Perioperative Nursing Review

Vocabulary practice flashcards covering perioperative nursing phases, classifications, aseptic techniques, anesthesia stages, surgical instruments, and postoperative complications.

Preoperative Phase

The phase of perioperative care that begins when the decision to proceed with surgical intervention is made and ends with the transfer of the patient onto the operating room (OR) table.

Intraoperative Phase

The phase of perioperative care that begins when the patient is transferred onto the OR table and ends with admission to the Post Anesthesia Care Unit (PACU).

Postoperative Phase

The phase of perioperative care that begins with the admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home.

Palliative Surgery

Surgical intervention performed to relieve pain or correct a problem without curing the underlying condition, such as inserting a gastrostomy tube for a patient unable to swallow.

Urgent Surgery

A surgical classification according to urgency where the surgical problem requires attention within 24 to 48 hours (e.g., cancer).

Informed Consent

The patient's autonomous decision about whether to undergo a surgical procedure, obtained by the surgeon as a legal requirement after informing the patient of risks and complications.

Circulating Nurse

A non-sterile surgical team member responsible for coordinating the team, verifying consent, monitoring aseptic practices, ensuring fire safety, and confirming the second verification of the surgical procedure and site.

Scrub Nurse

A surgical team member who performs a surgical hand scrub, sets up sterile tables, prepares sutures and equipment, and assists the surgeon by anticipating required instruments.

Unrestricted Zone

An area in the operating room suite where street clothes are allowed and which interfaces with other departments, including the patient reception and holding area.

Semi-Restricted Zone

An operating room area where scrub attire (scrub clothes and caps) is required, including areas where surgical instruments are processed.

Restricted Zone

An operating room area where scrub clothes, shoe covers, caps, and masks are worn, encompassing the operating room and sterile core area.

Physical Disinfection by Boiling

A decontamination method using $100^\text{C}$ boiling water to destroy most pathogens except spores.

Pasteurization

A high-level disinfection process for items like reusable respiratory devices and anesthesia circuits, involving exposure to hot water at $60^\text{C}$ to $80^\text{C}$ for $30\text{ minutes}$.

Autoclaving

The most common method of sterilization, utilizing steam at a temperature of $121^\text{C}$ and $1\text{ atm}$ pressure for $30\text{ minutes}$.

Non-Critical Items

Under Spaulding's classification, items that come into contact only with intact skin, such as stethoscopes, BP cuffs, and tourniquets.

Semi-Critical Items

Under Spaulding's classification, items that come in contact with mucous membranes and non-intact skin, requiring high-level disinfection (e.g., GI endoscopes, laryngoscopes, bronchoscopes).

Critical Items

Under Spaulding's classification, items that penetrate sterile tissues, body cavities, or the vascular system, requiring sterilization (e.g., surgical instruments, implants, catheters, needles).

Stage 1 General Anesthesia

The beginning anesthesia/induction stage characterized by feelings of detachment, drowsiness, hallucinations, and exaggerated perception of noises.

Stage 2 General Anesthesia

The excitement/delirium stage characterized by dilated pupils, rapid pulse rate, irregular respirations, and uncontrolled patient movements requiring physical restraints.

Stage 4 General Anesthesia

The medullary depression or danger stage resulting from excessive anesthesia, characterized by shallow respirations, a weak thready pulse, widely dilated pupils, and risk of death.

Epidural Anesthesia

Regional anesthesia achieved by injecting a local anesthetic agent into the epidural space surrounding the dura mater of the spinal cord, notable for the absence of headache.

Spinal Anesthesia

Conduction nerve block produced when a local anesthetic is introduced into the subarachnoid space at the lumbar level, usually between $L4$ and $L5$.

Monitored Anesthesia Care (MAC)

Moderate sedation administered by an anesthesiologist or anesthetist who must be prepared and qualified to convert to general anesthesia if necessary.

Trendelenburg Position

A surgical position where the patient is flat on their back with the head lower than the feet, used in lower abdomen and pelvic surgeries to displace intestines into the upper abdomen.

Reverse Trendelenburg Position

A surgical position with the head elevated, commonly used for thyroidectomy, laparoscopic gallbladder, biliary tract, or stomach procedures.

Kraske Position

Also known as jack-knife position, where the hips are positioned over the center break of the table, legs lowered usually $90^\text{o}$, and bed tilted head-downward; used for rectal procedures.

Surgical Blade #10

A cutting instrument blade used primarily to open the skin, fitting handle sizes #3 or #7.

Surgical Blade #11

A pointed surgical blade used to make initial skin punctures for tiny deep incisions.

Mayo Scissors

Heavy-duty surgical scissors used for cutting heavy fascia and sutures.

Metzenbaum Scissors

Delicate surgical scissors used specifically for cutting delicate tissues.

Babcock Forceps

Grasping forceps with rounded jaw ends designed to grasp delicate tissues without injury (e.g., Fallopian tubes).

Plain Surgical Gut

An absorbable suture derived from sheep intestine submucosa or beef intestine serosa that loses strength in 5 to 10 days and is digested within 70 days.

Chromic Surgical Gut

An absorbable suture treated to support wounds for about 14 days, lose tensile strength up to 21 days, and absorb within 90 days.

Surgical Silk

A non-absorbable suture material that loses its tensile strength when wet, commonly used in gastrointestinal serosa and fascia closure.

Surgical Cotton

A non-absorbable suture material that gains tensile strength when wet.

Aldrete Score

A postoperative scoring system evaluating activity, respiration, circulation, consciousness, and oxygen saturation to determine readiness for transfer from the PACU (target score 8 to 10).

Dehiscence

The total or partial disruption or separation of wound edges where underlying subcutaneous tissue has not parted.

Evisceration

The protrusion of internal organs or viscera through an abnormal wound opening.

Primary Hemorrhage

Bleeding that occurs at the exact time of the surgical procedure.

Intermediary Hemorrhage

Bleeding occurring within a few hours post-surgery when rising blood pressure to normal dislodges insecure clots from untied vessels.

Secondary Hemorrhage

Bleeding occurring sometime after surgery due to a slipped suture, infection, or vessel erosion by a drainage tube.

Atelectasis

Postoperative alveolar collapse or incomplete expansion of the lung, manifested by decreased breath sounds, crackles, and cough.

Homan's Sign

Calf pain experienced upon dorsiflexion of the foot, serving as a clinical manifestation of deep vein thrombosis (DVT).

Pulmonary Embolism (PE)

Postoperative complication caused by the obstruction of pulmonary arterioles by an embolus originating in the venous system, presenting most frequently with dyspnea and tachypnea.