NR 226 Perioperative Nursing
Pre-operative - answer begins with decision to have surgery, lasts until patient is
transferred to operating room
intraoperative - answer extends from admission to surgical department to transfer to
recovery room
postoperative - answer lasts from admission to recovery room to a follow-up evaluation
in the clinical setting or home
classifications of surgical procedures - answer urgency
major or minor risk
purpose
purposes for surgery - answerdiagnostic
ablative
pallitative
reconstructive
transplantation
constructive
types of anesthesia - answergeneral
regional
topical
local
conscious sedation
general anesthesia - answeradministration of drugs by inhalation, intravenous, rectal, or
oral route
regional anesthesia - answeranesthetic agent injected near a nerve or nerve pathway or
around operative site
no sedation
topical anesthesia - answerused on mucous membranes, open skin, wounds, burns
conscious anesthesia - answerused for short-term procedures
three phases of general anesthesia - answerinduction—from administration of
anesthesia to ready for incision
, maintenance—from incision to near completion of procedure
emergence—starts when patient emerges from anesthesia and is ready to leave
operating room
informed consent information - answerdescription of procedure and alternative therapies
underlying disease process and its natural course
name and qualifications of person performing procedure
explanation of risks and how often they occur
explanation that patient has the right to refuse treatment or withdraw consent
informed consent - answervoluntary Agreement
legal document with ethical imperatives
person performing surgery obtains consent (usually MD)***
nurse witnesses
nurse witnesses for informed consent - answernurse's signature indicates:
patient signed without coercion
patient was alert & aware (competent)
score for PARS to leave PACU - answer8-10
score for PARSAP before discharge - answer18
based on multiple factors including ambulation
may be lower if patient could not use extremities before surgery
ambulatory surgery - answeroutpatient, same day, usually out in 24 hours
may require additional teaching and home care services for certain patients
benefits of ambulatory surgery - answerreduces length of hospital stay and cuts costs
reduces stress for the patient
outcome for surgical patient - answerbe free from injury and adverse effects
be free from infection
maintain fluid and electrolyte balance; skin integrity
demonstrate understanding of physiologic and psychological responses to surgery
participate in rehabilitation process
considerations for adolescents - answermay be more dramatic, sure they are going to
die
explain procedure to both parents and patient
how might smoking affect surgery patients? - answercomplications with anesthesia
Pre-operative - answer begins with decision to have surgery, lasts until patient is
transferred to operating room
intraoperative - answer extends from admission to surgical department to transfer to
recovery room
postoperative - answer lasts from admission to recovery room to a follow-up evaluation
in the clinical setting or home
classifications of surgical procedures - answer urgency
major or minor risk
purpose
purposes for surgery - answerdiagnostic
ablative
pallitative
reconstructive
transplantation
constructive
types of anesthesia - answergeneral
regional
topical
local
conscious sedation
general anesthesia - answeradministration of drugs by inhalation, intravenous, rectal, or
oral route
regional anesthesia - answeranesthetic agent injected near a nerve or nerve pathway or
around operative site
no sedation
topical anesthesia - answerused on mucous membranes, open skin, wounds, burns
conscious anesthesia - answerused for short-term procedures
three phases of general anesthesia - answerinduction—from administration of
anesthesia to ready for incision
, maintenance—from incision to near completion of procedure
emergence—starts when patient emerges from anesthesia and is ready to leave
operating room
informed consent information - answerdescription of procedure and alternative therapies
underlying disease process and its natural course
name and qualifications of person performing procedure
explanation of risks and how often they occur
explanation that patient has the right to refuse treatment or withdraw consent
informed consent - answervoluntary Agreement
legal document with ethical imperatives
person performing surgery obtains consent (usually MD)***
nurse witnesses
nurse witnesses for informed consent - answernurse's signature indicates:
patient signed without coercion
patient was alert & aware (competent)
score for PARS to leave PACU - answer8-10
score for PARSAP before discharge - answer18
based on multiple factors including ambulation
may be lower if patient could not use extremities before surgery
ambulatory surgery - answeroutpatient, same day, usually out in 24 hours
may require additional teaching and home care services for certain patients
benefits of ambulatory surgery - answerreduces length of hospital stay and cuts costs
reduces stress for the patient
outcome for surgical patient - answerbe free from injury and adverse effects
be free from infection
maintain fluid and electrolyte balance; skin integrity
demonstrate understanding of physiologic and psychological responses to surgery
participate in rehabilitation process
considerations for adolescents - answermay be more dramatic, sure they are going to
die
explain procedure to both parents and patient
how might smoking affect surgery patients? - answercomplications with anesthesia
