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Nursing: A Concept-Based Approach to Learning, Volume 1, 3rd Ed.
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Perioperative Care

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Nursing: A Concept-Based Approach to Learning, Volume 1, 3rd Ed. | Registered Nurse (RN) School Study Aid

Perioperative Care
39 Picmonics to Learn | 1 hr 5 mins
Preoperative Care
Preop Education
Surgical Procedure
NPO
Turn, Cough, Deep Breathe, Incentive Spirometer
Lower Extremity Exercises
Compression Stockings or SCD's
Pain Management
Safety
Informed Consent
Physical Preparation
Preop Checklist
Handoff to Surgery
Universal Precautions
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2 mins
Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
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2 mins
Interprofessional Team Member Roles
Roles of Members of the Health Care Team
Physician
Advanced Practice Registered Nurse
Nurse
Unlicensed Assistive Personnel
Physical Therapist
Occupational Therapist
Respiratory Therapist
Social Worker
Pharmacist
Dietitian
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4 mins
6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Nursing Considerations
Three Checks
Check for Allergies
Assess the Patient
Education
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2 mins
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
Bleeding Time Lab Values
2-7 Minutes
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41 secs
Hematocrit (Hct) Lab Values
Women: 36% - 46%
Men: 41% - 53%
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1 min
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
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47 secs
Red Blood Cell Count (RBC) Lab Values
Women: 3.5-5.5 million cells/ MuL
Men: 4.3-5.9 million cells/ MuL
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1 min
Platelet Lab Value
150,000-400,000 Micro L
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40 secs
Sodium (Na+) Lab Value
135-145 mEq/L
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24 secs
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Treat and Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
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2 mins
Potassium (K+) Lab Value
3.5 to 5.0 mEq/L
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20 secs
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
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1 min
Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
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2 mins
Metabolic Alkalosis Assessment
Signs and Symptoms
Increased pH > 7.45
Increased HCO3 > 26
Excitable State
Arrhythmias
Paresthesias
Muscle Cramps
Muscle Weakness
Decreased Respiratory Effort
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1 min
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
Blood Glucose Lab Value
70-100 mg/dL
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25 secs
Ondansetron
Indications
Postoperative Vomiting
Chemotherapy-induced Nausea and Vomiting
Mechanism
5-HT3 Serotonergic Antagonist
Centrally-acting Antiemetic
Side Effects
Headache
Constipation
QT Prolongation
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1 min
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Macrolides
Mechanism of Action
Bacteriostatic
Bind to 23S rRNA of 50S Subunit
Inhibit Protein Synthesis by Blocking Translocation
Macrolides
Erythromycin
Azithromycin
Clarithromycin
Indications
Gram-Positive Cocci
Atypical Pneumonia
Chlamydia
Considerations
Resistance by Methylation of 23S rRNA Binding
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2 mins
Aminoglycoside Overview
End in "-mycin"
GNATS
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Indications
Severe Gram Negative Infections
Bowel Surgery Prep
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1 min
Tetracyclines Overview
End in "-cycline"
Mechanism of Action
Bacteriostatic
Indications
Infectious Diseases
Acne
Periodontal Disease
Nursing Considerations
Avoid Milk, Antacids, Iron
Sunlight Protection
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1 min
Cephalosporins
Starts with "Cef-"
Mechanism of Action
Bactericidal
Indications
Gram-Positive and Gram-Negative Infections
Side Effects
Allergic Reactions
Thrombophlebitis
Bleeding
Contraindications
Renal Impairment
Considerations
Avoid IV Calcium with Ceftriaxone
No Alcohol
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2 mins
Penicillin
Mechanism of Action
Weakens Cell Wall
Indications
Gram-Positive Infections
Prophylaxis
Side Effects
Pain at IM Injection Site
Allergic Reaction
Considerations
Skin Tests
Allergy ID
Medication Education
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2 mins
Sulfonamides
Mechanism of Action
Bacteriostatic
Indications
Urinary Tract Infection
Side Effects
Crystalluria
Photosensitivity
Hemolytic Anemia
Kernicterus
Rash
Considerations
Sulfa Allergy
Encourage Fluids
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2 mins
Fluoroquinolones
End in "-floxacin"
Mechanism of Action
Bactericidal
Indications
Variety of Infections
Side Effects
GI Distress
Photosensitivity
Achilles Tendon Rupture
Contraindications
Pregnancy
Children
Myasthenia Gravis
Considerations
Avoid Milk Products or Antacids
Slow IV Infusion
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2 mins
Vancomycin
Mechanism of Action
Inhibits Bacterial Cell Wall Synthesis
Indications
Serious Gram-Positive Infections
Side Effects
Nephrotoxicity
Ototoxicity
Red Man Syndrome
Thrombophlebitis
Nursing Considerations
Culture Samples First
Infuse IV Over 60 Minutes
Take Around the Clock
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2 mins
Standard Precautions
Hand Hygiene
Wash In / Wash Out
Alcohol-Based Hand Rub
Hand Washing
Personal Protective Equipment (PPE)
Gown
Face Mask
Goggles/Face Shield
Gloves
Donning and Removing PPE
Discard Sharps in Puncture-Resistant Container
Cough Etiquette
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2 mins
Patient Position Overview
Position Techniques
Trochanter Roll
Trapeze Bar
Ankle-Foot Orthotic (AFO) Devices
Positions
Fowlers Position
Supine Position
Trendelenburg
Side-Lying Position
Prone Position
Sims' Position
Nursing Considerations
Reposition q2 Hours/Prevent Skin Breakdown
Confirm Body Alignment
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2 mins
Types of Wound Healing
Types of Wounds
Acute
Chronic
Healing Process
Primary Intention
Approximated Edges
Secondary Intention
Edges Not Approximated
Tertiary Intention
Delayed Closure due to Infection and Necrosis
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2 mins
Blood Transfusion Administration
Proper Patient Identification
Large Bore Needle
Y Tubing
Baseline Vital Signs
Slow IV Infusion
Monitor During First 15 Minutes or 50 mL of Blood
Monitor for Reactions
Considerations
Do Not Add Anything To Same IV Line
No Dextrose or Lactated Ringers
Jehovah's Witnesses, No Transfusions
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3 mins
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
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2 mins
Hypothermia Interventions
Remove From Environment
Remove Wet Clothing
Passive Rewarming
Warm Clothing
Active Rewarming
Heated Blankets
Warm IV Solutions
Heated Oxygen
Warm Gastric Lavage
Considerations
Warm Trunk BEFORE Extremities
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2 mins
Postoperative Fever
5 W's
Wind (Days 1-3)
Atelectasis
Pneumonia
Water (Days 3-5)
Urinary Tract Infection from Catheter
Walking (Days 4-6)
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Wound (Days 5-7)
Infection
Wonder Drugs (Days 7+)
Drugs
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2 mins

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