What are some of the complications an obese patient would have with surgery?
delayed wound healing, wound dehiscence, infection, pneumonia, atelectasis, thrombophlebitis, dysrhythmias, and heart failure.
When doing pre-op teaching, what does the nurse teach the patient preoperatively that they should be doing post-operatively to increase the recovery?
Protein, colories, and vitamins are needed for wound healing and recovery from surgery; low-fat, high-fiber diets are important for chronic cardiovascular fitness, but are contraindicated in the would healing phase following surgery; failure to use the gastrointestinal tract for more than 4 or 5 days allows the intestinal mucosa to atrophy, putting the patient at risk for infection.
What medications are we likely to give someone before they go into surgery?
Sedation, reducing anxiety, inducing amnesia to minimize unpleasant surgical memories, increasing comfort during preoperative procedures, reducing gastric acidity and volume, increasing gastric emptying, decreasing nausea and vomiting, and reducing the incidence of aspiration by drying oral and respiratory secretions.
Sedation medications prior to surgery.
Reducing anxiety medications prior to surgery.
Morphine; Sublimaze; Roxicodone; Vicodin; Ultram; Tylenol with Codeine
Inducing amnesia medications prior to surgery.
Reduce gastric acidity and volume prior to surgery.
Tagamet; Pepcid; Axid; Zantac;
Prevacid; Prilosec; Protonix;
Enhances gastric emptying prior to surgery.
Reduces oral and respiatory secretions to decrease risk of aspiration; decreases bomiting and laryngospasm
Atropine sulfate; Robinul; Scopolamine
Prevents surgical site infections in orthopedic and general surgeries and is associated with lower risk of mortality in elderly patients.
What is the function of the different OR workers (scrub tech, scrub nurse, circulating nurse)?
Scrub person - handles sutures, instruments, and other equipment immediately adjacent to the sterile field.
Circulating nurse - oversees the physical aspects of the operating room itself, including the equipment, assests with transferring and positioning the patient, prepares the patient's skin, ensures that no break in aseptic technique occurs, and counts all sponges and instruments.
If given a set of ABGs can you diagnose the disorder?
PaCO2 35-45 mmHg (parital pressure of carbon dioxide)
PaO2 80-100 mmHg (parital pressure of oxygen)
HCO3 22-26 mmHg (bicarbonate concentration)
What lab values would be important to inform the surgeon before going into surgery?
Hgb; Hct; Glucose; hemoglobin-A1c; WBC; Platelet count; CO2; K+; Na+; Cl-; PT; PTT; BUN
How do you know after surgery when the patient is ready to eat?
Audible bowel sounds or passage of flatus
Be able to tell how peak and trough antibiotic levels are obtained?
peak (1-2 hours after oral administration, 1 hour after intramuscular administration, and 30 minutes after intavenous administration); trough (lowest level, usually a few minutes before the next scheduled dose)
What kind of precautions are necessary, when a patient is taking chemotherapy?
Nurses teach patients to increase fluid intake to flush out the drugs; to get extra rest, which can both assist therapy and help the patient avoid other illnesses; to limit their exposure to other people, expecially children or thos with infections.
What are the leading causes of cancer in the US?
What are the medications given for gout and the nursing implication for them?
NSAIDs - Indomethacin (Indocin)
Corticosteroids (for whom NSAIDs are contraindicated)
Uricosuric drugs (Benemid, Anturane)