Term
|
Definition
| Laparotomy Vaginal Hysterectomy |
|
|
Term
|
Definition
| Tonsillitis & Adenoidectomy |
|
|
Term
|
Definition
| Total Abdominal Hysterectomy with Bilateral Sappingo-oopherectomy |
|
|
Term
|
Definition
|
|
Term
|
Definition
EndoscopicRetogradeCholangio
Pancreatography
(gall stones) |
|
|
Term
|
Definition
Open reduction internal fixation
(fractures) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Coronary Artery Bypass Graph |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Extracorporeal Shockwave Lithotripsy |
|
|
Term
|
Definition
|
|
Term
|
Definition
Laparotomy
(belly button) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Vaginal Birth after C-section |
|
|
Term
|
Definition
| Transurethral resection of prostate |
|
|
Term
| What anesthesia uses Lidicane for pain and is never used on children? |
|
Definition
|
|
Term
| What % of local is used for carpal tunnel blocks? |
|
Definition
|
|
Term
| What type of anesthesia is used in the ER for procedures and dislocations? |
|
Definition
|
|
Term
| What is the most common type of med is used for CS? |
|
Definition
|
|
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
|
|
Term
| How many hours must a patient be NPO for CS? |
|
Definition
|
|
Term
These tests are ran for what type of anesthesia-
PG, CBC, BMP, H&H, CXR for COPD, over 50-EKG? |
|
Definition
|
|
Term
| What anesthesia can the patient be able to move a body part on command? |
|
Definition
|
|
Term
These tests are ran for which anesthesia-
CBC, BMP, PG, over 40-EKG, PT/PTT/INR for spinal? |
|
Definition
|
|
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
|
|
Term
| How long does a patient have to be NPO for E/S? |
|
Definition
|
|
Term
| What anesthesia is used for major surgery? |
|
Definition
|
|
Term
| What is a major concern for GA? |
|
Definition
|
|
Term
| How long is a patient NPO for GA? |
|
Definition
|
|
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
|
|
Term
These tests are run for which type of anesthesia-
CBC, BMP, BNP, CXR over 40, EKG over 35, PG? |
|
Definition
|
|
Term
| What procedure starts with a bowel prep with both laxatives and antibiotics? |
|
Definition
|
|
Term
| What procedure starts with a bowel prep? |
|
Definition
|
|
Term
| What type of procedure requires a Foley cath? |
|
Definition
|
|
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
|
|
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
|
|
Term
| How often are VS taken for all surgical patients? |
|
Definition
|
|
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
|
|
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
|
Definition
|
|
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
|
|
Term
| What will help with urinary retention? |
|
Definition
| palpating the bladder, use non-pharmacological interventions, may use a straight cath, may require urecholine |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What may be caused by AES if not positioned properly? |
|
Definition
|
|
Term
| What machine inflates leggings to increase venous return? |
|
Definition
|
|
Term
| These-respiratory arrest, PE, CVA, CA, MI, hemorrhage and shock-happen within what time frame of surgery? |
|
Definition
|
|
Term
| Thesep-PE, DVT, Shock, and infection-can happen within what time frame during surgery? |
|
Definition
|
|
Term
| These-Dehiscence, evisceration and infection-can occur during what time frame? |
|
Definition
|
|
Term
|
Definition
| chest pains; cannot get air |
|
|
Term
|
Definition
| give O2, cardiac monitor, DDimer, Spiral CAT, stat PT/PTT/INR, heprin bolus IV |
|
|
Term
|
Definition
| drooping paralysis on one side |
|
|
Term
| What may happen during an MI? |
|
Definition
|
|
Term
| What is done for Respiratory Arrest? |
|
Definition
| call code and administer Narcan |
|
|
Term
|
Definition
|
|
Term
|
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
|
Definition
|
|
Term
|
Definition
|
|
Term
| Where is evisceration most common? |
|
Definition
|
|
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
|
|
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
|
|
Term
| What healing phase is taking place when platelets clump at site of injury beginning the process of clot formation? |
|
Definition
|
|
Term
| What wound healing phase causes vasoconstriction? |
|
Definition
|
|
Term
| What wound healing phase lasts 0-10 days? |
|
Definition
|
|
Term
| This happens in the cellular phase... |
|
Definition
|
|
Term
| What destroys dead cells and secretes factors that stimulate collagen and new capillaries? |
|
Definition
|
|
Term
| What wound healing phase lasts 4 days- 2 or 3 weeks? |
|
Definition
|
|
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
|
|
Term
| What happens during the maturation phase? |
|
Definition
| remodeling of scar tissue, and capillaries disappear |
|
|
Term
|
Definition
| there are no blood vessels in them |
|
|
Term
| When does Sanguinous drainage appear? |
|
Definition
|
|
Term
| When does Serosanguinous drainage appear? |
|
Definition
|
|
Term
| When does Serous drainage appear? |
|
Definition
|
|
Term
| What is drainage is bloody? |
|
Definition
|
|
Term
| What drainage is a mixture of blood and serum? |
|
Definition
|
|
Term
| What drainage appears as clear yellow liquid? |
|
Definition
|
|
Term
| What type of wound drainage is purulent? |
|
Definition
|
|
Term
| What type of wound drainage contains stool? |
|
Definition
|
|
Term
| What wound drainage is white to yellow and cheese like in consistency? |
|
Definition
|
|
Term
| What type of wound healing intention is a laceration with staples or sutures? |
|
Definition
|
|
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
|
|
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
|
|
Term
| What wounds are dying tissue? |
|
Definition
|
|
Term
| What wounds are black tissue in wound bed? |
|
Definition
|
|
Term
| What is done to Ischemic wounds? |
|
Definition
|
|
Term
| What type of wound are Pressure sores? |
|
Definition
|
|
Term
| What does Tunneling tissue feel like? |
|
Definition
|
|
Term
|
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
|
|
Term
|
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
|
|
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
|
|
Term
|
Definition
Dry sterile dressing
used for clean surgical wounds |
|
|
Term
|
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
|
|
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
|
|
Term
| What is the most common type of Chemical Debridement? |
|
Definition
|
|
Term
| What type of wound treatment uses force to remove necrotic tissue? |
|
Definition
|
|
Term
| What is a type of Mechanical debridement? |
|
Definition
|
|
Term
| What type of wound treatment is excised from wound with client under anesthesia? |
|
Definition
|
|
Term
| What wound treatment is where the wound or cavity is "stuffed" with material to both absorb drainage and control bleeding? |
|
Definition
|
|
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
|
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
|
|
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
|
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
|
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
|
|
Term
| What are wire retention sutures used for? |
|
Definition
|
|
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
|
|
Term
| What dressing comes in pre cut squares? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| What type of dressing is used for burns? |
|
Definition
|
|
Term
| What type of dressing is used to prevent air from entering the thoracic cavity? |
|
Definition
|
|
Term
| What type of dressing is used to protect decub and stasis ulcers? |
|
Definition
|
|
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
|
Definition
| Adhesive-rarely used, Paper-used if allergic to tape, Silk and Medipor |
|
|
Term
| How far apart are steri strips placed? |
|
Definition
|
|
Term
|
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
|
|
Term
|
Definition
|
|
Term
| What is sterile to non-sterile? |
|
Definition
|
|
Term
| How many inches is considered dirty on a sterile package as soon as opened? |
|
Definition
|
|
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
|
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
|
|
