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36 Cards in this Set
- Front
- Back
time span that includes preparation, process and recovery from surgery
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perioperative care
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nursing care before surgery
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preoperative
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nursing care in the OR, PAR, and PACU
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intraoperative
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nursing care after surgery
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postoperative
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can choose whether to have the surgery
plastic surgery, tubal ligation, vasectomy |
optional/elective surgery
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necessary at some time
hernia repair, prolapsed uterus, hip joint replacement |
required/nonelective surgery
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must be performed within a short period of time
removal of malignancy, inflamed appendix |
urgent/nonelective surgery
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must be performed immediately
severe internal hemorhage, ruptured appendix, angioplasty |
emergency surgery
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Fear, Deficient Knowledge, Anticipatory Grieving, Disturbed Body Image, Risk for Aspiration, Ineffective Airway Clearance, Pain, Hyperthemia, Hypothermia, Altered Tissue Perfusion (cerebral, Peripheral), Deficient Fluid Volume, Impaired Tissue/Skin Intergrity, Impaired Physical Mobility
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nursing diagnoses setablished for perioperative care
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providing emotional support
prepairing the client physically for surgery ensuring that all legal matters (i.e. surgical consent) are carried out ensuring that the physical exam and all lab tests are done providing client/family teaching providing routine pre and post operative care |
nursing interventions common to surgical procedures
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poor healing, hypostatic pnemonia, more difficult surgery, more underlying disorders likely
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risk factor of obesity
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poor healing, skin breakdown over bony prominances
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risk factor of poor nutrition, malnutrition, anorexia, bulimia
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reduced circulation
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risk factor of dehydration
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confusion, hypostatic pnemonia, dehydration and poor nutrition, poor muscle tone, inadequate diet, lack of digestive enzymes, coeisting disorders
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risk factor of old age
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lung disorders, circulatory disorders
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risk factor of tobacco use
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cardiac disorders, digestive disorders, withdrawal headaches,
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risk factor of caffeine use
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bleeding disorders, fluid retention, kidney damage, confusion and other complications
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risk factor of dependence on perscription drug
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difficulty in carrying out preoperative instructions, inability to care for onesel, inability to recognize complications, inability to return for follow-up, inadequate diet
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risk factor of lack in available caregivers
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because older adults are more suseptable to overdose due to low body weight
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use caution because height and weight are used to calculate exact dosages of narcotics and anesthetics
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baseline repsiratory assessment is important because
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older individuals are more suseptible to aspiration and hypostatic pneumonia
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mobility is important because
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early mobility helps prevent complications due to immobility, skin breakdown etc.
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client can still respond to commands with this type of sedation
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minimal
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sedation with depressed LOC, client can breath without assistance, respond to painand follow some commands, protective reflexes are maintained
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moderate
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sedation where client cannot be easily aroused, but can respond after repeated stim. respiration may need support
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deep
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IV sedatives used alone or in conjunction with a local
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conscious sedation
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older clients may react more, more quickly or opposite
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overreaction and paridoxical reaction
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complete or partial loss of sensation
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anesthesia
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anesthesia precautions
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allegies, ID band checked by 2 staff, postop vitals and pain frequently as ordered, I&O and watch for bladder distention
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Unconscious, loss of reflexes and muscle control
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general anesthesia
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pain sensations are blocked off in a limited area
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local anesthesia
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field block via injection, nerve block injecting near nerves
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conduction block
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an extensive conduction nerve block
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spinal block
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if a slow acting anesthesia is used, how will the client proceed through the stages of anesthesia?
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gradually through 3 recognizable stages, as the client wakes the stages are reversed
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reflexes present, heart rate normal, slower rate and increased depth of respiration, normal BP, some dialation adn react to light
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Stage I: Beginning anesthesia (analgesia and amnesia)
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active reflexes, increased heart rate, irregular breathing, increased BP, wide dialation and divergent
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Stage II: Dreams and excitement
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Four planes (light to deep) 3rd or 4th best for most surgery, progressive loss of reflexes, decreased heart rate, depressed resp. til apneic, decreased BP, constriced to slight dialtion and fixed
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Stage III: Surgical ansethesia
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