Professional Documents
Culture Documents
Elective SX = Planned
Emergency SX = Unplanned
Same-Day Admission = Inpatient
Prior to SX Admission = Chronic Medical condition
Ambulatory SX = (Same day/outpatient sx) = Most common
ST. JOHNS WORT = Prolongs Anesthetic effect
GOLDENSEAL = Increase BP and swelling
LICORICE = Increase BP, swelling, or electrolyte imbalance
SCREEN FOR LATEX ALLERGY MUST INFORM PHYSICIAN/SURGEON to USE
NON-LATEX!
RESPIRATORY SCREENING: Airway Infection = Cancelled SX due to increased
risk of bronchospasm or decreased O2. Report to SX for corticosteroids if
asthmatic. Smokers should stop 6 weeks prior though unlikely.
ENDOCRINE SCREENING: PTS with DM- NEED TO TAKE SERUM GLUCOSE or
CAPILLARY IN MORNING OF SX TO GET BASELINE!
PRE-OP TEACHING:
SENSORY = patients want to know what they will see, hear, smell, and feel
during SX.
PROCESS = general flow of what is going to happen
PROCEDURAL********** = Details that are more specific (ex. IV line that
will be started while pt, with marked site w/ indelible marker, etc) THEY
CANNOT DRIVE AFTER SURGERY!
GENERAL SX INFO: ALL pt should be taught deep breathing/coughing/early
amb post op. Let them know of tubes, drains, etc. Tell them specificially what
they will have after waking up (ex. Total joint replacement will have an
immobilizer, or neurogsurgery = might wake up in ICU)
LEGAL PREPARATIONS: Informed consent must be signed (only surgeon can
do this +witness [nurse]). If patient is ALOC, family member can do it. In
emergency, next-in-line kin is contacted, if no response, sx is initiated w/o
consent.
PRE-OP MEDS: DO NOT GIVE PREOP MEDS UNTIL PATIENT SIGNS CONSENT!
PATIENT MUST REMAIN IN BED AFTER MEDS ARE GIVEN!
Hb = measurement of gas carrying capacity of RBC.
(Females: 11.7-16.0 g/dL Males: 13.2-17.3)
_____________________________________________________________
CHAPTER 35 HF
DX: Difficult bc of unspecific s/s. EMB may be used for those who develop
unexplained, new HF,. EF is used to differentiate systolic and diastolic HF.
BNP levels aid in LEFT VENTRICULAR DYSNFUNCTION.
Nursing diagnoses
Activity intolerance
Fluid volume excess
Impaired gas exchange
Anxiety
Deficient knowledge
Planning: Overall goals
Decrease in symptoms (e.g., shortness of breath, fatigue)
Health promotion
Treatment or control of underlying heart disease key to preventing
HF and episodes of ADHF (e.g., valve replacement, control of
hypertension, coronary revasculariztion)