Surgery/Post-op/Pre-op Flashcards

  • Malignant Hyperthermia

    • This is a genetic, life-threatening complication of anesthesia

  • Tachypnea, tachycardia, unstable blood pressure, cyanosis, skin modeling, muscle rigidity

  • Surgeon

    • The surgeon is responsible for discussing the patient’s status, surgery results, and surgery complications with the patient and family.

    • You can witness but not perform the consent (give the information)

  • Wound evisceration

    • The protrusion of internal organs and tissues through an incision

  • Obstructive Sleep Apnea 

    • This condition causes breathing to stop and start repeatedly during sleep. It increases the risk of apnea and oxygen desaturation during surgical procedures. 

  • Silvadene Cream

    • This medication primarily prevents or treats wound infections in second-and third-degree burns and other wound infections as prescribed by the provider. It has antimicrobial properties and should only be used ON THE WOUND ITSELF.

  • Perioperative nursing

    • This is a type of nursing that includes activities that are performed by an RN before, during, and after surgery.

  • Pneumonia

    • This common post-op complication is caused by poor lung expansion and retained pulmonary secretions. S/S include fever, chills, productive cough, chest pain, purulent mucus, and dyspnea.

  • Sensory preparation

    • This is an important thing to discuss with patients in the pre-operative phase. It is important to discuss sensations that are typically experienced after surgery. (Ex. OR is bright and cold)

  • Pre-op teaching

    • This is an important part of nursing care prior to surgery. It includes discussing with the patient what tests they’ll have prior to surgery, when/what they’ll be able to eat before and after surgery, reasons for delays in surgery, pain management options, and sensations typically experienced after surgery.

  • Priorities

    • For the first 24 hours after surgery, the highest priority is maintaining respiratory, CV, and neuro status, as well as wound management and pain control. 

  • Smoking

    • If a pt has a history of smoking, it is important to plan for aggressive pulmonary hygiene after surgery- including frequent turning, deep breathing and coughing, and frequent incentive spirometer use.

  • Paralytic ileus

    • This is the loss of intestinal function. It is important to watch for this condition after surgery. S/S include abdominal distention and discomfort and faint/absent bowel sounds. 

  • Nausea/Vomiting

    • This post-op condition affects approximately 30% of patients in the PACU and can lead to pulmonary aspiration, dehydration, and arrhythmias resulting from fluid/electrolyte imbalances. 

  • Wound dehiscence

    • This is the separation of wound edges at the suture line caused by unusual strain on the suture line from coughing. Malnutrition, obesity, old age, and poor circulation also contribute to this. 

  • Assessment

    • Depending on the patient's condition, the RN completes an assessment at least every 15 minutes in the PACU or more frequently.

  • Glucose Control

    • This is an important factor in pre-op patients. If this is not well-controlled, risks for adverse outcomes, including wound infection, circulatory impairment, hyperglycemia, and mortality increase. 

  • Patient

    • As a nurse, it is important to discuss expectations of surgery and expected recovery time with this person before a surgical procedure.

  • Ambulatory surgery

    • With this type of surgery, the patient's family or caregiver is responsible for the post-op care and should be included in education on the surgery and post-op care.

  • Elderly

    • This portion of the population is more likely to have surgical complications due to multiple physiological factors, including increased skin fragility, degenerative changes in the myocardium and heart valves, decreased respiratory muscle strength, decreased renal function, sensory losses, lower hemoglobin levels, and decreased reaction time.

  • Chronic Respiratory Disease

    • Emphysema, bronchitis, asthma

      • A patient who undergoes surgery and has a history of this medical condition may encounter surgical complications, including reduced respiratory function and severe hypoventilation.

  • Informed consent

    • This is required before surgery (except in emergencies) and should be obtained by the surgeon.

  • Bowel Prep

    • This is part of the pre-op phase for a patient who is having surgery that involves the lower GI tract and often includes the use of enemas and/or laxatives.

  • Cardiovascular

    • In the immediate post-op period, patients are at risk for developing complications with this body system due to blood loss, anesthesia, and electrolyte imbalances.

  • Self-concept

    • Patients with a positive self-concept are more likely to adapt to the stress of surgery well and approach surgical experiences positively and appropriately.

  • Venous thromboembolism/DVT

    • This is considered a “never event” after a total hip or knee surgery because it is usually preventable. It can be prevented via IPC/SCD cuffs, compression stockings, early ambulation, anticoagulants, adequate hydration, and leg exercises.

    • S/S- Calf pain, swelling, redness, warm, tender

  • Obesity

    • This surgical risk factor increases a patient’s risk for atelectasis, pneumonia, pressure ulcers, blood clots, poor wound healing, and death.

  • Classification of surgery

    • This can be based on a surgical procedure:

      • Seriousness (major or minor surgery)

      • Urgency (elective, urgent, or emergent)

      • Purpose (diagnostic, palliative, reconstructive, transplant, cosmetic, ablative (removal of tissue))

  • Alcohol Abuse

    • Patients who undergo surgery and have a history of this may have unpredictable reactions to anesthesia and go into withdrawal during and after surgery.

  • Operating Room

    • After surgery, the nurse that will be caring for the patient in the PACU should get report from the nurse in the OR.

    • Estimated blood loss (EBL), types of anesthesia, meds received, vitals, IVF (IV fluids), Urine loss, surgical wound information\

  • Hemorrhage

    • This is the loss of a large amount of blood in a short amount of time and can occur during or after surgery. 

    • S/S include hypotension, weak and rapid pulse, cool and clammy skin, rapid breathing, restlessness, and reduced urine output.

    • Patients with coagulation disorders are at an increased risk.

  • Diagnostic screening

    • Before surgery, pt with pre-existing conditions may need to have this type of testing performed to decrease the risk of significant complications. 

      • Ex. An ECG may be needed before surgery for a pt with a history of heart disease.

  • Cough/Deep breathe

    • These are important nursing interventions for most post-op patients; however, they may be contraindicated in post-op pts who had brain, spinal, head, neck, or eye surgery.

  • Occupation

    • Before surgery, it is important to discuss this with a pt, as surgery often results in physical limitations that may affect a patient’s ability to return to work.

  • Urgent

    • This is a type of surgical classification in which the procedure is necessary for a patient's health and often prevents the development of additional problems but is not necessarily an emergency

      • Ex. Excision of cancerous tumor, removal of the gallbladder for stones