Influence exam 2

Nurs 309

What are the 6 reasons for surgery?

Diagnosis, cure, palliation, prevention, cosmetic, and exploration.

What is inpatient surgery?

Surgery requiring hospital admission and usually an overnight stay.

What is ambulatory surgery?

Outpatient surgery where the patient is discharged the same day.

What is the perioperative period?

The period involving preoperative, intraoperative, and postoperative care.

What are major perioperative nursing responsibilities?

Assessment, safety, asepsis, positioning, temperature control, and patient support.

What is the goal of preoperative preparation?

Identify risks, establish baseline data, prepare the patient, and prevent complications.

What does a preoperative interview assess?

Health information, allergies, understanding, emotional state, readiness, and expectations.

What are major parts of a preoperative assessment?

Baseline, psychological, physiological, medications, diagnostics, culture, and education.

What medication history is important before surgery?

Prescription, over-the-counter, herbal drugs, and antiplatelet use.

What cardiovascular conditions matter before surgery?

Hypertension, angina, dysrhythmias, heart failure, and myocardial infarction.

What cardiovascular tests/care may be needed preoperatively?

Electrocardiogram, coagulation studies, antibiotics, and venous thromboembolism prophylaxis.

What respiratory history is important before surgery?

Respiratory disease/infection, dyspnea, cough, hemoptysis, chronic obstructive pulmonary disease, or asthma.

Why encourage smoking cessation before surgery?

To reduce respiratory and other postoperative complications.

What is assessed in the nervous system preoperatively?

Neurologic function, vision, hearing, and cognitive deficits.

What genitourinary issues matter before surgery?

Renal/urinary disease, renal function, voiding problems, pregnancy, and prostate problems.

What integumentary issues are assessed before surgery?

Piercings, tattoos, and history of skin breakdown.

What musculoskeletal issues are assessed before surgery?

Arthritic joints and mobility restrictions.

What endocrine problems increase surgical risk?

Hypoglycemia, hyperglycemia, ketosis, cardiovascular changes, poor healing, and infection.

What immune factors matter before surgery?

Immunocompromise and use of immunosuppressive medications.

Why assess fluid and electrolyte status before surgery?

Vomiting, diarrhea, and bowel preparation can cause imbalances and hypovolemia.

What are the 3 types of preoperative teaching?

Sensory, process, and procedural information.

What is sensory information in preoperative teaching?

What the patient may see, hear, feel, or experience around surgery.

What is process information in preoperative teaching?

The general flow of events before, during, and after surgery.

What is procedural information in preoperative teaching?

Specific details about procedures the patient will experience.

What must informed consent include?

Diagnosis, purpose, risks, success probability, alternatives, and prognosis.

Who explains the surgery for informed consent?

The provider performing the procedure; the nurse verifies understanding and witnesses per policy.

What antibiotic may be given preoperatively?

Cefazolin is commonly used for surgical infection prophylaxis.

Why might beta blockers be continued before surgery?

To manage hypertension or coronary artery disease and avoid abrupt withdrawal.

What are examples of other preoperative medications?

Antiemetics, antidiuretics, benzodiazepines, and opioids.

What should ambulatory surgery teaching include?

Time/place, what to bring, clothing, food/fluid restrictions, and a responsible adult.

Why is a responsible adult needed after ambulatory surgery?

Anesthesia and sedation can impair judgment, coordination, and safety.

What is checked on the day of surgery?

Teaching, history/physical, vital signs, notes, labs, diagnostics, consultation, skin, and surgical site.

What are the 3 surgical zone classifications?

Unrestricted, semirestricted, and restricted.

What is an unrestricted surgical zone?

Areas such as holding, locker, and information areas.

What is a semirestricted surgical zone?

Areas requiring authorized personnel wearing appropriate surgical attire.

What is a restricted surgical zone?

Operating rooms and areas requiring strict sterile technique.

What is the scrub nurse's role?

Maintains the sterile field and handles sterile instruments and supplies.

What is the circulating nurse's role?

Remains unsterile, coordinates care, documents, and supports the surgical team.

What are major intraoperative nursing responsibilities?

Room preparation, transfer, asepsis, anesthesia assistance, positioning, and safety.

What happens when the patient is admitted to the operating area?

Reassess, answer questions, verify valuables/intake-output, confirm orders, and prepare the patient.

How is a surgical site prepared?

Clean from clean to dirty, allow the area to dry, then apply sterile draping.

What are major surgical safety concerns?

Infection, physical trauma, physiologic effects, and communication errors.

What is the purpose of surgical positioning?

Provide surgical access while preventing injury and complications.

How can perioperative hypothermia be prevented?

Monitor temperature, use warming blankets, and warm intravenous fluids.

What is moderate anesthesia/sedation?

The patient responds purposefully and maintains spontaneous breathing.

What is general anesthesia?

Anesthesia that produces a general loss of consciousness.

What is local anesthesia?

Anesthesia that numbs a specific area.

What is spinal anesthesia?

Anesthetic delivered into the spinal/subarachnoid space.

What is epidural anesthesia?

Anesthetic delivered into the epidural space.

What is Monitored Anesthesia Care (MAC)?

Anesthesia care involving monitoring with varying levels of sedation or anesthesia.

What are common anesthetic routes?

Intravenous, inhalation, local, and regional routes.

What are anesthetic adjuncts?

Benzodiazepines, neuromuscular blockers, and antiemetics used with anesthesia.

What is ketamine used for?

Dissociative anesthesia and analgesia.

What is fentanyl used for during anesthesia?

Analgesia and helping induce or maintain anesthesia.

What is desflurane used for?

Induction and maintenance of general anesthesia.

What is succinylcholine used for?

Rapid skeletal muscle paralysis, especially for intubation.

What is dexmedetomidine used for?

Sedation, including in some nonintubated patients.

What is malignant hyperthermia?

A rare, life-threatening reaction to certain anesthetic agents.

What medication treats malignant hyperthermia?

Dantrolene (Dantrium).

What is the Post Anesthesia Care Unit (PACU)?

The area where patients initially recover after anesthesia.

What is Phase I postoperative care?

Initial recovery and stabilization after anesthesia.

What is the priority immediately after surgery?

Assess and maintain airway, breathing, and circulation.

What equipment should be available in the PACU?

Airway, oxygen, suction, pulse oximetry, vital-sign equipment, and emergency equipment.

What is postoperative airway obstruction?

Blocked airflow that can impair ventilation and oxygenation.

What is hypoxemia?

Abnormally low oxygen in the blood.

What is atelectasis?

Collapse of alveoli that reduces effective gas exchange.

What are postoperative respiratory complications?

Airway obstruction, hypoxemia, atelectasis, pulmonary edema, aspiration, bronchospasm, hypoventilation, and pulmonary embolism.

How can positioning help prevent postoperative respiratory complications?

Proper positioning promotes airway patency and ventilation.

Why does splinting help after surgery?

It supports the incision during coughing and deep breathing.

What are postoperative cardiovascular complications?

Hypotension, hypertension, and dysrhythmias.

What is emergence delirium?

Acute confusion or agitation during emergence from anesthesia.

What is postoperative cognitive dysfunction?

Cognitive changes that may occur after surgery.

What temperature complications can occur after surgery?

Hypothermia, shivering, fever, and malignant hyperthermia.

What are postoperative gastrointestinal complications?

Nausea, vomiting, constipation, ileus, and hiccups.

What is postoperative ileus?

Temporary slowing or absence of gastrointestinal motility after surgery.

What urinary complication commonly occurs after surgery?

Urinary retention.

What does Catheter-Associated Urinary Tract Infection (CAUTI) mean?

A urinary tract infection associated with an indwelling urinary catheter.

What does Surgical Site Infection (SSI) mean?

An infection involving the surgical incision or operative site.

What is the Modified Aldrete Scoring System used for?

Assessing readiness to progress from Phase I to Phase II recovery.

What is Phase II postoperative care?

Continued observation and recovery before discharge or further care.

What are key priorities in postoperative care?

Control pain, monitor recovery, prevent complications, and promote safe ambulation.

Why is postoperative ambulation important?

It promotes circulation and helps prevent complications such as venous thromboembolism.

What is pain according to McCaffery?

Pain is whatever the person experiencing it says it is.

Why is pain subjective?

The person experiencing the pain is the authority on their pain.

What are the 4 processes of nociception?

Transduction, transmission, perception, and modulation.

What is transduction?

Tissue injury causes chemical mediators to be released.

What is transmission?

Pain impulses travel from the injury toward the brain.

What is perception?

The conscious awareness of pain.

What is modulation?

Descending signals from the brain modify incoming pain impulses.

What is nociceptive pain?

Pain caused by tissue damage.

What is neuropathic pain?

Pain caused by peripheral or central nerve damage.

What words describe neuropathic pain?

Burning, numbing, shooting, stabbing, electric, hot, or itchy.

What words describe nociceptive pain?

Sharp, aching, throbbing, dull, or cramping.

What is somatic pain?

Pain from skin, mucous membranes, bone, joints, muscles, or connective tissue.

What is visceral pain?

Pain from internal organs or body cavities.

What is acute pain?

Sudden pain that usually lasts less than three months.

What is chronic pain?

Pain that continues beyond the normal recovery period.

What sympathetic changes can occur with acute pain?

Increased heart rate, respiratory rate, blood pressure, sweating, and pallor.

What can chronic pain cause?

Decreased activity, fatigue, withdrawal, anxiety, and depression.

What should the nurse assess when assessing pain?

Onset, duration, location, intensity, quality, and associated symptoms.