NUR 145 Module A- Surgery Review
Questions and Correct Answers
Perioperative phase ✅-period of time that constitutes the Surgical experience
-consists of three phases
1) preoperative Phase
2) intraoperative Phase
3) postoperative Phase
Preoperative phase ✅period of time from when the decision for surgical interventions
is made to when the patient is transferred to the OR table
Intraoperative phase ✅period of time that begins with transfer of the patient to the OR
area and continues until the patient is admitted to the postanesthsia care unit (PACU)
Postoperative phase ✅period of time that begins with the admission of the patient to
the post anesthesia care unit (PACU) and ends after follow-up evaluation in the clinical
setting or home
Categories of surgery based on urgency ✅1) emergent (pt requires IMMEDIATE
attention; disorder may be life-threatening)
-without delay
-Ex: severe bleeding, fractured skull, gunshot or stab wounds
2) urgent (pt requires PROMPT attention)
-within 24-30 hours
-Ex: acute gallbladder infection, kidney or uretheral stones
3) required (pt NEEDS to have the surgery)
-within a few weeks or months
-Ex: thyroid disorders, cataracts
4) elective (patient SHOULD have surgery)
-failure to have surgery is not catastrophic
-Ex: repair of scars, hernia, vaginal repair
5) optional (decision rests with the pt)
-personal preference
-Ex: cosmetic surgery
Preoperative Assessment ✅-nutritional, fluid status
-dentition
-drug/alcohol use
, -oxygenation
-perfusion
-hepatic & renal function
-endocrine function
-immune function
-psychosocial factors
-spiritual & cultural Factors
Nutrition and fluid status (preop assessment) ✅-optimal nutrition is needed for healing
& resisting infection
-identify factors such as obesity, weight loss, malnutrition, deficiencies in specific
nutrients, metabolic abnormalities, & effects of medication on nutrition that may affect
the pt's surgical course
-nutritional needs determined by BMI & waist circumference
-nutritional deficiencies should be corrected BEFORE surgery to provide adequate
protein for tissue repair
-assess patient for HYDRATION status (turgor, urinalysis, edema, crackles in lungs)
Dentition (preop assessment) ✅-dental caries (decayed teeth), dentures & partial
plates are significant to anesthesiologist (could become dislodged during intubation,
occluding the airway)
-assessment of the mouth is also important because any bodily infections, even in the
mouth, can be a source of post-op Infection
Drug & alcohol use (preop assessment) ✅-ingesting moderate amounts of alcohol
before surgery can weaken pt's immune system, & increases the chance of post-op
complications
-illicit drugs & alcohol may impede effectiveness of some medications (need more
anesthesia usually)
-pt who suffers from alcohol abuse often suffers from malnutrition, other systemic
problems or metabolic imbalances, this increases surgical risk
-ask frank questions in nonjudgmental way
Oxygenation (preop assessment) ✅-educate pt about breathing exercises
-educate about use of incentive spirometry
-pt's who smoke are urged to stop 30 DAYS BEFORE surgery to reduce pulmonary &
wound healing complications
-pt's who smoke are more likely to experience delayed wound healing & complications
such as pneumonia
-pt's with underlying chronic respiratory illnesses are assessed carefully for threats to
their pulmonary status
Perfusion (preop assessment) ✅-pt preparation for surgery includes ensuring that the
cardiovascular system can support the oxygen, fluid & nutritional needs of the
perioperative period
-if pt has uncontrolled HTN, surgery is postponed until BP is regulated
Questions and Correct Answers
Perioperative phase ✅-period of time that constitutes the Surgical experience
-consists of three phases
1) preoperative Phase
2) intraoperative Phase
3) postoperative Phase
Preoperative phase ✅period of time from when the decision for surgical interventions
is made to when the patient is transferred to the OR table
Intraoperative phase ✅period of time that begins with transfer of the patient to the OR
area and continues until the patient is admitted to the postanesthsia care unit (PACU)
Postoperative phase ✅period of time that begins with the admission of the patient to
the post anesthesia care unit (PACU) and ends after follow-up evaluation in the clinical
setting or home
Categories of surgery based on urgency ✅1) emergent (pt requires IMMEDIATE
attention; disorder may be life-threatening)
-without delay
-Ex: severe bleeding, fractured skull, gunshot or stab wounds
2) urgent (pt requires PROMPT attention)
-within 24-30 hours
-Ex: acute gallbladder infection, kidney or uretheral stones
3) required (pt NEEDS to have the surgery)
-within a few weeks or months
-Ex: thyroid disorders, cataracts
4) elective (patient SHOULD have surgery)
-failure to have surgery is not catastrophic
-Ex: repair of scars, hernia, vaginal repair
5) optional (decision rests with the pt)
-personal preference
-Ex: cosmetic surgery
Preoperative Assessment ✅-nutritional, fluid status
-dentition
-drug/alcohol use
, -oxygenation
-perfusion
-hepatic & renal function
-endocrine function
-immune function
-psychosocial factors
-spiritual & cultural Factors
Nutrition and fluid status (preop assessment) ✅-optimal nutrition is needed for healing
& resisting infection
-identify factors such as obesity, weight loss, malnutrition, deficiencies in specific
nutrients, metabolic abnormalities, & effects of medication on nutrition that may affect
the pt's surgical course
-nutritional needs determined by BMI & waist circumference
-nutritional deficiencies should be corrected BEFORE surgery to provide adequate
protein for tissue repair
-assess patient for HYDRATION status (turgor, urinalysis, edema, crackles in lungs)
Dentition (preop assessment) ✅-dental caries (decayed teeth), dentures & partial
plates are significant to anesthesiologist (could become dislodged during intubation,
occluding the airway)
-assessment of the mouth is also important because any bodily infections, even in the
mouth, can be a source of post-op Infection
Drug & alcohol use (preop assessment) ✅-ingesting moderate amounts of alcohol
before surgery can weaken pt's immune system, & increases the chance of post-op
complications
-illicit drugs & alcohol may impede effectiveness of some medications (need more
anesthesia usually)
-pt who suffers from alcohol abuse often suffers from malnutrition, other systemic
problems or metabolic imbalances, this increases surgical risk
-ask frank questions in nonjudgmental way
Oxygenation (preop assessment) ✅-educate pt about breathing exercises
-educate about use of incentive spirometry
-pt's who smoke are urged to stop 30 DAYS BEFORE surgery to reduce pulmonary &
wound healing complications
-pt's who smoke are more likely to experience delayed wound healing & complications
such as pneumonia
-pt's with underlying chronic respiratory illnesses are assessed carefully for threats to
their pulmonary status
Perfusion (preop assessment) ✅-pt preparation for surgery includes ensuring that the
cardiovascular system can support the oxygen, fluid & nutritional needs of the
perioperative period
-if pt has uncontrolled HTN, surgery is postponed until BP is regulated
