Duplicate
Export
Register
NCM 112 RLE
1 Flashcard Deck
Send to Chat
AI Edit
Heading 3
Highlight
Here's your flashcard deck!
Untitled Flashcards
Study
What is the definition of the Pre-operative Phase?
The Pre-operative Phase begins when the client decides to have surgery and ends when the client is transferred to the operating bed.
What are the five types of surgery based on urgency?
a. Emergent b. Urgent c. Required d. Elective e. Optional
requires immediate intervention due to a life-threatening condition
Emergent
necessary for the client's health, but the timing can be planned
Required
equires prompt intervention, but not immediately life-threatening
Urgent
What are the key nursing activities during the Pre-operative Phase?
The key nursing activities during the Pre-operative Phase include: a. Assessment of the client b. Identification of potential or actual health problems. c. Planning specific care based on the individual’s needs d. Pre-operative teaching, including the client and support persons
Briefly explain each type of surgery based on urgency.
a. Emergent: requires immediate intervention due to a life-threatening condition. b. Urgent: requires prompt intervention, but not immediately life-threatening. c. Required: necessary for the client's health, but the timing can be planned. d. Elective: the client chooses to have the surgery for improved quality of life. e. Optional: the client chooses to have the surgery for personal reasons.
What is the purpose of 'Diagnostic' surgery?
Diagnostic surgery is performed to confirm a suspected diagnosis.
What is the purpose of 'Curative' surgery?
Curative surgery is aimed at repairing or removing a damaged body organ to cure a disease.
What is the purpose of 'Palliative' surgery?
Palliative surgery is performed to alleviate pain.
What is the purpose of 'Reconstructive' surgery?
Reconstructive surgery is used to repair physical deformities or for plastic surgery.
What is the purpose of 'Transplantation' surgery?
Transplantation surgery involves replacing a diseased or damaged organ with either a donated or artificial organ.
What are some of the 'DO’s' when conducting a pre-operative visit?
- Ensuring the client is well-informed about the procedure. - Providing complete information, including risks. - Offering support to address any concerns.
What are some of the 'DON’T’s' during a pre-operative visit?
- Avoiding hasty decisions without informed consent. - Not withholding information about treatment and risks. - Refraining from neglecting the client's need for information and reassurance.
What is the definition of 'Informed Consent' in the context of a pre-operative visit?
Informed Consent is an agreement by a client to accept a course of treatment or a procedure after complete information, including the risk of treatment and related facts, has been provided by the physician.
What are the diagnostic tests typically conducted before surgery?
Diagnostic tests conducted before surgery may include: a. CP clearance b. Urinalysis c. CBC (Complete Blood Count) d. X-ray e. FBS (Fasting Blood Sugar)
Why is it important to conduct diagnostic tests before surgery?
Diagnostic tests are essential to assess the patient's overall health, identify any underlying conditions, and ensure they are fit for the surgical procedure. These tests help in planning and managing the surgery effectively.
When does the Intraoperative Phase begin and end?
The Intraoperative Phase begins when the client is transferred to the operating room and ends when the client is admitted to the post-anesthesia area or recovery room.
What are the key activities performed during the Intraoperative Phase to provide comprehensive care during surgery?
Activities during the Intraoperative Phase include: - Assessing the client's physiologic and psychologic status. - Reviewing diagnostic test and lab study results. - Positioning the client for surgery. - Performing the surgical skin preparation. - Assisting in preparing the sterile field. - Opening and dispensing sterile supplies. - Monitoring and maintaining a safe, aseptic environment. - Managing catheters, tubes, drains, and specimens. - Performing sponge, sharps, and instrument counts. - Administering medications and solutions to the sterile field. - Documenting nursing care and the client's response to interventions.
What is the primary focus of the Intraoperative Phase?
The primary focus of the Intraoperative Phase is to provide the client with comprehensive, safe, and effective care during the surgical procedure.
What are the two main factors that govern the choice of surgical incisions?
The two main factors governing surgical incisions are direction and location.
What does surgical skin preparation involve, and why is it done?
Surgical skin preparation involves cleaning the surgical site, removing hair (or shaving the operative site if necessary), and applying an antibacterial agent. It is done to reduce the risk of post-operative wound infection.
What is the purpose of skin preparation in surgery, and how is it achieved?
The purpose of skin preparation is to reduce the risk of post-operative wound infection. This is achieved by: - Removing soil and transient microbes from the skin. - Reducing the resident microbial count to sub-pathogenic amounts quickly and with minimal tissue irritation. - Inhibiting rapid rebound growth of microbes.
What should a nurse do when inspecting the prospective surgical area, and why is this important?
The nurse should inspect the prospective surgical area for growths, moles, rashes, pustules, irritations, abrasions, bruises, or any broken or ischemic areas. This should be recorded and reported to the surgeon to ensure the safety of the surgical procedure.
Why is it essential for a nurse to determine if a client is allergic to any solutions used in skin preparation?
It is crucial to determine if a client is allergic to any solutions used in skin preparation to prevent allergic reactions or complications during or after surgery.
What is the recommended concentration of iodine or iodophors for effective antiseptic use in surgery?
The recommended concentration is 1.5% or 2% in water or in 70% alcohol.
What are iodophors, and how are they different from plain iodine?
Iodophors, such as Betadine Surgical scrub, are iodine complexes combined with detergents, making them more suitable for surgical use.
What additional properties does Povidone-iodine (iodophor) have, making it an excellent antiseptic?
Povidone-iodine has a surfactant, wetting, and dispersive agent, enhancing its antiseptic properties.
How does iodophor in 70% alcohol function during skin cleansing, and what are its characteristics?
Iodophor in 70% alcohol is an excellent cleansing agent that removes debris from the skin surfaces while slowly releasing iodine.
What is the recommended concentration of iodine or iodophors for effective antiseptic use in surgery?
The recommended concentration is 1.5% or 2% in water or in 70% alcohol.
What are iodophors, and how are they different from plain iodine?
Iodophors, such as Betadine Surgical scrub, are iodine complexes combined with detergents, making them more suitable for surgical use.
What additional properties does Povidone-iodine (iodophor) have, making it an excellent antiseptic?
Povidone-iodine has a surfactant, wetting, and dispersive agent, enhancing its antiseptic properties.
How does iodophor in 70% alcohol function during skin cleansing, and what are its characteristics?
Iodophor in 70% alcohol is an excellent cleansing agent that removes debris from the skin surfaces while slowly releasing iodine. It has broad-spectrum antimicrobial properties and is non-toxic and non-irritating to the skin or mucous membrane.
What proteins do isopropyl or ethyl alcohols target?
Isopropyl or ethyl alcohols target proteins in cells.
How do isopropyl or ethyl alcohols work as antiseptics?
Isopropyl or ethyl alcohols denature proteins in cells by coagulating them, making them effective broad-spectrum antiseptic agents.
What precautions should be taken when using alcohol as an antiseptic in surgery?
Alcohol should not be applied to mucous membranes or used in an open wound.
How should a nurse scrub the skin when using an alcohol-based antiseptic?
The nurse should scrub the skin starting at the site of incision with a circular motion in ever-widening circles to the periphery. Sufficient pressure and friction should be used to remove dirt and microorganisms from the skin and pores.
Why is the technique of scrubbing the skin important when using an alcohol-based antiseptic?
The technique of scrubbing the skin is important for effective skin preparation in surgery.
What does the abdominal preparation area include?
The abdominal preparation area includes the breast line to the upper third of the thighs.
What is the patient's position during abdominal preparation?
The patient is in a supine position during abdominal preparation.
What areas are encompassed in rectoperineal and vaginal preparation?
Rectoperineal and vaginal preparation includes the pubis, vulva, labia, anus, and adjacent areas, including the inner aspects of the upper third of the thighs.
Which regions are involved in lateral thoracoabdominal preparation?
Lateral thoracoabdominal preparation includes the axilla, chest, and abdomen, extending from the neck to the crest of the ilium.
How should the patient be positioned during lateral thoracoabdominal preparation?
The patient is in a lateral position on the operating table during lateral thoracoabdominal preparation.
What does the chest and breast preparation area cover?
The chest and breast preparation area covers the shoulder, upper arm down to the elbow, axilla, and chest wall to the table line. It extends beyond the sternum to the opposite shoulder. If the patient is in a lateral position, the back is also prepped.
What areas are part of hip preparation?
Hip preparation includes the abdomen on the affected side, the thigh to the knee, buttock to the table line, groin, and pubis.
What does the knee and lower leg preparation area encompass?
The knee and lower leg preparation area encompasses the entire circumference of the affected leg and extends from the foot to the upper part of the thigh.
Describe the dorsal position.
In the dorsal position, the patient lies on their back in a horizontal recumbent position, with arms extended at the sides and held in place by a draw sheet.
What characterizes the dorsal lithotomy position?
In the dorsal lithotomy position, the patient's legs are flexed on the abdomen and held in place by stirrups.
How is the Trendelenburg position defined?
The Trendelenburg position involves tilting the table so that the pelvis is positioned higher than the head.
What is the patient's posture in the jack knife or modified knee chest position?
In the jack knife or modified knee chest position, the patient lies on their abdomen with the hip joint over the break of the table.
How is the patient's body oriented in the lateral/side-lying/Sim's position?
In the lateral/side-lying/Sim's position, the patient's body is turned to the side.
What is general anesthesia?
General anesthesia is a reversible state of consciousness produced by anesthetic agents.
What are the basic elements of general anesthesia?
The basic elements of general anesthesia include loss of consciousness, analgesia (insensibility to pain), hypnosis (artificial sleep), and relaxation (rendering a part of the body less tense).
What happens when a patient is under general anesthesia?
When a patient is under general anesthesia, they are unconscious and do not recall the surgical procedure.
Advantages of General Anesthesia
General anesthesia allows the client to be unconscious, making it easier to regulate respiration and cardiac function.
Tailoring Anesthesia to Client's Needs
Anesthesia can be adjusted to the length of the operation and the client's age and physical status.
Effects of General Anesthesia on Respiratory and Circulatory Systems
General anesthesia depresses the respiratory and circulatory systems.
Methods of Administering General Anesthesia: Inhalation
Inhalation is the most common and controllable method because uptake and elimination of anesthetic agents primarily occur through pulmonary ventilation.
Delivery of Anesthetic Vapor in Inhalation Anesthesia
The anesthetic vapor, whether from a volatile liquid or anesthetic gas, is inhaled by the patient and carried to the bloodstream by passing across the alveolar membrane into general circulation and onto the body's tissues.
Halothane (Fluothane)
Halothane is a halogenated volatile compound used as an anesthetic agent.
Characteristics of Halothane
Halothane is potent, non-irritating, has a pleasant odor, and acts as a cardiovascular and respiratory depressant.
Use of Halothane in Surgical Procedures
Halothane is used in various surgical procedures, except in routine obstetrics where uterine relaxation is not desired.
Disadvantages of Halothane
Halothane has the potential to be toxic to the liver and can progressively depress respiration. It can also act as a cardiovascular depressant, potentially causing hypotension, bradycardia, or cardiac arrest.
What is Enflurane (Ethane)?
Enflurane, also known as Ethane, is an inhalation anesthetic used in surgery.
What is Methoxyflurane (Penthrane)?
Methoxyflurane, or Penthrane, is another inhalation anesthetic commonly used during surgical procedures.
What is Nitrous oxide (N2O), and how is it administered during surgery?
Nitrous oxide (N2O) is an inhalation anesthetic. It is administered with oxygen during surgery.
How is intravenous anesthesia administered, and why is oxygen always used in conjunction with it?
Intravenous anesthesia is injected directly into the circulation, typically via a peripheral vein. It is always administered with oxygen to ensure adequate oxygenation during surgery.
What are barbiturates, and how are they used in anesthesia?
Barbiturates are a type of intravenous anesthesia. They are used to induce and maintain anesthesia during surgery.
What is Ketamine Hydrochloride, and how is it utilized in anesthesia?
Ketamine Hydrochloride is an intravenous anesthetic agent used for anesthesia induction and maintenance.
How are narcotics employed in anesthesia, and what are some examples of narcotics used in surgery?
Narcotics are used as part of intravenous anesthesia. Examples include Morphine sulfate, Fentanyl (Sublimaze), and Meperidine Hydrochloride (Demerol).
What are narcotic agonists and antagonists, and how are they relevant to anesthesia?
Narcotic agonists initiate drug actions by binding to specific receptors, while antagonists neutralize or impede the actions of other drugs, often reversing their effects. For example, when narcotics cause respiratory depression, opiate antagonists like Naloxone Hydrochloride (Narcan) can be used to reverse these effects.
How are tranquilizers involved in intravenous anesthesia, and what are some examples of these drugs?
Tranquilizers are administered during anesthesia. Examples include Diazepam (Valium) and Midazolam (Versed).
What is the primary purpose of local or regional anesthesia in surgery, and how is it achieved?
Local or regional anesthesia is used to block sensation in a specific body part or region. This is accomplished by blocking conductivity of sensory nerves supplying that area.
How is topical anesthesia applied, and what types of surfaces is it commonly used on?
Topical anesthesia is applied directly to skin, mucous membranes, open skin surfaces, wounds, or burns. It is absorbed rapidly and is commonly used for various procedures.
How is local anesthesia (infiltration) administered, and what types of surgical procedures is it typically used for?
Local anesthesia (infiltration) involves the injection of anesthetic agents into tissues to block peripheral nerve stimuli. It is commonly used for minor surgical procedures such as suturing wounds or performing biopsies.
What is a nerve block, and how does it work to provide anesthesia?
A nerve block involves injecting an anesthetic drug around a specific nerve or nerve plexus to interrupt sensory, motor, or sympathetic impulses, thereby producing loss of sensation.
What is a major anesthesia block, and what is an example of such a block?
A major block involves multiple nerves or a plexus and can anesthetize a larger area. An example is the brachial plexus block, which anesthetizes the arm.
What is a minor anesthesia block, and provide an example.
A minor block involves a single nerve and is used for more specific anesthesia. An example is a facial nerve block.
When is the intravenous block (Bier Block) most often used, and how does it work?
The Bier Block is used for procedures involving the arm, wrist, and hand. It involves applying an occlusion tourniquet to the extremity to prevent the spread of the injected intravenous agent beyond the involved extremity.
What is spinal anesthesia or an intrathecal block, and how is it administered?
Spinal anesthesia is achieved by injecting the anesthetic drug into the subarachnoid space, causing a loss of sensation below the level of the diaphragm. It doesn't result in a loss of consciousness.
What is the procedure for spinal anesthesia and where is the lumbar puncture typically performed?
The procedure involves a lumbar puncture between the L4 and L5 interspace.
What is a potential complication of spinal anesthesia, and how is it treated?
A postural-dependent spinal headache can occur. Treatment includes keeping the patient flat in bed for 6-8 hours, hydration to replace lost cerebrospinal fluid (CSF), and providing analgesics.
For what types of surgeries is spinal anesthesia commonly used?
Spinal anesthesia is typically used for abdominal surgery, pelvic surgery, urologic procedures, and is advised for specific patient populations, including alcoholics, barbiturate addicts, and muscular patients. It can also be used for patients with certain medical conditions.
What is the recommended position for a patient receiving spinal anesthesia, and how should the patient be positioned on the operating table?
The patient is usually in a lateral position with their back at the edge of the operating room table, parallel to it. The knees are flexed onto the abdomen, and the head is flexed toward the knees. Hips and shoulders should be vertical to the table to prevent spinal rotation.
What is the first principle of surgical asepsis?
Only sterile items are used within the sterile field.
Which part of gowns is considered sterile in the surgical field?
Gowns are considered sterile from the waist to shoulder level, in front and the sleeves.
At what level are tables considered sterile in the surgical field?
Tables are sterile only at table level.
Who in the surgical team touches only sterile items?
Sterile persons who are members of the surgical team touch only sterile items.
What should unsterile persons avoid doing in relation to a sterile field?
Unsterile persons should avoid reaching over a sterile field.
What is the status of the edges of anything that encloses sterile articles?
The edges of anything that encloses sterile articles are considered unsterile.
When should the sterile field be created?
The sterile field should be created as close as possible to the time of use.
How should sterile areas be continuously maintained?
Sterile areas should be continuously kept in view.
Where should sterile persons remain within the sterile area?
Sterile persons should keep well within the sterile area.
How much contact with sterile areas should sterile persons maintain as a minimum?
Sterile persons should keep contact with sterile areas to a minimum.
What should unsterile persons avoid in relation to sterile areas?
Unsterile persons should avoid sterile areas.
What results in contamination of a sterile field?
Destruction of the integrity of microbial barriers results in contamination.
What is a surgical conscience?
A surgical conscience is an inner voice that guides the practice of asepsis and sterile technique, telling us what is right or wrong.
What is the purpose of a surgical scrub?
The purpose of a surgical scrub is to remove as many microorganisms as possible from the hands and arms by mechanical washing and chemical asepsis before participating in an operation.
Why should fingernails not extend beyond the fingertips during a surgical scrub?
Extending fingernails beyond the fingertips can lead to glove puncture and is a potential source of contamination.
What are the primary purposes of a surgical scrub?
The primary purposes of a surgical scrub are to decrease the number of microorganisms on the skin to an irreducible level, keep the microbial population minimal during the operation, and reduce the risk of microbial contamination of the operative wound.
What is the goal of surgical asepsis?
The goal of surgical asepsis is to prevent microorganisms from entering the client.
What should be inspected on the hands and forearms before a surgical scrub?
The skin integrity of the hands and forearms should be inspected for cuts and abrasions, and it should be intact.
Why should all finger jewelry be removed before a surgical scrub?
Finger jewelry should be removed because it can harbor microorganisms.
What should be done to ensure that all hair is covered before a surgical scrub?
All hair should be covered by headgear.
What should be done with gowns once they are contaminated in the surgical area?
Contaminated gowns should never be worn outside the surgical area.
What is the open method of gloving used for?
The open method is used for minor operations.
What is the closed method of gloving used for?
The closed method is used for major procedures.
Members of the sterile team in the operating room
Operating surgeon, assistant to the surgeon, and scrub nurse
Members of the unsterile team in the operating room
Anesthesiologist, circulating nurse, and others like medical technicians and transport aides
First duty of a scrub nurse before the surgeon arrives
Complete scrub according to accepted practice
What a scrub nurse should put on before the surgeon arrives
Sterile gown and gloves
Purpose of draping tables as necessary
Maintain sterility and prepare for the surgical procedure
When a scrub nurse should count sponges, instruments, needles, and sharps
Before the start of the operation
What a scrub nurse should do with surgical needles in terms of counting
Count surgical needles with the circulating nurse
How sponge counts should be recorded by the circulating nurse
Immediately
When counts should be performed during a surgical procedure
Before the start of the operation and before the surgeon starts closure of the body cavity or deep or large incision
What is involved in the table count performed by a scrub nurse and the circulating nurse
Counting all items on the instrument table and mayo stand
What is involved in the floor count performed by the circulating nurse
Counting sponges and other items that are recovered from the floor
What is involved in the field count performed by the circulating nurse
Totaling the floor and table counts and informing the surgeon if the sponge count is correct
Actions taken when an incorrect count is detected during a surgical procedure
Repeat the entire count immediately, look in various areas, check drapes and items on the table, recheck the field and wound, call the head nurse to check, take X-rays if necessary, make an incident report
What a scrub nurse should do after the surgeon and assistant scrub
Gown and glove the surgeons and assistants as soon as they enter the room
How a scrub nurse assists in draping the client
Offers towels, towel clips, and drapes to assist in draping the client according to the routine procedure
What should be positioned after draping is completed in the operating room
Mayo table should be brought into position at a right angle to the operating table
How a scrub nurse should hand a skin knife to the surgeon and a hemostat to the assistant
Hold the handle with the blade down and pointed towards the wrist, should never be pointed towards the surgeon
Role of a scrub nurse in terms of anticipating the needs of the surgeon during the operation
Watch the field and anticipate the needs of the surgeon, keep one step ahead in offering instruments, sutures, or sponges, quietly notify circulating nurse of supplies not on the table
How instruments should be passed to the surgeon during a procedure
Passed in a positive manner, slapped firmly into their palm in the proper position for use
What is the primary function of a hemostat in the operating room?
Controlling bleeding
In the surgical setting, what is the main purpose of scissors?
Cutting tissues
When would you typically use Mayo scissors during a surgical procedure?
Cutting sutures
How should instruments be maintained in terms of cleanliness during surgery, especially when they come into contact with blood?
Instruments should be kept as clean as possible, and any blood should be wiped off with a moist sponge
What is the recommended practice for returning instruments after use or cleaning?
Instruments should be promptly returned to the mayo stand after use or cleaning
What should you avoid using for small tissue specimens, and why?
Large clamps should be avoided for small specimens because they may damage or crush the tissue
Where should tissue specimens be placed, and what should be done if unsure about the specimen?
Tissue specimens should be placed in a specimen bottle, basin, wrapper, or towel. If unsure about the specimen, consult the surgeon
What is the key aspect to maintain when handling tissue specimens?
The surgical team should maintain sterile technique and be vigilant for any breaks in sterility
When should the count of sponges, needles, and instruments be performed during surgery?
The count should be conducted with the circulating nurse when the surgeon begins the closure of the wound
How should the mayo stand be cleared off as closure progresses?
The mayo stand should be cleared, leaving specific items such as a knife handle with a blade, tissue forceps, scissors, four hemostats, and two Allis forceps
What should be prepared to clean the area surrounding the incision once skin closure is completed?
A damp sponge should be ready to wash the blood from the area surrounding the incision after skin closure
What supplies should be ready for use during closure?
Betadine, dressings, and plaster should be readily available for use during closure
When should the circulating nurse wash hands and arms at the beginning of the day?
The circulating nurse should wash hands and arms for five minutes at the beginning of the day before entering the operating room
How can the circulating nurse assist the sterile scrub nurse after the scrub person or nurse has scrubbed?
The circulating nurse can provide assistance by opening packages of sterile supplies, flipping suture packets onto the instrument table, and ensuring the availability of essential supplies
What should the circulating nurse do when the patient arrives in the operating room?
The circulating nurse should greet and identify the patient, check the wristband, review the patient's chart for important information, ensure the patient's hair is covered with a cap, assist the patient in moving to the OR table, and make sure the patient is appropriately covered and positioned
What special care should be taken when placing arm boards for an IV?
The circulating nurse should place arm boards on both the left and right arms if an IV is to be infused
How should the circulating nurse assist in providing comfort during the induction of general anesthesia?
The circulating nurse should stay in the room and near the patient to provide comfort and assist the anesthesiologist in case the patient becomes agitated. This helps prevent potential injuries or falls
Why is it important for the circulating nurse to maintain a quiet environment during anesthesia induction?
A quiet environment is essential because patients may become excited during induction due to tactile or auditory stimulation, especially in the case of alcoholics
When is it appropriate to reposition the patient after anesthesia induction?
Repositioning the patient should only be done after receiving approval from the anesthesiologist
What precautions should be taken if cautery is to be used during surgery?
If cautery is to be used, ensure that the inactive dispersive electrode plate is placed in contact with the patient's skin to properly ground the patient. Avoid areas with scar tissue, hair, or bony prominences
Why is it important to adjust the overhead spotlight during surgery, and what considerations should be made?
The overhead spotlight should be adjusted to the site of the incision, but it should not be focused on the patient before they are asleep, as pre-op medications can affect the pupils. Using dim light is less irritating
What role does the circulating nurse play in the operating room regarding the needs of the sterile team?
The circulating nurse anticipates the needs of the sterile team, closely monitors the operation, and facilitates the quick retrieval of supplies.
What should the circulating nurse do if they must leave the room during surgery?
The circulating nurse should inform the scrub nurse before leaving the room.
How should the circulating nurse handle and count discarded sponges?
The circulating nurse should carefully collect, separate sponges by size, and count them. Sponge forceps or gloves should be used; bare hands should not be used.
If requested by the surgeon, how can the circulating nurse assist in monitoring blood loss during surgery?
The circulating nurse can weigh sponges and measure blood volume from the suction container.
What responsibilities does the circulating nurse have regarding obtaining blood products for transfusion?
The circulating nurse should obtain blood products for transfusion as necessary, either from the refrigerator or the blood bank.
How can the circulating nurse remain informed about the patient's condition during surgery?
The circulating nurse should know the patient's condition at all times by staying attentive and observing the surgical procedure.
What tasks are associated with preparing and labeling specimens for transportation to the laboratory?
The circulating nurse should prepare and label specimens for transportation to the laboratory.
What is the role of the circulating nurse in ensuring sterile technique during surgery?
The circulating nurse should remain alert to any breaks in sterile technique.
What responsibilities does the circulating nurse have in relation to counting sponges, sharps, and instruments during closure?
The circulating nurse should count sponges, sharps, and instruments with the scrub nurse, report the counts as correct or incorrect to the surgeon, and complete count records.
What should the circulating nurse do if another patient is scheduled to follow the current operation?
The circulating nurse should call the ward for the next patient at least 45 minutes before the scheduled time of operation to request pre-op medication. They should also ask the transport aide to fetch the client from the ward 30 minutes before the operation.
How can the circulating nurse help the surgeons and assistants after the operation is completed?
The circulating nurse can open the neck and back closures of gowns for the surgeons and assistants to remove the gowns without contaminating themselves.
What role does the circulating nurse play in assisting with dressing the patient after the operation?
The circulating nurse helps with dressing by having the scrub nurse roll drapes off the patient before applying the outer layer of dressing.
What is the responsibility of the circulating nurse regarding the connection of drainage systems?
The circulating nurse ensures that all drainage systems are connected as indicated.
How can the circulating nurse ensure the cleanliness of the patient after the operation is completed?
The circulating nurse washes off blood and feces, puts a clean gown and blanket on the patient, and arranges for a clean recovery room stretcher.
What are the final documentation requirements in the patient's chart after the operation?
The final documentation in the patient's chart includes the assessment of the client's skin condition, urine output, blood loss, the type of dressing used, and the time the patient was discharged from the operating room.
How can the circulating nurse help transport the patient to the recovery room or post-anesthetic care unit?
The circulating nurse can help move the patient to the stretcher or bed, ensuring that the chart and proper records accompany the patient. A nursing assistant can also assist in transporting the patient to the recovery room.
What is the primary function of Metzenbaum Scissors?
Metzenbaum Scissors are used for tissue dissection and are delicate, with curved tips for easy use.
What is the purpose of Mayo Scissors in surgery?
Mayo Scissors are used to cut suture materials during suturing and can be either straight or curved.
Describe the function of blade handles or scalpels in surgical procedures.
Blade handles or scalpels are metal handles with sterile blades used for incising the skin and for sharp dissection.
What is the function of Tissue/Thumb Forceps in surgery?
Tissue/Thumb Forceps are used for precision holding, particularly for delicate tissue used in suturing.
How do Thumb Forceps differ from regular Tissue Forceps?
Thumb Forceps are used to grasp tough tissue, such as fascia and breast tissue.
What is the purpose of Adson Forceps with teeth?
Adson Forceps with teeth are used for heavy-duty clasping, such as with the skin and suturing.
What is the role of Adson Pick-ups in surgery, particularly the smooth variety?
Smooth Adson Pick-ups are used to grasp delicate tissue.
How are Babcock forceps typically used in surgery?
Babcock forceps are used to grasp delicate tissue, such as the ovary, and are available in long and short sizes.
Describe the function of Kocher forceps.
Kocher forceps are used to grasp heavy tissue and can also be used as a clamp. The jaws may be straight or curved.
What is the primary purpose of Straight Clamps in surgical procedures?
Straight Clamps are used to clamp off superficial arteries, vessels on muscle layers, and serve as all-purpose hemostats.
When and how are Allis forceps used in surgery?
Allis forceps, which have teeth to hold tissue firmly, are used on tissue that will be excised. They are used to grasp tissue and come in short and long sizes.
For what specific purpose are Mosquito Clamps employed, especially in pediatric patients?
Mosquito Clamps are used to hold sutures aside, particularly for pediatric patients.
What role do Towel Clips play in the surgical field, and how is a backhaus towel clip used?
Towel Clips are used to keep towels that restrict the surgical field attached to the patient. A backhaus towel clip is used to hold towels and drapes in place.
What is the primary function of a Needle Holder in surgery?
A Needle Holder is used to hold suture needles firmly and push them through tissue. It is also used to secure scalpel blades to handles.
How are Malleable or Ribbon Retractors used in surgery, and what makes them manual?
Malleable or Ribbon Retractors are used to retract deep incisions and may be bent into various shapes. They are manual, meaning they require manipulation by hand.
What is the primary purpose of a Balfour Retractor with a Bladder blade, and how is it classified in terms of retention?
A Balfour Retractor with a Bladder blade is used to retract wound edges during deep abdominal procedures. It is classified as self-retaining.
When is a Deaver Retractor used in surgery?
A Deaver Retractor is used to retract deep abdominal or chest incisions.
What is the function of a Richardson Retractor?
A Richardson Retractor is used to pull layers of tissues aside in deep abdominal or chest incisions to better visualize the surgical site.
How are Army-Navy Retractors utilized in surgery, and what types of incisions are they best suited for?
Army-Navy Retractors are held at one end and used for shallow or superficial incisions.
What is the primary purpose of absorbable sutures in surgery, and how do they function?
Absorbable sutures are used to stitch tissues together and hold them until healing occurs. These materials are digested by the body cells and fluids during tissue healing, ensuring that absorption coincides with healing time.
Name two types of absorbable sutures and describe their characteristics.
a. Plain suture/Plain Catgut: Absorbed in 5 to 10 days, untreated gut. b. Chromic Suture/Chromic Cutgut: Treated with chromic oxide to control and lengthen the absorption time; not suitable for suturing the skin due to infection risk.
What sets non-absorbable sutures apart from absorbable ones, and when are they typically used?
Non-absorbable sutures are not absorbed or digested during the healing process and must be removed when healing is complete. They are often used for skin or retention sutures.
What is the purpose of a ligature or tie in surgical procedures, and where is it placed?
A ligature or tie is used to occlude the lumen of a blood vessel, typically placed around the vessel.
Define 'Surgical gut' or 'Cutgut' and specify the source of this suture material.
Surgical gut or Cutgut is a suture material made from the intestine of sheep.
Differentiate between 'Free Tie' and 'Suture Ligature' in surgical contexts.
Free Tie refers to a single strand of material handed to the surgeon to ligate or tie a vessel or structure, while Suture Ligature is a strand attached to a needle before use to ligate or tie a vessel or structure.
How is a 'Stay' or 'Tension Suture' used, and what role does it play in surgery?
A Stay or Tension Suture is a heavy, non-absorbable suture placed through tissue on each side of the primary suture line and a short distance from it. It is used to relieve tension and as a precautionary measure when there is a possibility of stress or pressure on the primary suture line.
What is the purpose of a 'Traction Suture' in surgery, and how is it utilized?
A Traction Suture is used to retract a part to the side of the operative field, keeping it out of the way.
Name two types of organic suture materials and describe them briefly.
a. Cotton Suture: Made from long staple cotton, treated to make it smooth, available in white or black. b. Silk Suture: An animal product made from silkworm cocoons, typically black.
Provide examples of inorganic suture materials and their applications.
a. Metal Clips b. Stainless Steel Wire: Used for skin closure and as a tension suture.
Where is post-operative care usually provided, and what is the immediate post-anesthetic phase of care?
Post-operative care is typically provided in the recovery room. The immediate post-anesthetic phase involves assessing the client for various parameters.
List the key assessments performed during the immediate post-anesthetic phase of care.
A. Adequacy of airway B. Oxygen saturation C. Adequacy of ventilation D. Level of consciousness E. Presence of protective reflexes F. Activity and ability to move extremities G. Skin color H. Fluid status
How can a nurse best assist a client with postoperative complications in preventing them?
By implementing "Huff coughing" every 2 hours or as needed, which helps keep the airways open and mobilizes secretions.
When caring for a client with a chronic lung disorder requiring supplemental oxygen, what is the appropriate and safe flow rate per nasal cannula?
The nurse should ensure 2 liters per minute or less of supplemental oxygen as clients with chronic lung disease may require only low levels of oxygen.
If the connection between chest tube and water seal is dislodged while a client with chest tubes is ambulating, what should the nurse do?
The most appropriate action is to reconnect the tube to the water seal as quickly as possible.
Among the listed clients, who is most at risk for issues with the transport of oxygen from the lungs to the tissues?
The client with anemia, as anemia involves a decrease in red blood cells and hemoglobin, which is essential for the transportation of oxygen to tissues.
What term best describes a client who experiences difficulty breathing while lying down and must assume an upright or sitting position to breathe more comfortably?
The client is experiencing "orthopnea," a condition where respiratory difficulty is related to a reclining position without other physical alterations.
What is the primary function of the respiratory system?
The function of the respiratory system is gas exchange.
How does the exchange of oxygen and carbon dioxide occur in the respiratory system?
Oxygen from inspired air diffuses from alveoli in the lung into the blood in the pulmonary capillaries, while carbon dioxide produced during cell metabolism diffuses from the blood into the alveoli and is exhaled.
Name some structures of the upper respiratory tract.
a) Mouth b) Nose c) Pharynx d) Larynx
What are the components of the lower respiratory tract?
a) Trachea b) Bronchi c) Bronchioles d) Alveoli e) Pulmonary capillary network f) Pleural membranes
What is inspiration, and how does it occur?
Inspiration is when air flows into the lungs. It happens when the diaphragm and intercostal muscles contract, increasing the thoracic cavity's size and lung volume while decreasing intrapulmonary pressure.
Describe the process of exhalation.
Exhalation is when air flows out of the lungs. It occurs as the diaphragm and intercostals relax, reducing lung volume and causing intrapulmonary pressure to rise, leading to the expulsion of air.
What happens during inspiration in terms of muscle actions and pressure changes?
During inspiration, the diaphragm and intercostal muscles contract, enlarging the thoracic cavity, increasing lung volume, and reducing intrapulmonary pressure. As a result, air rushes into the lungs to equalize the pressure.
How is gas exchange facilitated in the respiratory system?
Gas exchange occurs after the alveoli are ventilated. Pressure differences on each side of the respiratory membranes affect diffusion, enabling oxygen to diffuse from the alveoli into pulmonary blood vessels and carbon dioxide to diffuse from pulmonary blood vessels into the alveoli.
What are the primary methods of oxygen transport from the lungs to the body's tissues?
Oxygen is mainly transported in two ways: 97% of it combines with hemoglobin in red blood cells and is carried to tissues as oxyhemoglobin, while the remaining oxygen is dissolved and transported in plasma and cells.
Name some factors that can influence respiratory function.
Factors that can influence respiratory function include age, environment, lifestyle, health status, medications, and stress.
What is hypoxia, and what are some common signs and symptoms of hypoxia?
Hypoxia is a condition of insufficient oxygen anywhere in the body. Common signs and symptoms include rapid pulse, rapid, shallow respirations, increased restlessness, flaring of nares, substernal or intercostal retractions, and cyanosis.
Name some altered breathing patterns and their characteristics.
Altered breathing patterns include tachypnea (rapid rate), bradypnea (abnormally slow rate), apnea (cessation of breathing), Kussmaul's breathing (deep and labored, often seen in diabetic ketoacidosis), Cheyne-Stokes respirations (recurrent central apneas alternating with a crescendo-decrescendo pattern), and Biot's respirations (abrupt and irregular periods of apnea with consistent rate and depth).
What do the terms orthopnea and dyspnea refer to?
Orthopnea refers to the difficulty of breathing when lying down, necessitating an upright or sitting position to breathe comfortably. Dyspnea refers to the sensation of breathlessness or difficulty in breathing.
What are the indicators of a partially obstructed airway? How does it differ from a completely obstructed airway?
A partially obstructed airway is indicated by low-pitched snoring sounds during inhalation. A completely obstructed airway is indicated by extreme inspiratory effort with no chest movement.
What are some nursing measures to promote respiratory function?
Nursing measures include ensuring a patent airway, appropriate positioning, encouraging deep breathing and coughing, and ensuring adequate hydration.
How can incentive spirometry (Sustained Maximal Inspiration Devices) benefit respiratory function? Mention its uses.
Incentive spirometry helps improve pulmonary ventilation, counteract the effects of anesthesia or hypoventilation, loosen respiratory secretions, facilitate respiratory gaseous exchange, and expand collapsed alveoli.
What is the recommended positioning of the spirometer during its use?
Hold the spirometer in an upright position.
How should you breathe before using the incentive spirometer?
Exhale normally.
What should you do with your lips in relation to the mouthpiece of the spirometer?
Seal the lips tightly around the mouthpiece.
Describe the initial breathing pattern when using an incentive spirometer.
Take in a slow, deep breath for 2 seconds, initially increasing to 6 seconds to keep the ball or cylinder elevated as much as possible.
What should you do after inhaling with the spirometer?
Remove the mouthpiece and exhale normally.
Why should you cough after using the incentive spirometer?
Coughing helps raise secretions, allowing the client to expectorate or swallow them.
What should you do after the coughing effort with the spirometer?
Relax and take several normal breaths before proceeding.
How often should the procedure with the incentive spirometer be repeated?
Repeat the procedure several times and then 4-5 times hourly.
How should the mouthpiece of the spirometer be cleaned?
Clean the mouthpiece with water and then shake it dry.
What is the purpose of percussion in postural drainage?
Percussion helps mechanically dislodge tenacious secretions from the bronchial walls by trapping air against the chest.
What is the purpose of vibration in PVD?
Vibration is used to promote movement and mobilization of secretions in the airways.
What should be done to minimize discomfort during percussion?
Cover the area to be percussed with a towel or cloth to reduce discomfort.
Describe the hand placement for providing vibrations.
Place hands, palms down on the chest area to be drained, one hand over the other with the fingers together and extended or the hands may be placed side by side.
What is postural drainage, and what does it require for effective drainage?
Postural drainage is the gravity-driven drainage of secretions from various lung segments. It requires a variety of positions to drain all segments of the lungs.
When is the best time to perform postural drainage?
The best times for postural drainage are before breakfast, before lunch, late afternoon, and before bedtime.
What is the purpose of deep breathing exercises and coughing exercises?
These exercises are used to remove secretions in the airways. Coughing raises secretions, allowing the client to expectorate or swallow them.
How can pursed lips breathing benefit clients with restricted chest expansion?
Pursed lips breathing creates resistance to the air flowing out of the lungs, prolonging expiration and preventing airway collapse. It's beneficial for clients with restricted chest expansion.
What are the two primary components of chest physiotherapy?
a) Percussion (clapping) - b) Vibration (quivering)
List some common uses of steam inhalation.
a) To liquefy mucous secretions - b) To warm and humidify air - c) To relieve edema of the airways - d) To soothe irritated airways - e) To administer medications
What should be done to the client before initiating steam inhalation?
Explain the procedure and purpose to the client. (a)
What is the recommended position for the client during steam inhalation?
Place the client in a semi-fowler’s position. (b)
How can the client's eyes be protected from irritation during steam inhalation?
Cover the client’s eyes with a washcloth. (c)
What safety precaution should be taken regarding the electrical device used for steam inhalation?
Check the electrical device before use. (d)
Where should the steam inhalator be placed during the procedure?
Place the equipment on a flat, stable surface. (e)
What is the optimal distance between the spout of the steam inhalator and the client's nose?
Place the spout 12-18 inches away from the client’s nose. (f)
How long should steam inhalation be administered?
Administer for 10-15 minutes. (g)
What instructions should be given to the client regarding post-steam inhalation activities?
Inform the client to perform Deep Breathing Exercises (DBE) and Coughing Exercises (CE) after the procedure. (h)
What post-procedure care should be provided to the client?
Provide oral hygiene. (i)
What should be done as part of the aftercare for the equipment used for steam inhalation?
Do aftercare of the equipment. (j)
Why is oxygen therapy needed for clients?
Adequate oxygen supply is required when clients have difficulty ventilating all areas of their lungs or experience impaired gas exchange.
Who can initiate oxygen therapy in an emergency situation?
Nurses may initiate oxygen therapy in an emergency situation.
What are the potential safety precautions associated with oxygen therapy?
Oxygen facilitates combustion. What precautions should be taken?
What is the purpose of humidifying oxygen, and when is it required?
Humidification is required when using high liter flows of oxygen to prevent the dehydration of respiratory mucous membranes. What liter flow doesn't require humidification?
Send to Chat
AI Edit
Normal Text
Highlight
You can edit it by clicking the 'edit'! Once you have a few cards, you can begin to study it in full screen or use our AI study mode!
Send to Chat
AI Edit
Normal Text
Highlight
Continue adding your notes here.
Scholarly Assistant's Insights
NCM 112 RLE flashcard deck: pre-operative phase, types of surgery, and nursing activities in a nutshell.
Nursing
Pre-operative Phase
Surgery Types
Nursing Activities
Diagnostic Surgery
+22 more
Ask Scholarly Assistant
Similar Pages
Login to Leave a Comment
Give your feedback, or leave a comment on a page to share your thoughts with the community.
Login