WHAT ARE THE PRE-OP NURSING RESPONSIBILITIES? ANSWERS 1.) SCHEDULE DIAGNOSTIC TESTS 2.) VERIFY ALL DOCUMENTS ARE IN MAR 3.) REPORT ABNORMAL DIAGNOSTIC RESULTS TO SURGEON 4.) PREPARE AND TEACH CLIENT -DO NOT OBTAIN CONSENT WHAT IS INFORMED CONSENT? ANSWERS -VOLUNTARY -EXPLANATION OF PROCEDURE AND ITS RISKS -DESCRIPTION OF BENEFITS AND ALTERNATIVE -ANSWER QUESTIONS -PATIENT MAY WITHDRAW CONSENT 1.) SURGEON MUST EXPLAIN THE RISKS INVOLVED WITH THE PROCEDURE DOES THE PATIENT UNDERSTAND? ANSWERS INFORMED CONSENT AND HEALTH LITERACY WHEN IS CONSENT NEEDED? ANSWERS 1.) INVASIVE PROCEDURE -INCISION, BIOPSY, CYSTOSCOPY, PARACENTESIS 2.) PROCEDURES WITH SEDATION OR ANESTHESIA 3.) NONSURGICAL PROCEDURES THAT CARRY MORE THAN SLIGHT RISK -ARTERIOGRAPHY 4.) PROCEDURES INVOLVING RADIATION AND CHEMO WHAT IF PATIENT IS UNABLE TO GIVE CONSENT? ANSWERS APPOINTED GUARDIAN IS ALLOWED TO MAKE MEDICAL DECISIONS AND SIGN FORM WHAT IS THE PRE-OP ASSESSMENT? ANSWERS 1.) MEDICAL HX -AGE -NUTRITION, WEIGHT -PREVIOUS SURGERY AND ANESTHESIA -DRUGS AND SUBSTANCE ABUSE -MED HX -LATEX ALLERGY 2.) PHYSICAL ASSESSMENT -BODY SYSTEMS, NUTRITIONAL, PSYCHOSOCIAL 3.) LABORATORY ASSESSMENT -ELECTROCARDIOGRAM -UA -BLOOD TYPE AND CROSSMATCH -CBC OR HGB/HCT CLOTTING STUDIES -ELECTROLYTES -SERUM CR -CHEST X-RAY EXAMINATION -PREGNANCY TEST WHAT ARE THE DIETARY RESTRICTION REGARDING SURGERY? ANSWERS NPO 8-12 HOURS LEADING UP TO SURGERY, THIS IS TO PREVENT ASPIRATION PNEUMONIA DURING SEDATION WHAT IS THE INTESTINAL PREP FOR SURGERY? ANSWERS FOR BOWEL OPERATION PATIENTS -IF NOT PREPARED PROPERLY CAN GET FECAL CONTAMINATION AND IS HARDER TO VISUAL THE SURGICAL FIELD (STOOL IS ANASTOMOSIS AREA) WHAT SKIN PREPARATION IS DONE PRE-OP? ANSWERS TO PREVENT INCIDENCE OF SURGICAL SITE INFECTION 1.) SHOWER VS CLOTHS -CHLOROHEXIDINE SCRUB BEFORE SURGERY 2.) SHAVE WITH ELECTRIC SHAVER IF IT IS NEEDED, NEVER DISPOSABLE RAZOR -CAN USE NONFLAMMABLE GEL TO KEEP HAIR AWAY FROM INCISION HOW DO YOU PREPARE THE CLIENT FOR SURGERY? ANSWERS 1.) VOID BEFORE PROCEDURE 2.) CHECK POSSIBLE PLACEMENT OF TUBES, DRAINS, VASCULAR ACCESS DEVICES 3.)TEACH: -DEEP BREATHING, INCENTIVE SPIROMETER, COUGHING AND SPLINTING WITH PILLOW TO REDUCE PAIN -EARLY AMBULATION, ANTI-EMBOLISM STOCKING, LEG EXERCISES, ROM EXERCISES 4.) GIVE SEDATIVE AND/OR ANALGESIC 5.) HANG PROPHYLACTIC ANTIOBIOTICS -30 MIN TO 1 HOUR PRIOR 6.) REMOVE JEWELRY, DENTURES (RISK FOR OBSTRUCTION AND ASPIRATION), NAIL POLISH (PULSE OX/CYANOSIS) WHAT ARE THE COMPLICATIONS OF GEN. ANESTHESIA? ANSWERS 1.) MALIGNANT HYPERTHERMIA 2.) OD 3.) COMPLICATIONS OF SPECIFIC AGENTS 4.) COMPLICATIONS OF INTUBATION WHAT IS TIME OUT? ANSWERS UNIVERSAL PROTOCOL FOR PREVENTING WRONG SITE, WRONG PROCEDURE, WRONG PERSON SURGERY -MEETING WITH ENTIRE OR IMMEDIATELY BEFORE TO VERIFY PATIENT, PROCEDURE, AND SITE WHAT NURSING MANAGEMENT OCCURS IN THE PACU? ANSWERS 1.) PHYSICAL ASSESSMENT AND CLINICAL MANIFESTATIONS -ABCS -MONITOR FOR BLEEDING -MONITOR VSS: TEMP (INFECTION) 2.) ASSESS ABILITY TO AMBULATION -STARTS SLOWLY, ASSESS FOR VERTIGO, MONITOR GAIT 3.) ASSESS FOR READINESS TO DISCHARGE WHAT DO YOU ASSESS FOR WITH SKIN IN THE PACU? ANSWERS 1.) ASSESS: DRESSING, DRAINS, CASTS -YELLOW/GREEN DRAINAGE ON THE SURGICAL INCISION INDICATES INFECTION 2.) DEHISCENCE 3.) EVISCERATION