Shared Flashcard Set

Details

Fundies/RD 04/03/13
Pre-op/Post-op
164
Nursing
Not Applicable
04/02/2013

Additional Nursing Flashcards

 


 

Cards

Term
LAVH
Definition
Laparotomy Vaginal Hysterectomy
Term
T&A
Definition
Tonsillitis & Adenoidectomy
Term
TAH w BSO
Definition
Total Abdominal Hysterectomy with Bilateral Sappingo-oopherectomy
Term
EGD
Definition
Endogastoduodenoscopy
Term
ERCP
Definition

EndoscopicRetogradeCholangio

Pancreatography

(gall stones)

Term
ORIF
Definition

Open reduction internal fixation

(fractures)

Term
D&C
Definition
Dilation & Curratage
Term
CABG
Definition
Coronary Artery Bypass Graph
Term
THR
Definition
Total Hip Repair
Term
ESWL
Definition
Extracorporeal Shockwave Lithotripsy
Term
Cysto
Definition

cystoscopic

(bladder)

Term
Lap
Definition

Laparotomy

(belly button)

Term
Appy
Definition
appendectomy
Term
VBAC
Definition
Vaginal Birth after C-section
Term
TURP
Definition
Transurethral resection of prostate
Term
What anesthesia uses Lidicane for pain and is never used on children?
Definition
Local
Term
What % of local is used for carpal tunnel blocks?
Definition
2%
Term
What type of anesthesia is used in the ER for procedures and dislocations?
Definition
Conscious Sedation
Term
What is the most common type of med is used for CS?
Definition
Versed
Term

What type of anesthesia are these steps used-

maintain own airway, fall asleep and dont remember procedure, cardiac monitor, BP q 15", no driving for 24h, recover in 1h

Definition
Conscious Sedation
Term
How many hours must a patient be NPO for CS?
Definition
8h
Term

These tests are ran for what type of anesthesia-

PG, CBC, BMP, H&H, CXR for COPD, over 50-EKG?

Definition
Conscious Sedation
Term
What anesthesia can the patient be able to move a body part on command?
Definition
Epidural/Spinal
Term

These tests are ran for which anesthesia-

CBC, BMP, PG, over 40-EKG, PT/PTT/INR for spinal?

Definition
Epidural/Spinal
Term
What are some common issues with E/S?
Definition

fluid challenge 1000/cc

hypotension

Term

These steps are for administering which type of anesthesia-

maintain own airway, supp O2, cardiac monitor-except if in labor, clear liquids-labor only?

Definition
Epidural/Spinal
Term
How long does a patient have to be NPO for E/S?
Definition
8h
Term
What anesthesia is used for major surgery?
Definition
General
Term
What is a major concern for GA?
Definition
aspiration pneumonia
Term
How long is a patient NPO for GA?
Definition
8h
Term

These steps are taken for which type of anesthesia-

don't maintain own airway, ET tube, vent until procedure over, VS q 15" ?

Definition
General Anesthesia
Term

These tests are run for which type of anesthesia-

CBC, BMP, BNP, CXR over 40, EKG over 35, PG?

Definition
General Anesthesia
Term
What procedure starts with a bowel prep with both laxatives and antibiotics?
Definition
Colostomy
Term
What procedure starts with a bowel prep?
Definition
Pelvic laparoscopic
Term
What type of procedure requires a Foley cath?
Definition
Open GYN/Pelvic
Term
Informed Consent must be provided by the MD-what steps must be in the Informed Consent?
Definition

Planned procedure

Expected outcome

Possible complications

Alternative treatments

Name of person actually performing procedure

 

Term
What situations can an Informed Consent be taken without a signature?
Definition
Only in a life-threatening emergency
Term
How many witnesses needs to witness an Informed Consent that is taken verbally?
Definition
2
Term
When does a Next of Kin sign the Informed Consent form?
Definition
if the patient has already taken the pre-op meds
Term
What is the LPN role pertaining to the Informed Consent form?
Definition

Ask patient to explain what they are having done

Be sure signature is obtained prior to pre-op meds

LPN signature is only to verify that the patient is the correct person

If the patient has any questions or concerns, contact surgeon

Term
What teaching is to prevent complications of immobility &/or general anesthesia?
Definition
turn, cough, deep breathe, splinting incision, leg exercises (AES or sequentials), pain management, equipment
Term
What is explained to patient during pre-op teaching?
Definition
When/where to arrive, explain anticipated care-dressings, casts, drains, PACU environment; where family can wait, MD will come to speak with them, anticipated recovery/discharge time
Term

What are some Pre-op Nursing Assessments?

 

Definition
Make sure ID is correct, NPO ??, Allergies ??, any previous surgeries-any problems before during or after, any chronic diseases-CHF, CAD, COPD, DM, CRF, CVA, smoker??, LMP or may be PG
Term

What is done during the physical assessment?

 

Definition
Lung sounds, bowel sounds, skin, basic neuro, extremities-edema, pulses
Term
What type of meds are usually given pre-op?
Definition
Atropine, Demerol, Vistaril, Zofran for N/V
Term
How often are VS taken once back in room?
Definition

First hour q 15"

Second hour q 30"

Third/fourth hour q hour

 

Term
How long are I&O's taken for all surgical patients?
Definition
48h
Term
How often are VS taken for all surgical patients?
Definition
q 4h ATC for 48h
Term
What are the ESE after surgery?
Definition
Pain, Nausea,Vomiting, Flatus, Urinary Retention
Term
How often is pain med given to patients?
Definition
30" before getting up or doing activities
Term
What is the most common anti-emetic given post-op?
Definition
Zofran
Term
How often can Zofran be given and how much?
Definition

4mg IV

q 15"-20" if not better

Term
What types of food will help nausea if patient is po?
Definition
saltine crackers, weak tea, carbonated lemon-lime soda
Term
What causes Flatus?
Definition
decrease peristalsis
Term
How can a patient increase peristalsis?
Definition
ambulate, rectal tube, rectal supp, medication
Term
What results if flatus is treated with a narcotic analgesic?
Definition
adynamic ileus
Term
What will help with urinary retention?
Definition
palpating the bladder, use non-pharmacological interventions, may use a straight cath, may require urecholine
Term
What is AES?
Definition
Anti-Embolism Stockings
Term
What to AES do?
Definition
increase venous return
Term
What may be caused by AES if not positioned properly?
Definition
DVT
Term
What machine inflates leggings to increase venous return?
Definition
Sequential Hose
Term
These-respiratory arrest, PE, CVA, CA, MI, hemorrhage and shock-happen within what time frame of surgery?
Definition
first 24h
Term
Thesep-PE, DVT, Shock, and infection-can happen within what time frame during surgery?
Definition
24h-48h
Term
These-Dehiscence, evisceration and infection-can occur during what time frame?
Definition
72h-weeks after
Term
What is PE?
Definition
chest pains; cannot get air
Term
What is done for PE?
Definition
give O2, cardiac monitor, DDimer, Spiral CAT, stat PT/PTT/INR, heprin bolus IV
Term
What is CVA?
Definition
drooping paralysis on one side
Term
What may happen during an MI?
Definition
BP falls, vomiting
Term
What is done for Respiratory Arrest?
Definition
call code and administer Narcan
Term
What is hypovolemic?
Definition
not enough blood volume
Term
What is atelectasis?
Definition
aleoli collapse and fluid builds in pleural cavity
Term
What are some symptoms of atelectasis?
Definition
SOB, decrease in pulse ox
Term
What may treat atelectasis?
Definition

20% or less-Incentive Spirometer q h

20% or more-chest tube

Term
What is dehiscence?
Definition
opening of wound
Term
What is evisceration?
Definition
protruding of organ
Term
Where is evisceration most common?
Definition
abdomen
Term
Who are high risk for wound infections?
Definition
obese, malnourished, steroid users, radiation, anemics, elderly, diabetics
Term
What type of wound is least likely to get an infection?
Definition
surgical
Term
What are some types of wounds?
Definition
laceration, puncture, avulsion, pressure ulcer, stasis ulcer, excoriation, burn
Term
What phase of wound healing lasts 0-4 days?
Definition
Hemostasis Phase
Term
What healing phase is taking place when platelets clump at site of injury beginning the process of clot formation?
Definition
Hemostasis
Term
What wound healing phase causes vasoconstriction?
Definition
Hemostasis
Term
What wound healing phase lasts 0-10 days?
Definition
Cellular phase
Term
This happens in the cellular phase...
Definition
inflammatory process
Term
What destroys dead cells and secretes factors that stimulate collagen and new capillaries?
Definition
Leukocytes
Term
What wound healing phase lasts 4 days- 2 or 3 weeks?
Definition
Reconstructive Phase
Term
What happens in the Reconstructive phase?
Definition
Collagen deposits, granulation tissue, wound contraction
Term
What wound healing phase lasts 3 weeks- 2 years?
Definition
Maturation Phase
Term
What happens during the maturation phase?
Definition
remodeling of scar tissue, and capillaries disappear
Term
Why are scars pale?
Definition
there are no blood vessels in them
Term
When does Sanguinous drainage appear?
Definition
first 24h
Term
When does Serosanguinous drainage appear?
Definition
24-72h
Term
When does Serous drainage appear?
Definition
72h
Term
What is drainage is bloody?
Definition
Sanguinous
Term
What drainage is a mixture of blood and serum?
Definition
Serosanguinous
Term
What drainage appears as clear yellow liquid?
Definition
Serous
Term
What type of wound drainage is purulent?
Definition
Pus
Term
What type of wound drainage contains stool?
Definition
Fecal
Term
What wound drainage is white to yellow and cheese like in consistency?
Definition
yeast
Term
What type of wound healing intention is a laceration with staples or sutures?
Definition
Primary Intention
Term
What is Primary Intention?
Definition
Surgically closed wound, edges well approximated, minimal scarring, heals quickly 2-3 weeks
Term
What type of wound healing intention is staph or decub ulcer?
Definition
Secondary Intention
Term
What is Secondary Intention?
Definition
Wound left open, granulation tissue eventually fills defect, large scar and underlying tissue defects, slow healing months to years
Term
What is Tetiary Intention?
Definition
delayed surgical closure of wound
Term
What types of wounds are found in Tetiary Intention?
Definition
Peritonitis, ruptured appendix
Term
What wounds do not need to rupture and let absorb into body?
Definition
Hematoma
Term
What wounds are dying tissue?
Definition
ischemic
Term
What wounds are black tissue in wound bed?
Definition
Necrotic
Term
What is done to Ischemic wounds?
Definition
Debridement
Term
What type of wound are Pressure sores?
Definition
Tunneling
Term
What does Tunneling tissue feel like?
Definition
Mushy or rigid
Term
What is Tunneling?
Definition
the outermost layer of tissue intact with underlying tissue destroyed by infection
Term
What type of wound is Second or Third degree Burns?
Definition
Slough
Term
What is Slough?
Definition

Yellow or white tissue

not infection but not normal granulation tissue

Term
What is assessed during Primary Intention?
Definition
Are staples/sutures intact, are edges well approximated or gaping, is there redness, drainage, what is the length of incision, the location, the directionality
Term
What is the normal amount of drainage from a wound?
Definition
10-20 cc
Term
How is Secondary Intention assessed?
Definition
Measure-length, width, circumference, and depth, type and amount of drainage, wound edges, wound bed
Term
What is used to measure wounds?
Definition
Push tool
Term
What is DSD?
Definition

Dry sterile dressing

used for clean surgical wounds

Term
What is W to D dressing?
Definition

Wet to dry

used for Secondary Intention

used to debride necrotic tissue

0.9% NaCl or antiseptic/antibiotic sol.

 

Term
What dressing is used as a protective moisture barrier and functions as replacement skin?
Definition
Hydrocolloid Dressing
Term

When is hydrocolloid dressing used?

 

Definition
with clean secondary intention wounds
Term
Which wound care treatment is medicated ointments which contain digestive enzymes?
Definition
Chemical debridement
Term
What is the most common type of Chemical Debridement?
Definition
Elase
Term
What type of wound treatment uses force to remove necrotic tissue?
Definition
Mechanical Debridement
Term
What is a type of Mechanical debridement?
Definition
Wound vac
Term
What type of wound treatment is excised from wound with client under anesthesia?
Definition
Surgical debridement
Term
What wound treatment is where the wound or cavity is "stuffed" with material to both absorb drainage and control bleeding?
Definition
Packing
Term

Types of Drainage:

Penrose-gravity small drainage

TLS- suction provided by test tube

JP- mild suction small drainage

Hemovac- moderate suction major surgeries

Sump drain- connected to suction machine;cath;only connected to intermittent drainage

Chest Tube- water seal system

 

Definition

T Tube- always exits at RUQ axillary line; gall bladder surgeries (cystic duct to common bile duct)

Ureteral Stent- exits at flank

Term
Drain Site Care:
Definition
Change dressing when soiled or loosened, remove old dressing carefully, clean from drain site outward, apply new dressing, re-establish suction systems after care
Term
What is a Penrose drain held into place with?
Definition
sterile safety pin
Term
What types of wounds cannot be sutured?
Definition

Pressure ulcers

severe lacerations

Term
What type of solution is most common for wound irrigation?
Definition
NS or antibiotic solutions
Term
What type of technique is flushing the wound?
Definition

Aseptic Technique

clean to dirty

Term

Steps for Suture/Staple removal:

 

Definition
Requires MD order, obtain equipment, explain to client-should not hurt, remove old dressing, assess wound healing
Term
How to remove staples:
Definition
Place "jaw" of staple remover between staple and clients skin, close handle. DO NOT PRY UP STAPLE, tool will do the work, observe wound for: dehiscence, bleeding, increased drainage; count and document # of staples removed
Term
To remove Sutures:
Definition
Hold "knot" of suture with forceps in your NON-DOMINATE hand and pull gently to create tension, slip the curved portion of the suture scissors under the knot and as close to the clients skin as possible, CUT THE SUTURE- not the drain, the central line or the clients skin; as the suture is cut pull gently with the forceps and remove the suture, observe the wound for dehiscence, bleeding and increased drainage, count and document # of sutures removed
Term
What are Montgomery Sutures used for?
Definition
Huge openings
Term
What are wire retention sutures used for?
Definition
Big abd surgeries
Term
Advantages and Disadvantages of Gauze:
Definition

Advantages- absorbent, inexpensive

Disadvantages- not a good choice for heavily draining wounds, leaves lint in wound

Term
Advantages and Disadvantages of Kling:
Definition

Advantages- applies minute compression, conforms to a variety of extremities

Disadvantages- minimum stretch, minimal absorbency

Term
What dressing comes in rolls?
Definition
Kling
Term
What dressing comes in pre cut squares?
Definition
Gauze
Term
Advantages and Disadvantages of Kerlix:
Definition

Advantages- very flexible, moderate absorbancy, applies moderate compression

Disadvantages- cost

Term
What type of dressing comes in pads called "fluff"?
Definition
Kerlix
Term
Advantages and Disadvantages of ABD's?
Definition

Advantages- used as top layer in most abdominal and ortho surgeries for 48h

Disadvantages- no flexibility

Term
Which type of dressing is water resistant on one side and has a blue line on the other?
Definition
ABD
Term
Advantages and Disadvantages of Non-adherent dressing?
Definition

Advantages- non-stick, keeps staples from catching on gauze

Disadvantages- no absorbency

Term
What type of dressing is used to protect granulation tissue?
Definition
Non-adherent dressing
Term
What type of dressing is used for burns?
Definition
Telfa
Term
What type of dressing is used to prevent air from entering the thoracic cavity?
Definition
Vaseline Gauze
Term
What type of dressing is used to protect decub and stasis ulcers?
Definition
Hydrocolloid dressings
Term
Advantages and Disadvantages of Transparent Dressing?
Definition

Advantages- allows easy assessment of wound, works well for IV sites

Disadvantages- self adhesive difficult to move without skin damage, no absorbency

Term
Advantages and Disadvantages of ACE wraps, Elastoplast, Burn net, and tube dressings:
Definition

Advantages- very flexible, amount of compression adjusted as applied

Disadvantages- usually only available in specialty areas, can trauatize skin when removed

Term

Types of Steri strips:

 

Definition
Adhesive-rarely used, Paper-used if allergic to tape, Silk and Medipor
Term
How far apart are steri strips placed?
Definition
1/2" to 1 inch
Term
Sterile Dressing Change:
Definition
Obtain supplies, don non-sterile gloves, remove old dressing, assess wound, change gloves or apply sterile gloves, cleanse wound as ordered, reapply dressing material using sterile technique, date, time, and intial dressing change, document findings
Term
What is sterile to sterile?
Definition
Sterile
Term
What is sterile to wet?
Definition
Dirty
Term
What is sterile to non-sterile?
Definition
Dirty
Term
How many inches is considered dirty on a sterile package as soon as opened?
Definition
1 inch around
Term
How to do a wound culture:
Definition
Obtain proper culture equipment, explain to client, remove old dressing using non-sterile gloves, rinse wound with NS, swab area, place swab in container, label and transport to lab, redress wound, document
Term
Post mortem Care:
Definition

Body can only be kept on unit for 2h max, if there is an autopsy-secure all equipment, tubes, etc. and describe condition of body in detailed note

If there is no autopsy- remove tubes, equipement, etc., bathe body, and close eyes and mouth

Body signed out to mortician or morgue tech

Term
Within how many hours of admission at an acute care facility after death will go under an autopsy?
Definition
24 h
Supporting users have an ad free experience!