| A | B |
|---|
| Who is responsible for obtaining the consent for surgery? | The surgeon |
| What should NOT be given prior to signing of the consent? | Mind-altering drugs |
| What is the purpose of a witness for consents? | Assurance that the patient was not coerced into signing. |
| How long should food and fluids be withheld prior to general anesthesia? | 6-8 hours |
| Why is the patient NPO prior to surgery? | To help prevent aspiration |
| What will be given in place of PO fluids due to NPO status? | IV fluids |
| When is an enema most likely ordered concerning surgery? | prior to intestinal surgery |
| What should the client do immediately before going downstairs for surgery? | Empty bladder |
| When will hair be shaved prior to surgery? | Only if it will interfere with the surgical procedure |
| What may be included in a pre-op prep? | Shaving, scrubs, showers, enemas, foley insertion, IV insertion, medications |
| Name some things the patient should refrain from prior to surgery. | Smoking, alcohol, OTC herbs, aspirin, anticoagulants. |
| What medication must be taken away slowly prior to surgery? | Corticosteroids (any steroid preparation) |
| What are the 3 most important exercises for post-op patients? | Turn, cough, and deep breathe (T, C, and DB) |
| What will T, C, and DB help prevent? | Pneumonia and atelectasis |
| Why are leg and foot exercises important post-op? | To prevent venous stasis and facilitate venous blood return (this will prevent DVT's) |
| What invasive devices may the patient need to be prepared for that may be used post-op?` | IV, foley, NG, drains, SCD's, TED hose, PCA |
| What will anxiety do to blood pressure and pulse? | Cause a slight increase |
| If the patient needs things explained more clearly, what should be done first? | Ask the patient his understanding of what is going to occur |
| What is the purpose of the pre-op check list? | To ensure everything is done and there will be no delays |
| What should the patient be wearing to the OR? | A gown and ID bracelet - nothing else |
| What should be checked concerning medications? | What they take and any allergies |
| What must be signed prior to any invasive procedure? | consent form |
| Who is typically in need of an EKG and possibly a CXR prior to surgery? | Those patients over 40 |
| How many repititions should the client do with each incentive spirometry (IS)? | 10-12 |
| After an IS inhalation, what should be done? | Hold breath for 5 seconds then exhale through pursed lips |
| How often should IS be done? | As often as tolerated. Minimum of hourly. Preferrably with every commercial break. |
| What can be done to prevent excessive movement at the incisional site when T, C, and DB? | Splinting with a pillow or folded blanket. |
| Give examples of things that should be removed prior to surgery. | glasses, dentures, hearing aids, artificial eyes or other prostheses. jewelry, makeup, nail polish, hair pins, |
| What could be sent down to the OR with the patient as long as there is adequate communication between departments? | Glasses, dentures, hearing aids, religious medals |
| What should be done after pre-op meds are given? | Side rails up, bed in low position, call bell within reach and instruct pt not to get up without assistance. |
| What is "time-out" | Stopping everything for double checks - right patient, correct identification, correct site for surgery |
| Name the two most common identifying factors of a patient | Name and birthdate |
| Reasons a patient may experience hypothermia during or after surgery. | Cool environment (65-70), cool IV fluids, exposure of skin, inhalation of cool vapors of anesthesia |
| What should be the first thing checked post-op on return to your unit? | AIRWAY PATENCY |
| Describe a post-op respiratory assessment. | airway patency, adequate ventilation, RR, monitor secretions, ovserve chest movements for symmetry, monitor oxygen admin and pulse ox |
| Explain a post op cardiovascular assessment | BP, temperature, pulse, skin color, capillary refill, peripheral pulses, bleeding, cardiac irregularities |
| Describe a musculoskeletal post op assessment | Movement of extremities, joint discomfort |
| What is included in a post-op integumentary assessment? | Inspection of surgical site, drains, and wound dressings; check for skin abnormalities |
| Explain a post op gastrointestinal assessment. | Assess bowel sounds, nausea, vomiting, patency of NG tube, abdominal distention, bowel sounds |
| What is included in a genitourinary post-op assessment? | Assess for bladder distention, color, quantity and quality of urine output and voiding ability or foley catheter patency; expect voiding at least 6-8 hours post-op |
| Prior to the first time out of bed, what should the patient do? | Dangle legs over the side of the bed to prevent orthostatic changes |
| What should be done often if the patient remains NPO post-op? | Frequent mouth care |
| What is assessed to determine the probable removal of an NG tube? | Return of bowel sounds and absence or decrease in nausea |
| What simple measure can assist in the return of peristalsis and the passing of flatus? | Ambulation |
| What should the urine output (UOP) be to be considered adequate? | >30ml/hr |
| If there is no catheter and the patient voids at least 6-8 hours after surgery, what should the expected amount be? | at least 200 ml |
| What post-op complication develops 3-5 days post op? | pneumonia |
| What post-op complication is caused from the collapse of the alveoli with retained mucous secretions and occurs 1-2 days post-op? | atelectasis |
| What are the first signs of hypoxia? | restlessness, agitation, and confusion |
| What post-op complication shows dyspnea, sudden, sharp chest or upper abdominal pain, increased heart rate, and decreased blood pressure | Pulmonary Embolism |
| What post-op complication will show restlessness, weak, rapid pulse, hypotension, cool, clammy skin, tachypnea, and reduced urine output? | Hemorrhage |
| Shock, which will follow uncontrolled hemorrhage, should be treated with this intervention first to increase venous return. | Elevate the legs |
| This is the easiest way to treat or prevent constipation caused by opioid administration. | Increase fluid intake (may also try ambulation and consumption of fiber-rich foods - stool softners and laxatives as last resort) |
| After assurance of airway patency, this should be one of the next things to do for your post-op patient. | vital signs |
