Med-Surg Unit 1 Study Guide Based on Instructor PowerPoints and Ignatavicius et al., 11th Edition
🛌 Perioperative Client Care
Perioperative Phases
• Preoperative: Begins with decision for surgery and ends at OR transfer
• Intraoperative: Begins in OR and ends with PACU admission
• Postoperative: Ends after last follow-up
Key Safety & Communication Systems
• NPSG: National Patient Safety Goals – focus on correct procedure, site, and client
• SBAR: Situation, Background, Assessment, Recommendation
• SCIP: Surgical Care Improvement Project (infection prevention, catheter removal, VTE prophylaxis)
• WHO Surgical Safety Checklist: Team communication, verification, equipment checks
• TeamSTEPPS: Enhances interprofessional teamwork
Risk Factors for Surgical Complications
• Client factors: Age extremes, obesity, comorbidities (DM, renal, cardiac, hepatic, pulmonary), poor
nutrition, infections
• Special risks:
• Malignant hyperthermia: Genetic, triggered by anesthesia (signs: muscle cramps, high temp,
family history)
• Hypothermia: Caused by anesthesia, cold OR, IVs; prevents healing
Preoperative Nursing Interventions
• Informed Consent: Voluntary, informed, documented
• Psychosocial Prep: Address anxiety, spiritual/cultural needs
• Preop Teaching:
• Deep breathing/coughing & splinting
• Turning & leg exercises
• Antiembolism stockings & SCDs
• Early ambulation (step-by-step instructions)
• Pain control: explain scales, strategies
• Checklist: ID, gown, NPO status, voided, vitals, dentures out, jewelry off
Intraoperative Care
• Maintain aseptic field, monitor vitals, manage positioning, and prevent injury
• Verify ID, consent, allergies, surgical site, documentation
Types of Anesthesia
• General: CNS depression; airway control needed
1
🛌 Perioperative Client Care
Perioperative Phases
• Preoperative: Begins with decision for surgery and ends at OR transfer
• Intraoperative: Begins in OR and ends with PACU admission
• Postoperative: Ends after last follow-up
Key Safety & Communication Systems
• NPSG: National Patient Safety Goals – focus on correct procedure, site, and client
• SBAR: Situation, Background, Assessment, Recommendation
• SCIP: Surgical Care Improvement Project (infection prevention, catheter removal, VTE prophylaxis)
• WHO Surgical Safety Checklist: Team communication, verification, equipment checks
• TeamSTEPPS: Enhances interprofessional teamwork
Risk Factors for Surgical Complications
• Client factors: Age extremes, obesity, comorbidities (DM, renal, cardiac, hepatic, pulmonary), poor
nutrition, infections
• Special risks:
• Malignant hyperthermia: Genetic, triggered by anesthesia (signs: muscle cramps, high temp,
family history)
• Hypothermia: Caused by anesthesia, cold OR, IVs; prevents healing
Preoperative Nursing Interventions
• Informed Consent: Voluntary, informed, documented
• Psychosocial Prep: Address anxiety, spiritual/cultural needs
• Preop Teaching:
• Deep breathing/coughing & splinting
• Turning & leg exercises
• Antiembolism stockings & SCDs
• Early ambulation (step-by-step instructions)
• Pain control: explain scales, strategies
• Checklist: ID, gown, NPO status, voided, vitals, dentures out, jewelry off
Intraoperative Care
• Maintain aseptic field, monitor vitals, manage positioning, and prevent injury
• Verify ID, consent, allergies, surgical site, documentation
Types of Anesthesia
• General: CNS depression; airway control needed
1