[NUR 324] - Midterm Exam Guide - Ultimate 27 pages long Study Guide!

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7 Feb 2017
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Quinnipiac University
NUR 324
MIDTERM EXAM
STUDY GUIDE
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Perioperative Nursing
Ambulatory Surgery: same day surgery
Bariatric: morbid obesity, may have special beds, gastric bypass surgey
Informed consent
Intraoperative phase: period of time from when patient is transferred into operating room to
admission to post anesthesia care unit (PACU)
Laparoscopy: tubes
Minimally inasie sugey: don’t euie geneal anesthesia
Perioperative phase: period of time from decision for surgery until patient is transferred into
operating room
Postoperative phase: period of time from when patient is admitted to PACU to follow up
evaluation in clinical setting or at home
Preadmission testing
Preoperative phase: before OR
Pre-Operative Care
Standard of care
- Perioperative nursing data set
safety
Physiologic responses
Behavioral responses
Health care systems (not every system is the same)
Practices impact surgery
- Technology
Scans, robotics, expensive
- Anesthesia
- Surgical classification
Diagnostic: Biopsy (benign or malignant)
Reparative: ACL repair
Reconstructive, cosmetic: birth defects (cleft palette), breast augmentation,
mastectomy (reparative)
Palliative: end of life care
- Preadmission testing
Initial preoperative assessment
o Done by surgeon or GP before surgery
Initiates teaching appropriate to patient’s needs
Involves family/significant other in interview
Verifies completion of preoperative testing
o Requires lab work, clotting time, INR factor, Chest x ray, EKG
Verifies understanding of surgeon-specific preoperative orders
o Know the surgeons preferred methods and test
Discusses, reviews advanced directive documents
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o Kno the patient’s ishes
Begins discharge planning by assessing patients need for postoperative
transportation care
Joint commission requires there be a history of physical 30 days prior to surgery
(elective cases)
- Special considerations
Geriatric/gerontologic considerations
o How strong you feel, who is going to assist at home, living situation
Obesity bariatric
Disabilities
o Underlying conditions
Ambulatory surgery
Emergency surgery
Categories of surgery
Level 1: emergent without delay
Level 2: urgent within 24-30 hours
Level 3: required within a few weeks/months
Level 4: elective no surgery, not catastrophic
Level 5: optional personal preference
Informed Consent
Persons autonomous decision
Persons cognitive function, must have informed consent
Is the sugeon’s esponsiility
Verbal and written clarity of communication
Legal mandate, benefit of process
Surgeons responsibility
Components are required
- Benefits
- Risk (must talk about)
- Alternatives
- Removal of body part
- Complications
- Disfigurement (permanent scar)
- Disability
- Postoperative care
- Give patient the knowledge that they can withdraw conscent at any time
Offer to answer any questions
Instructions that patient can withdrawal consent
Information if care differs from standards of care (any new technologies being used for first
time)
Invasive procedures
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