NUR 314 Exam 1 Peri-Op Perioperative Nursing Exam
1 Study Guide
Surgery
Art and science of treating diseases, injuries, and deformities by operation and instrumentation
patients have surgery for:
Diagnosis
Cure
Palliation
Prevention
Cosmetic improvement
Exploration
surgical settings
- Elective surgery is carefully planned
- Emergency surgery arises with unexpected urgency
- Inpatient (Same-day admission)
- Ambulatory (same day or outpatient)
Ambulatory surgery (same day or outpatient)
• Minimally invasive
• Endoscopy or surgical clinics
• Hospital outpatient surgery clinics
The Nurses Role in surgery:Assessment Exam
- The Joint Commission (TJC) requires a history and physical assessment
,- Enable ACP to rate patient for anesthesia administration
- Indicator of perioperative risk and overall outcome
- Assess results of diagnostic test
- Monitor blood glucose levels with diabetic patients
Patient Interview and Assessment
- Check documented information before interview (Avoids repetition)
- Occurs in advance of or on day of surgery (HCP's office, Ambulatory surgery center, Hospital)
purpose of patient interview and assessment
- Obtain health information, including drug and food allergies
- Provide and clarify information about the surgery and anesthesia
- Assess emotional state and readiness
- Determine expectations
assessment goals
- Identify risk factors
- Plan care to ensure patient safety
- Identify cultural and ethnic factors that may affect surgical experience
- Adequate information from surgeon to make an informed consent for surgery
- Verify consent is signed & witnessed
psychosocial assessment
- Excessive stress response can be magnified and affect recovery
◦ Influencing factors: Age, Experiences with illness and pain, Current health, Socioeconomic status
- Use common words and language
- Use translators if needed: Decreases level of anxiety
,- Communicate all concerns to surgical team
anxiety with surgery
- High anxiety level can impair cognition, decision making, and coping abilities
- Conflict with interventions (i.e., blood transfusions) and religious or cultural beliefs
anxiety can arise from
- Lack of knowledge
- Uncertainty about outcome
- Past experiences and stories
common fears with surgery
- Death or disability: May prompt postponement, Influence outcome
- Pain and discomfort: Confirm drugs will be available, Teach pain intensity scale
- Mutilation/altered body image
- Assess concerns with an accepting attitude
- Anesthesia (Loss of control)
- Disruption of life functioning: Range from fear of permanent disability to temporary limiting of
usual activities, Include family and financial concerns, Consultations as needed
hope with surgery
- May be strongest method of coping
- Never deny or minimize
- Assess and support
health history with surgery
, - Health problems and surgeries
- Understanding of reasons for surgery
- Problems with previous surgeries
- Menstrual/obstetric history
- family health: Inherited traits, Heart and endocrine diseases
- Reactions/problems to anesthesia (Malignant hyperthermia)
current medications with surgery
- Prescription and OTC
- Herbs
- Diet supplements
- Antiplatelets/NSAIDs
- Recreational
- Drugs
- Alcohol
- Tobacco
- Drug intolerances/allergies
- Latex allergy ◦Hay fever ◦Asthma ◦Food allergies
review of body systems
- Confirms the presence or absence of diseases
- Alerts to areas to closely examine
- Provide essential data to determine specific preoperative tests
cardiovascular system
◦12-lead electrocardiogram (ECG/EKG)
◦Coagulation studies (PT/INR)
◦Possible prophylactic antibiotics
1 Study Guide
Surgery
Art and science of treating diseases, injuries, and deformities by operation and instrumentation
patients have surgery for:
Diagnosis
Cure
Palliation
Prevention
Cosmetic improvement
Exploration
surgical settings
- Elective surgery is carefully planned
- Emergency surgery arises with unexpected urgency
- Inpatient (Same-day admission)
- Ambulatory (same day or outpatient)
Ambulatory surgery (same day or outpatient)
• Minimally invasive
• Endoscopy or surgical clinics
• Hospital outpatient surgery clinics
The Nurses Role in surgery:Assessment Exam
- The Joint Commission (TJC) requires a history and physical assessment
,- Enable ACP to rate patient for anesthesia administration
- Indicator of perioperative risk and overall outcome
- Assess results of diagnostic test
- Monitor blood glucose levels with diabetic patients
Patient Interview and Assessment
- Check documented information before interview (Avoids repetition)
- Occurs in advance of or on day of surgery (HCP's office, Ambulatory surgery center, Hospital)
purpose of patient interview and assessment
- Obtain health information, including drug and food allergies
- Provide and clarify information about the surgery and anesthesia
- Assess emotional state and readiness
- Determine expectations
assessment goals
- Identify risk factors
- Plan care to ensure patient safety
- Identify cultural and ethnic factors that may affect surgical experience
- Adequate information from surgeon to make an informed consent for surgery
- Verify consent is signed & witnessed
psychosocial assessment
- Excessive stress response can be magnified and affect recovery
◦ Influencing factors: Age, Experiences with illness and pain, Current health, Socioeconomic status
- Use common words and language
- Use translators if needed: Decreases level of anxiety
,- Communicate all concerns to surgical team
anxiety with surgery
- High anxiety level can impair cognition, decision making, and coping abilities
- Conflict with interventions (i.e., blood transfusions) and religious or cultural beliefs
anxiety can arise from
- Lack of knowledge
- Uncertainty about outcome
- Past experiences and stories
common fears with surgery
- Death or disability: May prompt postponement, Influence outcome
- Pain and discomfort: Confirm drugs will be available, Teach pain intensity scale
- Mutilation/altered body image
- Assess concerns with an accepting attitude
- Anesthesia (Loss of control)
- Disruption of life functioning: Range from fear of permanent disability to temporary limiting of
usual activities, Include family and financial concerns, Consultations as needed
hope with surgery
- May be strongest method of coping
- Never deny or minimize
- Assess and support
health history with surgery
, - Health problems and surgeries
- Understanding of reasons for surgery
- Problems with previous surgeries
- Menstrual/obstetric history
- family health: Inherited traits, Heart and endocrine diseases
- Reactions/problems to anesthesia (Malignant hyperthermia)
current medications with surgery
- Prescription and OTC
- Herbs
- Diet supplements
- Antiplatelets/NSAIDs
- Recreational
- Drugs
- Alcohol
- Tobacco
- Drug intolerances/allergies
- Latex allergy ◦Hay fever ◦Asthma ◦Food allergies
review of body systems
- Confirms the presence or absence of diseases
- Alerts to areas to closely examine
- Provide essential data to determine specific preoperative tests
cardiovascular system
◦12-lead electrocardiogram (ECG/EKG)
◦Coagulation studies (PT/INR)
◦Possible prophylactic antibiotics
