausea and vomiting after surgery.

What should be done if a client refuses a pregnancy test?

Document the refusal as it is the client's right.

What is the role of the nurse in postoperative care?

To monitor recovery, manage pain, and prevent complications.

What is the importance of documenting care during the perioperative phase?

To provide a legal record and ensure continuity of care.

What must a client be informed about before undergoing a treatment or procedure?

The client must be aware of the treatment or procedure, who will perform it, its purpose, expected outcomes, risks, benefits, and alternatives.

What should be included in a preoperative assessment?

A complete client history, consent, confirmation of two identifiers, and screening for conditions that increase surgical risks.

What is malignant hyperthermia?

A severe fever caused by general anesthesia, which can be life-threatening.

What are the responsibilities of the scrub nurse during surgery?

The scrub nurse ensures that surgical instruments are sterile and ready, hands tools to the surgeon, and may also function as the instrument nurse.

What is the significance of documenting allergies in the perioperative phase?

Allergies must be noted and verified to prevent adverse reactions during surgery.

What is local anesthesia?

Local anesthesia prevents conduction of pain impulses by affecting both motor and sensory nerves at the surgical site.

What is regional anesthesia?

Regional anesthesia causes a temporary loss of feeling in a specific area of the body.

What is general anesthesia?

General anesthesia uses drugs or inhalants to depress the central nervous system, rendering the patient unconscious.

What is moderate or conscious sedation?

Moderate or conscious sedation allows the client to remain relaxed and calm while being able to follow commands without pain or anxiety.

What does the Aldrete scoring system assess?

The Aldrete scoring system assesses recovery criteria including respiration, oxygen saturation, consciousness, circulation, and activity.

What is the minimum score required for discharge according to the Aldrete scoring system?

A score of 9 is required for discharge.

What is the focus of the preoperative phase?

The preoperative phase focuses on physical and psychological preparations for the client before surgery.

What occurs during the postoperative phase?

The postoperative phase occurs immediately after surgery, focusing on recovery and monitoring for complications.

What should be confirmed with two identifiers during preoperative assessment?

The client's name, medical record number, age, date, time, medical diagnosis, chief complaint, and the source of information.

What is the importance of client teaching before surgery?

Client teaching ensures that the patient understands the procedure, risks, and recovery process, which can improve outcomes.

What is the role of the anesthesiologist during surgery?

The anesthesiologist administers anesthesia and monitors the patient's vital signs throughout the procedure.

What should be done if a client is a smoker before surgery?

The nurse should advise the client to stop smoking prior to the procedure, especially for surgeries involving the chest or abdomen.

What is the purpose of screening for additional surgical risk factors?

Screening identifies clients who may have a higher risk of complications during or after surgery.

What should be documented regarding surgical specimens?

Specimens utilized for surgery must be labeled correctly and positioned in the appropriate media.

What occurs during the intraoperative phase?

The period from when clients are moved onto the operating table until they are transferred to recovery.

What is the postoperative phase?

The final phase immediately after surgery, which can last a few hours or include longer recuperation.

What is the importance of hand-off communication in nursing?

To ensure accurate transfer of client information and continuity of care.

How does poor glycemic control affect surgical outcomes?

It increases the risk for wound infection and mortality.

What are intrinsic and extrinsic risks in surgery?

Intrinsic risks are related to the patient's health, while extrinsic risks are environmental or procedural factors.

What role does the circulating nurse play during surgery?

Coordinates care, verifies consent, provides emotional support, and ensures client safety.

What is the purpose of a 'time out' before surgery?

To confirm the correct patient, procedure, and site to prevent errors.

What should be documented regarding allergies during the perioperative phase?

Client's allergies to medications, foods, and environmental elements, including the nature of prior reactions.

What is informed consent in a surgical context?

A client's full understanding and choice to undergo a procedure, including risks and benefits.

What is the ASA Physical Status Classification for a normal healthy patient?

ASA I.

What does ASA II indicate in the ASA Physical Status Classification?

A patient with mild systemic disease.

What does ASA IV indicate?

A patient with severe systemic disease that is a constant threat to life.

What is the significance of documenting a client's smoking status before surgery?

Smoking increases surgical risks, especially for procedures involving the chest or abdomen.

What should be done for clients who could become pregnant before surgery?

A pregnancy test should be administered and documented.

What is the impact of smoking on surgical outcomes?

It can lead to increased complications and delayed healing.

What should be included in the client's medical history during preoperative assessment?

Allergies, medications, past surgeries, and any chronic conditions.

What is the importance of client education before surgery?

To ensure understanding of the procedure, risks, and postoperative care.

What does ASA V indicate in the ASA Physical Status Classification?

A moribund patient who is not expected to survive without the operation.

What should be done with the client's consent form?

It must be verified and documented by the circulating nurse.

What is the significance of documenting intolerances to medications?

To prevent adverse reactions during surgery and ensure safe medication administration.