Week 1 exam - notes PDF

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Perioperative nursing is divided into three phases Preoperative -when the decision is made or surgery has been scheduled Ends when the client is transferred to the or Intraoperative – begins when the client is transferred to the or Ends when the client is transferred OUT of the OR Postoperative- Begins when the client leaves the OR for the PACU Ends when the client is transferred to med surg unit or discharged home (outpatient First thing we do is the history Past health history Diagnosed medical conditions (previous or current) Allergies – indicative of latex allergy (1 question on this) Previous surgeries and problems Medication use Substance abuse Reactions to anesthesia - Malignant hyperthermia (1-2 questions)_ (allergic reaction to anesthesia) Drug named dantrolene which is a muscle relaxer Assess anxiety Lab results Dvt risk Head to toe and vitals signs Ginseng, gingkobolva, ginger, gingko pg.302 Patients with latex allergy are scheduled early in the morning Incision and drainage and infectious last case as well as

Normal labs: (2 QUESTIONS) HCT WBC NA K CA CL MG PO4BUN GREAT HB/HCT

All patients who are on bed rest, immobile, females over 65, or heart problems are high risk for DVT Early ambulation is the key to prevent this SCD situational compression devices CPM machine – keeps cycling their leg PT is another good option to help someone ambulate Promotes wound healing Atelectasis – incentive spirometry All pre op patients above 40 must get an EKG BMP + a urine routine= includes sodium, potassium, chloride, calcium, bun Never tell a patient to prep their own skin that’s your job (shaving, dentures, nail polish) Order of removal: Jewelry at home Cellphones before holding area Dentures out Eyewear Hearing aid (always the last one) THE NURSE IS ONLY RESPOSNIBLE TO WITNESS THE CONSENT (PATIENT WHO SIGNED THE CONSENT) PATIENT CAN REVOKE CONSENT AT ANY TIME (1-2 QUESTIONS ON CONSENT THIS WEEK) CONSENT NEEDS TO BE SIGNED BEFORE TAKING ANXIETY MEDICATION AND ALSO MAKE SURE THE PATIENT USES THE BATHROOM PRIOR TO TAKING IT ATROPINE – DRY OUT SECRETIONS IN THE MOUTH METACLOPROMIDE ZOFRAN IN THE OR SCRUB NURSE - WHOEVER IS ACTIVILY PARTICIPATING IN THE SURGERY CIRCULATORY NURSE – HAND OFF REPORT IS GIVEN TO THIS NURSE Every minor who is pregnant can make decisions for themselves Minors can give consent for sti/std testing Emancipated minor (3) questions from fundamentals each week on each quiz (17,18,19) this week Postoperative nursing care Pacu nurse Immediate to 48hr -respiratory depress 30ml per hour is REQUIRED FOR A PACU PATIENT

DEHISCNE – SPEARTION ON WOUND EVISERATION – ORGANS COME OUT LOW FOELWERS WITH KNEES BENT Jehovah witness does not want blood do not give it to them and honor it Precautions for dvt Thyroid post up – abcs Ketamine and starts hallucinating get benzopyine to help them out (the chart in the book) If blood pressure is post up it is expected to decrease but look at vitalks and see if above normal Antidotes (1 question)...