ATI Med-Surg Exam 1 Surgery

preoperative - decision to have surgery to operating room intraoperative - operating room to post anesthesia care unit postoperative - PACU, admit as an in patient, discharge home, follow up. medication reconciliation - A procedure to maintain an accurate and up-to-date list of medications for all patients between all phases of health care delivery. respiratory/ cardiovascular - surgery is delayed if issues arise in either of these systems bilirubin, albumin, ALT, AST - if these values are elevated then there is something wrong with the liver drug toxicity - if something is wrong with the liver then there may be ______ due to anesthesia, because liver metabolizes drugs medicine - if kidneys are not functioning then they cannot excrete ____ which can also lead drug toxicity 0.5-1.5 - normal creatinine levels 10-20 - normal BUN levels concentrated - BUN levels tell you how ____ the blood is high - BUN is not as accurate because if you eat a high protein diet, or are dehydrated, then you BUN levels would be ____ infection, wound healing - if patient is hyperglycemic before surgery then this can cause _____ and delay ______ blood pressure, heart rate - if patient has hyperthyroidism then they could have high ____ and high ____ before surgery nutrition - check albumin levels for wound healing - if a patient is malnourished then this could affect ____ low blood pressure - if patient is dehydrated then they could have Dentition - if patients need to be intubated, a tooth can be knocked into their lungs if you are not aware of their dental condition bleeding - if patient is taking aspirin, ibuprofen, herbal supplements, this can increase their risk for 3.5-5 - normal albumin level latex, drug, iodine - allergies that need to be acknowledged before surgery how is obesity a surgical risk - fatty tissue is at risk for infection, more difficult to suture so they are at risk for wound separation how is pregnancy a surgical risk - not only dealing with mom, but you may be compromising baby as well how is age a surgical risk - the ability for your body to return to normal function after surgery is diminished how are immunocompromised patients a surgical risk - harder to heal, immune system doesn't work well, risk for infection how is dehydration a surgical risk - if a patient is dehydrated the cardiovascular system is compromised and they can have hypotension and tachycardio hypovolemia - decreased blood volume how are systemic problems a surgical risk - if a patient has renal failure, there will be fluid buildup, heart will be overloaded, lungs will be filled with fluid. to improve circulation, and get GI system moving - why do you want patients to ambulate after surgery to keep lungs active - why do we encourage deep breathing, coughing, and incentive spirometry before/ after surgery preparing the bowel - a cleansing enema or laxative may be prescribed the evening before surgery and may be repeated the morning of surgery preparing the skin - disinfect the skin, you can trim hair if patient is hairy, DO NOT SHAVE the patient - the person undergoing the procedure the surgeon - performs the surgical procedure the anesthesiologist/CRNA - Assesses the patient before surgery, selects the anesthesia, administers it, intubates the patient if necessary, manages any technical problems related to the administration of the anesthetic agent, and supervises the patient's condition throughout the surgical procedure. the circulating nurse - Nurse who assists the surgeon and scrub nurse by providing needed materials during the procedure and by handling the surgical specimen. This person does not wear sterile clothing and may enter and leave the operating room during the procedure. the scrub nurse - a nurse who assists surgeons during surgery, wearing sterile attire and handling sterile equipment and supplies difficult intubation - potential intra op complication associated with problems with airways nausea and vomiting - potential intraop complication associated with GI tract anaphylaxis - potential intraop complication that is known as a severe allergic reaction hypoxia/ respiratory complications - potential intraop complication that is associated with lack of oxygen hypothermia - potential intraop complication that is associated with low body temperature malignant hyperthermia - potential intraop complication that is defined as a sudden rise in patients core body temperature that is also accompanied by hypertension and tachycardia dantrolene sodium - given to reverse effects of malignant hyperthermia maintain patent airway, maintain cardiovascular stability, relieve pain and anxiety, and control nausea and vomiting - priority goals of post-operative care hypopharyngeal obstruction - When the patient lies on his or her back, the lower jaw and the tongue fall backward and the air passages become obstructed hemorrhage - excessive bleeding hypotension - low blood pressure shock - A condition in which the circulatory system fails to provide sufficient circulation to enable every body part to perform its function; also called hypoperfusion.