NUR 303 Exam 3
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1. 1. Describe the surgical experience, including perioperative phases, classifica-
tions of surgery, types of anesthesia, informed consent, and advance directives,
and outpatient/same-day surgery.: 3 phases of the perioperative period:
- Perioperative: begins w/decision to have surgery; ends when pt is transferred to OR
- Intraoperative: begins when pt is transferred to OR; ends when pt is transferred to PACU
- Postoperative: begins when pt is admitted to PACU; ends at complete recovery/last follow-up
Purpose of surgeries:
- Diagnostic: make/confirm a diagnosis
- Ablative: remove a diseased body part
- Palliative: relieve/reduce intensity of an illness
- Reconstructive: restore function to traumatized/malfunctioning tissue
- Transplant: replace a diseased/malfunctioning organ
- Constructive: restore function in congenital anomalies
Types of anesthesia:
- General: inhalation/IV; CNS depression; vent needed; NPO prior
- Moderate sedation/Analgesia: conscious sedation; short-term minimally invasive procedures; pain controlled
- Regional: injected near nerve/nerve pathway or around operative site; pt is awake
- Topical/local: pt is awake; only affects area of procedure
Informed Consent: description of procedure & alternative therapies, disease process, surgeon/physician info, risks,
right of refusal/withdraw, expected outcome, recovery/rehab, treatment, etc. (must be done before pain meds
administration)
Advanced Directives: allow pts to specify instructions for treatment should they be unable to communicate postop (living
wills, durable POA)
Outpt/Same-Day Surgery: reduces length of stay; cuts costs; reduces stress; may require additional teaching/home care
services
2. 1. Consider preoperative nursing assessment to identify factors that increase
risks for surgical and postoperative complications.: - developmental level (older adult)
- medical history (CVD, respiratory disorders, kidney/liver diseases, endocrine diseases)
, NUR 303 Exam 3
Study online at https://quizlet.com/_hma8r1
- surgical history (previous complications, latex sensitivity, pneumonia, thrombophlebitis, DVT, thrombus, infection)
- medication history
- nutritional status (malnutrition/obesity)
- use of alcohol, nicotine, drugs (alcohol/drugs require higher doses of anesthesia, nicotine use warrants higher risk
of respiratory complications)
- ADLs & occupation (active vs sedentary)
- coping patterns/support system (fears, resources)
- sociocultural needs (beliefs about surgery, individualized nursing care needs)
Medication risks:
- Anticoagulants (hemorrhage)
- Diuretics (electrolyte imbalance, respiratory depression)
- Tranquilizers (hypotension)
- Adrenal steroids (CV collapse due to abrupt withdrawal
- Antibiotics in mycin group (respiratory paralysis when combined with certain muscle relaxants)
3. 1. Discuss preparation of a patient physically and psychologically for surgery.-
: Presurgical screening:
Common tests:
- chest x-ray
- ECG
- complete WBC count
- electrolyte levels
- UA
Nursing care:
- explain tests to pt
- record results before surgery
- report abnormals
Nursing interventions:
- establish therapeutic relationship
- allow pt to verbalize concerns
- use active listening
, NUR 303 Exam 3
Study online at https://quizlet.com/_hma8r1
- use open-ended questions
- use touch to demonstrate genuine empathy
- be prepared to respond to common questions
Prepping for surgery:
- physician visit for informed consent
- anesthesiologist/anesthetist visit
- physical prep (NPO, meds, preop checklist)
- show visitors to waiting room & tell them what to expect
Preop:
- teach pain management (timing to request, ambulation, stay on top, splinting incision, alternatives)
- teach physical activities (deep breathing, coughing, IS, leg exercises, turning, early ambulation)
- skin prep
- elimination (foley)
- nutrition/fluids (NPO prior, IV fluids after)
- rest & sleep
verify consent is signed
TJC Protocol:
- preoperative pt ID
- marking operative site
- final verification ("time out")
- OR nurse transfers pt & does safety checks
4. 1. Identify assessments and interventions specific to the prevention of com-
plications in the immediate and early postoperative phases.: Every 10-15 mins:
- respiratory status (airway, SpO2)
- CV status (BP)
- temp
- CNS status (LOC, movement)
- fluid status
- wound status
Study online at https://quizlet.com/_hma8r1
1. 1. Describe the surgical experience, including perioperative phases, classifica-
tions of surgery, types of anesthesia, informed consent, and advance directives,
and outpatient/same-day surgery.: 3 phases of the perioperative period:
- Perioperative: begins w/decision to have surgery; ends when pt is transferred to OR
- Intraoperative: begins when pt is transferred to OR; ends when pt is transferred to PACU
- Postoperative: begins when pt is admitted to PACU; ends at complete recovery/last follow-up
Purpose of surgeries:
- Diagnostic: make/confirm a diagnosis
- Ablative: remove a diseased body part
- Palliative: relieve/reduce intensity of an illness
- Reconstructive: restore function to traumatized/malfunctioning tissue
- Transplant: replace a diseased/malfunctioning organ
- Constructive: restore function in congenital anomalies
Types of anesthesia:
- General: inhalation/IV; CNS depression; vent needed; NPO prior
- Moderate sedation/Analgesia: conscious sedation; short-term minimally invasive procedures; pain controlled
- Regional: injected near nerve/nerve pathway or around operative site; pt is awake
- Topical/local: pt is awake; only affects area of procedure
Informed Consent: description of procedure & alternative therapies, disease process, surgeon/physician info, risks,
right of refusal/withdraw, expected outcome, recovery/rehab, treatment, etc. (must be done before pain meds
administration)
Advanced Directives: allow pts to specify instructions for treatment should they be unable to communicate postop (living
wills, durable POA)
Outpt/Same-Day Surgery: reduces length of stay; cuts costs; reduces stress; may require additional teaching/home care
services
2. 1. Consider preoperative nursing assessment to identify factors that increase
risks for surgical and postoperative complications.: - developmental level (older adult)
- medical history (CVD, respiratory disorders, kidney/liver diseases, endocrine diseases)
, NUR 303 Exam 3
Study online at https://quizlet.com/_hma8r1
- surgical history (previous complications, latex sensitivity, pneumonia, thrombophlebitis, DVT, thrombus, infection)
- medication history
- nutritional status (malnutrition/obesity)
- use of alcohol, nicotine, drugs (alcohol/drugs require higher doses of anesthesia, nicotine use warrants higher risk
of respiratory complications)
- ADLs & occupation (active vs sedentary)
- coping patterns/support system (fears, resources)
- sociocultural needs (beliefs about surgery, individualized nursing care needs)
Medication risks:
- Anticoagulants (hemorrhage)
- Diuretics (electrolyte imbalance, respiratory depression)
- Tranquilizers (hypotension)
- Adrenal steroids (CV collapse due to abrupt withdrawal
- Antibiotics in mycin group (respiratory paralysis when combined with certain muscle relaxants)
3. 1. Discuss preparation of a patient physically and psychologically for surgery.-
: Presurgical screening:
Common tests:
- chest x-ray
- ECG
- complete WBC count
- electrolyte levels
- UA
Nursing care:
- explain tests to pt
- record results before surgery
- report abnormals
Nursing interventions:
- establish therapeutic relationship
- allow pt to verbalize concerns
- use active listening
, NUR 303 Exam 3
Study online at https://quizlet.com/_hma8r1
- use open-ended questions
- use touch to demonstrate genuine empathy
- be prepared to respond to common questions
Prepping for surgery:
- physician visit for informed consent
- anesthesiologist/anesthetist visit
- physical prep (NPO, meds, preop checklist)
- show visitors to waiting room & tell them what to expect
Preop:
- teach pain management (timing to request, ambulation, stay on top, splinting incision, alternatives)
- teach physical activities (deep breathing, coughing, IS, leg exercises, turning, early ambulation)
- skin prep
- elimination (foley)
- nutrition/fluids (NPO prior, IV fluids after)
- rest & sleep
verify consent is signed
TJC Protocol:
- preoperative pt ID
- marking operative site
- final verification ("time out")
- OR nurse transfers pt & does safety checks
4. 1. Identify assessments and interventions specific to the prevention of com-
plications in the immediate and early postoperative phases.: Every 10-15 mins:
- respiratory status (airway, SpO2)
- CV status (BP)
- temp
- CNS status (LOC, movement)
- fluid status
- wound status
