When was AORN established? What is their focus?
- 1956
- clinical practice, professional practice, administrative practice, patient outcomes, and quality improvement
When are ambulatory surgery centers used?
�Hospital-based or freestanding
�Many laparoscopic surgeries, such as gallbladder removal (cholecystectomy)
Name and define the 4 classifications of Surgery.
1. Seriousness: Major or minor
2. Urgency: Elective, urgent, emergency
3. Purpose:
Diagnostic, ablative, palliative, reconstructive/restorative, procurement for transplant, constructive, or cosmetic
4. Moribound: at the point of death
Can the Nursing Process be used for patients who are having surgeries?
Yes.
Why is it important for the nurse to do a thorough assessment on a patient who is going to have surgery?
To make sure that everything is accurately documented beforehand so that certain things ca be taken into consideration.
What areas should be included in an assessment of a patient who is going to have a surgical procedure?
-Through the patient's eyes
-Nursing history
- Medical history
- Surgical history
- Risk factors
- Medications
-Allergies
- Smoking habits
- Alcohol ingestion and substance use and abuse
- Pregnancy
- Perceptions and knowledge regarding surgery
Name the 7 risk factors that can increase a patient's risk for complications during or after a surgical procedure?
�Smoking
�Age
�Nutrition
�Obesity
�Obstructive sleep apnea (OSA)
�Immunosuppression
�Fluid and electrolyte imbalance
�Postoperative nausea and vomiting (PONV)
�Venous thromboembolism (VTE)
Why is it important for the nurse to know about a patient's perceptions and knowledge about the surgical procedure they are going to have?
To help ease some of the anxiety that the patient has about the procedure.
What areas should be included when taking a patient's medication history?
�Inpatient vs. outpatient
What allergies should the nurse assess the surgical patient for?
�Medications, topical agents, latex, food
Why would it be important to assess the patient for alcohol & substance use/abuse?
Because it may affect the anesthsia.
Why would it be important to assess the smoking history for a surgical patient?
it is a vasoconstrictor and can cause an increase in blood pressure and heart rate.
Why would it be important to assess the patient's available support sources?
The patient will not be able to assume the normal functioning that they could before surgery immediately after surgery.
Why is it important to know the patient's occupation prior to having surgery?
Surgery often results in physical changes and restrictions that prevent a person from immediately return to work.
Why is it important to assess a patient's pain prior to having surgery?
Some patients often prevent with painful conditions.
Why is important to assess the patient's emotional health, i.e. self-concept, body image, coping resources?
Surgery is physiologically stressful and creates anxiety in patients and their families.
Why is it important to assess a patient's culture and religion prior to them having surgery?
Each patient is unique in how he or she perceives and reacts to the surgical experience.
What areas should the nurse include in the physical assessment of a surgical patient?
- General Survey
- Head and Neck
- Integument
- Thorax and Lungs
- Heart and Vascular System
- Abdomen
- Neurological
Status
-Diagnostic Screening
List 4 possible nursing diagnoses that would be appropriate to use with a surgical patient.
-Impaired Airway Clearance
- Anxiety
- Impaired Skin Integrity
- Risk for Infection
- Acute Pain
For a surgical procedure, who is legally responsible to explain the procedure and to obtain the surgical consent?
The Surgeon is legally responsible to explain the surgical procedure and obtain surgical consent.
What areas should be covered in preoperative teaching?
- Reasons for preoperative instructions and exercises
- Preoperative Routines
- Surgical Procedure
- Time of Surgery
- Postoperative unit and location of family during surgery and recovery.
- Anticipated postoperative monitoring and therapies
- Sensory pr
What is included in the physical preparation of a patient for surgery?
- Minimizing risk for surgical wound infection
- Maintaining normal fluid and electrolyte balance
- Preventing bowel incontinence and contamination
- Preparation on the Day of Surgery
On the day of surgery, what all must be done to prepare the patient for their surgery?
- Hygiene
- Preparation of hair and removal of cosmetic
- Removal of prostheses
-Safeguarding Valuables
- Preparing the bowel and bladder
- Vital signs
- Prevention of deep vein thrombosis (Anti-embolism Devices)
- Administering preoperative medications
-
What should the nurse include in their preoperative evaluation?
-Through the patient's eyes
-Patient outcomes
What all takes place in the Intraoperative Surgical Phase?
The circulating nurse: Does not scrub in and uses the nursing process in the management of patient care activities in the OR suite.
The scrub nurse: must have thorough knowledge of each step of the surgical procedure and the ability to anticipate each ins
During Intraoperative Implementation, what takes place?
- Physical preparation
- Intraoperative warming
- Latex sensitivity/Allergy
- Introduction of Anesthesia
- Positioning the patient for surgery
- Documentation of intraoperative care.
Name and define the 4 types of Anesthesia.
General Anesthesia: Patient loses all sensation, consciousness, and reflexes, including gag and blink reflexes.
Regional Anesthesia: Loss of sensation in an area of the body by the anesthetizing sensory pathways.
Local Anesthesia: Loss of sensation at the
Why does the circulating nurse in the OR conduct an ongoing evaluation while the patient is having their surgery? What types of things are they paying close attention to?
The patients positioning, antimicrobial skin preparation, medications, implants, placement and function of IPC devices, specimens, warning devices, and surgical counts of instruments and dressings.
What takes place during the postoperative surgical recovery (phase 1)?
-Handoff
- Complete systems assessment
- Trying to arouse the patient
- Assessment every 15 minutes
- Removal of artificial airway.
What takes place during the postoperative surgical recovery (phase 2)?
-Monitoring vital signs
- Monitoring responsiveness
- Postoperative teaching
-
When assessing a patient's postoperative condition, what 5 areas should be included in the assessment?
- Through the patient's eyes
- Airway and respiration
- Circulation
- Temperature control
- Fluid and electrolyte balance
- Neurological functions
After a patient has surgery, what should be included in the postoperative assessment?
- Through the patient's eyes
- Airway and respiration
- Circulation
- Temperature control
- Fluid and electrolyte balance
- Neurological functions
What implementations should a nurse include in acute postoperative care?
- Through the patient's eyes
- Airway and respiration
- Circulation
- Temperature control
- Fluid and electrolyte balance
- Neurological functions
What implementations should a nurse include in postop care?
- Maintaining respiratory function
- Preventing circulatory complications
- Promoting early mobility
- Achieving rest and comfort
- Temperature regulation
- maintaining neurological function
- maintaining fluid and electrolyte balance
- Promoting normal g
When preparing a patient for discharge, what should the nurse include?
- Written educational materials for all patients after surgery.
What options are available for patients at discharge, if they are not quite ready to be discharged independent to home after surgery?
- Home care assistance
- Assistive personnel
- Discharge rehabilitation