NUR 227 Perioperative Nursing Review
Questions and Correct Answers
What are the 3 phases of perioperative care? ✅pre-operative/pre-anesthesia
Intraoperative
Postoperative/post-anesthesia-PACU and beyond
Which phase involves:
Nursing and anesthesia provider assessment
Planning of care
Interventions to prepare for surgical procedure ✅preoperative phase
Which phase involves:
Starts when patient is wheeled into OR and ends when transferred to immediate
postoperative recovery area (PACU)
Nurses assume several roles in phase (RNFA, scrub nurse, circulating nurse)
✅intraoperative phase
Which phase involves:
Immediate period usually spent in PACU
PACU nursing care focused on recovery from general anesthesia, airway management,
pain management and close observation of physiologic indicators
Ongoing postoperative care in ICU, step-down or med-surg units ✅postoperative
phase
What are some purposes of surgery? ✅diagnosis (ex. Biopsy)
Cure (ex. Removal of tumor)
Palliation (ex. Comfort like remove something due to pain)
Prevention (ex. Remove breast tissue to prevent cancer)
Exploration (ex. Surgeon looking to see what is going on)
Cosmetic improvement (ex. Rhinoplasty)
Which type of surgery "comes in, has surgery and goes home on the same day"?
✅ambulatory
Ex. Deviated septum
Which type of surgery "comes in for surgery and then is a post-op admit"? ✅same day
admit
Ex. More advanced surgery like bowel surgery
Which type of surgery "already admitted to hospital, has surgery, stays post-op"?
✅inpatient-admitted
Ex. Admitted for appendix issue but turned into more bowel issues
, Improves quality of life (physical or psychological) - cataract or breast reduction
Time not essence in scheduling
General risks: bleeding, infection, anesthetic exposure
Relatively low mortality/ morbidity risk ✅elective surgery
More time sensitive
Not required within 24 hours, but scheduling should be considered a priority -
cholecystectomy for gallstone removal, uterine artery ablation for postmenopausal
bleeding from fibroids
Relatively low morbidity and mortality risk ✅semi-elective surgery
Required within 24 hours of diagnosis
Done to prevent unnecessary complications that can occur with waiting - hip fracture
repair, appendenctomy ✅urgent surgery
Cannot be delayed and must occur w/in 24 hours; ideally scheduled w/in 2 hours
Any day = promotes critical injury or systemic deterioration; required as result of an
urgent medical condition - stabilize a GI bleed, subdural hematoma ✅emergency
surgery
The patient interview/history entails... ✅checking documented info prior to interview
(avoids repetition)
Occurs in advance or on day of surgery
Purpose: obtain health info, determine expectations, provide and clarify info on
procedure, assess emotional state and readiness
What are the 8 steps of patient interview/history? ✅*look at details
1. Explore patient's understanding
2. Ask about previous surgeries and anesthetics
3. Ask about the patient's family health history (adverse reactions like malignant
hyperthermia)
4. Ask about current med use, including prescription, OTC, and herbal meds
5. Ask about medication allergies/intolerances *also non-drug allergies
6. Ask about recreational drug use, abuse, addiction in same way you asked about
current medication use
7. Ask about tobacco use
8. Ask about possible pregnancy - use last date of menstrual period or use ordered UPT
What is the most important non-drug allergy to consider? ✅latex (either irritant-non
allergy aka skin or type I aka true allergy)
Risk factors:
- hx anaphylactic reaction during procedure
- multiple surgical procedures
- food allergies (kiwi, banana, avocado, chestnuts)
Questions and Correct Answers
What are the 3 phases of perioperative care? ✅pre-operative/pre-anesthesia
Intraoperative
Postoperative/post-anesthesia-PACU and beyond
Which phase involves:
Nursing and anesthesia provider assessment
Planning of care
Interventions to prepare for surgical procedure ✅preoperative phase
Which phase involves:
Starts when patient is wheeled into OR and ends when transferred to immediate
postoperative recovery area (PACU)
Nurses assume several roles in phase (RNFA, scrub nurse, circulating nurse)
✅intraoperative phase
Which phase involves:
Immediate period usually spent in PACU
PACU nursing care focused on recovery from general anesthesia, airway management,
pain management and close observation of physiologic indicators
Ongoing postoperative care in ICU, step-down or med-surg units ✅postoperative
phase
What are some purposes of surgery? ✅diagnosis (ex. Biopsy)
Cure (ex. Removal of tumor)
Palliation (ex. Comfort like remove something due to pain)
Prevention (ex. Remove breast tissue to prevent cancer)
Exploration (ex. Surgeon looking to see what is going on)
Cosmetic improvement (ex. Rhinoplasty)
Which type of surgery "comes in, has surgery and goes home on the same day"?
✅ambulatory
Ex. Deviated septum
Which type of surgery "comes in for surgery and then is a post-op admit"? ✅same day
admit
Ex. More advanced surgery like bowel surgery
Which type of surgery "already admitted to hospital, has surgery, stays post-op"?
✅inpatient-admitted
Ex. Admitted for appendix issue but turned into more bowel issues
, Improves quality of life (physical or psychological) - cataract or breast reduction
Time not essence in scheduling
General risks: bleeding, infection, anesthetic exposure
Relatively low mortality/ morbidity risk ✅elective surgery
More time sensitive
Not required within 24 hours, but scheduling should be considered a priority -
cholecystectomy for gallstone removal, uterine artery ablation for postmenopausal
bleeding from fibroids
Relatively low morbidity and mortality risk ✅semi-elective surgery
Required within 24 hours of diagnosis
Done to prevent unnecessary complications that can occur with waiting - hip fracture
repair, appendenctomy ✅urgent surgery
Cannot be delayed and must occur w/in 24 hours; ideally scheduled w/in 2 hours
Any day = promotes critical injury or systemic deterioration; required as result of an
urgent medical condition - stabilize a GI bleed, subdural hematoma ✅emergency
surgery
The patient interview/history entails... ✅checking documented info prior to interview
(avoids repetition)
Occurs in advance or on day of surgery
Purpose: obtain health info, determine expectations, provide and clarify info on
procedure, assess emotional state and readiness
What are the 8 steps of patient interview/history? ✅*look at details
1. Explore patient's understanding
2. Ask about previous surgeries and anesthetics
3. Ask about the patient's family health history (adverse reactions like malignant
hyperthermia)
4. Ask about current med use, including prescription, OTC, and herbal meds
5. Ask about medication allergies/intolerances *also non-drug allergies
6. Ask about recreational drug use, abuse, addiction in same way you asked about
current medication use
7. Ask about tobacco use
8. Ask about possible pregnancy - use last date of menstrual period or use ordered UPT
What is the most important non-drug allergy to consider? ✅latex (either irritant-non
allergy aka skin or type I aka true allergy)
Risk factors:
- hx anaphylactic reaction during procedure
- multiple surgical procedures
- food allergies (kiwi, banana, avocado, chestnuts)
