CCTC NUR 120 UNIT 1C: PERIOPERATIVE
NURSING
Surgeries classified according to: - ANSWERSpurpose, degree of risk, and degree of urgency
Emergent surgery- - ANSWERSHave to have the surgery to live
Urgent surgery - ANSWERSthe surgery is necessary
Elective surgery- - ANSWERSpatients choice to have the surgery
Surgery as a stressor. What causes anxiety? - ANSWERShow they will afford it, fear of what will happen, who
will take care of kids, how they will perform ADLs
General Adaptation Syndrome (GAS): - ANSWERShas three phases: alarm, resistance, and exhaustion
Sympathetic Nervous System "Fight or Flight" Response to surgery: - ANSWERSEpinephrine, norepinephrine
and cortisol levels elevate. Heart rate and heart strength will elevate. Blood vessels will constrict in skin, guts,
and kidneys. Together this causes an increased BP and decreased blood
Neuroendocrine Responses to Surgery: - ANSWERSincreased aldosterone levels, production of ADH,
production of glucocorticoids, and blood sugar
Metabolic Responses to Surgery: - ANSWERSIncreased metabolic rate: kidney retains Na & H2O, Increased BP
/ blood volume, Glycogen to glucose, Suppress immune system
Factors Affecting Patient Response to Surgery: - ANSWERSDiversity, Age, Nutrition, Dentition, Drug or Alcohol
Abuse, Chronic disease & disabilities, Drug therapy
, Geriatric Response to Surgery: - ANSWERSCardiac reserves, renal and hepatic functions, and GI activity are all
likely to be decreased
Informed Consent- - ANSWERSis the patient's autonomous decision about whether to undergo a surgical
procedure.
When does an informed consent need to be signed by the patient? - ANSWERSbefore sedation
Nurse's responsibility with an informed consent? - ANSWERStwo nurses witness that the patient understands
the procedure and both nurses have to sign the form if they feel like the patient understands
Who signs the informed consent? - ANSWERSThe patient as long as they are alert and oriented. Family
members can sign if patient isn't able to sign. Telephone consent can be done if they aren't able to get to the
hospital. If someone speaks another language there needs to be a translator to translate the message to the
patient and then the patient can sign.
Informed consent should contain the following: - ANSWERSExplanation of procedure and its risks, Description
of pros and cons, An offer to answer questions about procedure, Instructions that the patient may withdraw
consent, A statement informing the patient if the protocol differs from the customary procedure
Preoperative Nursing Interventions: - ANSWERSBeginning with the nursing hx and physical examination, list of
medications taken routinely, hx of allergies, surgical and anesthetic hx, the patient's overall health status, level
of experience, and understanding may be established.
Psychological Preparation for the patient before surgery: - ANSWERSGive them information regarding surgery
with confidence, anxiety reduction techniques, and teach them at the appropriate time
When is preoperative patient education initiated? - ANSWERSAs soon as possible, beginning in the physician's
office, in the clinic, or at the time of Pre-Admission Testing when diagnostic tests are performed.
principals of patient teaching: - ANSWERSpatient readiness assessment
Preoperative instructions to prevent postoperative complications: - ANSWERSdiaphragmatic breathing,
coughing, leg exercises, turning to the side, getting out of bed, maintain patient safety, Medications the night
before surgery, Preventing Wound Infection/Skin Prep, Promote sleep and rest
NURSING
Surgeries classified according to: - ANSWERSpurpose, degree of risk, and degree of urgency
Emergent surgery- - ANSWERSHave to have the surgery to live
Urgent surgery - ANSWERSthe surgery is necessary
Elective surgery- - ANSWERSpatients choice to have the surgery
Surgery as a stressor. What causes anxiety? - ANSWERShow they will afford it, fear of what will happen, who
will take care of kids, how they will perform ADLs
General Adaptation Syndrome (GAS): - ANSWERShas three phases: alarm, resistance, and exhaustion
Sympathetic Nervous System "Fight or Flight" Response to surgery: - ANSWERSEpinephrine, norepinephrine
and cortisol levels elevate. Heart rate and heart strength will elevate. Blood vessels will constrict in skin, guts,
and kidneys. Together this causes an increased BP and decreased blood
Neuroendocrine Responses to Surgery: - ANSWERSincreased aldosterone levels, production of ADH,
production of glucocorticoids, and blood sugar
Metabolic Responses to Surgery: - ANSWERSIncreased metabolic rate: kidney retains Na & H2O, Increased BP
/ blood volume, Glycogen to glucose, Suppress immune system
Factors Affecting Patient Response to Surgery: - ANSWERSDiversity, Age, Nutrition, Dentition, Drug or Alcohol
Abuse, Chronic disease & disabilities, Drug therapy
, Geriatric Response to Surgery: - ANSWERSCardiac reserves, renal and hepatic functions, and GI activity are all
likely to be decreased
Informed Consent- - ANSWERSis the patient's autonomous decision about whether to undergo a surgical
procedure.
When does an informed consent need to be signed by the patient? - ANSWERSbefore sedation
Nurse's responsibility with an informed consent? - ANSWERStwo nurses witness that the patient understands
the procedure and both nurses have to sign the form if they feel like the patient understands
Who signs the informed consent? - ANSWERSThe patient as long as they are alert and oriented. Family
members can sign if patient isn't able to sign. Telephone consent can be done if they aren't able to get to the
hospital. If someone speaks another language there needs to be a translator to translate the message to the
patient and then the patient can sign.
Informed consent should contain the following: - ANSWERSExplanation of procedure and its risks, Description
of pros and cons, An offer to answer questions about procedure, Instructions that the patient may withdraw
consent, A statement informing the patient if the protocol differs from the customary procedure
Preoperative Nursing Interventions: - ANSWERSBeginning with the nursing hx and physical examination, list of
medications taken routinely, hx of allergies, surgical and anesthetic hx, the patient's overall health status, level
of experience, and understanding may be established.
Psychological Preparation for the patient before surgery: - ANSWERSGive them information regarding surgery
with confidence, anxiety reduction techniques, and teach them at the appropriate time
When is preoperative patient education initiated? - ANSWERSAs soon as possible, beginning in the physician's
office, in the clinic, or at the time of Pre-Admission Testing when diagnostic tests are performed.
principals of patient teaching: - ANSWERSpatient readiness assessment
Preoperative instructions to prevent postoperative complications: - ANSWERSdiaphragmatic breathing,
coughing, leg exercises, turning to the side, getting out of bed, maintain patient safety, Medications the night
before surgery, Preventing Wound Infection/Skin Prep, Promote sleep and rest
