NURS 120 MED SURGE-PERIOPERATIVE NURSING CARE
EXAM GUIDE A+ 2023
Chapter 95 – Med Surg ATI
Preoperative
o Begins when the decision is made, or surgery scheduled
o Ends when the client is transferred to the operating room (OR)
o 4 G’s need to be avoided (garlic, ginseng, ginger and ginko) Pg. 1,192
o Pre-op phase (H/P, past/ medical surgical procedures)
Intraoperative
o Begins when the client is transferred to the OR
o Ends when the client is transferred to a post anesthesia care unit (PACU)
Postoperative
o Begins when client leaves the OR for the PACU
o Ends when the client is transferred to Med-Surg Unit or discharged home
(outpatient) Assessing risk factors from surgery:
o Infection
o Anemia
o Hypovolemia
o Electrolyte imbalance
o Age
o Pregnancy (fetal risk with anesthesia)
o Chronic Respiratory disease (COPD, pneumonia, asthma)
o CV disease
,NURS 120 MED SURGE-PERIOPERATIVE NURSING CARE
EXAM GUIDE A+ 2023
o Diabetes Mellitus (decrease intestinal motility, altered blood glucose levels,
delayed healing)
o Liver disease (altered medication metabolism, increased risk for bleeding).
o Kidney disease
o Endocrine disorders
o Immune disorders (allergies, immunocompromised)
o Coagulation defect
o Malnutrition (delayed healing)
o Obesity (Hypoventilation, anesthesia elimination, wound healing)
o Current medications (HTN, anticoagulants, NSAIDs, TCA, herbal medications (G’s),
Long-term corticosteroids
o Substance abuse
o Family History (Malignant Hyperthermia)
o Allergies (Latex, anesthetics)
Preoperative Assessment
Allergic to eggs: avoid flu or covid vaccine
o Obtain a detailed history
Past health history:
o Diagnosed medical conditions (previous and current)
o Allergies: Banana or Kiwi – indicative of latex allergy
o Eggs/Soybean – Do not give propofol
o Shellfish – No Iodine – Seafood – No Iodine
, NURS 120 MED SURGE-PERIOPERATIVE NURSING CARE
EXAM GUIDE A+ 2023
o Previous surgeries and problems
o Medication use: how much, when, what, how often, last dose, which route
o Substance abuse
o Reactions/problems to anesthesia (patient or family)
o Assess anxiety level and support systems
▪ Lab results
o Venous Thromboembolism risk: do a physical assess.
o Head to toe assessment, Vital signs, and O2 Sat
o After surgery- 6 hrs to a
chair Diagnostic Tests
Lab profile: PLEASE REVIEW ALL THE NORMAL VALUES
o UA: r/o infections, Renal function
o Blood type & crossmatch: Ready for transfusion – Please go through procedure of
blood transfusion – steps and other Nsg Responsibilities – ATI/Exam
o Complete before surgery:
o CBC: Infection/immune status,
o Hgb and Hct (fluid status, anemia)
o Electrolytes
o Kidney function (Serum Creatinine and BUN)
o Pregnancy tests – Fetal risk for Anesthesia
o Heart and Lung Status (CXR)
EXAM GUIDE A+ 2023
Chapter 95 – Med Surg ATI
Preoperative
o Begins when the decision is made, or surgery scheduled
o Ends when the client is transferred to the operating room (OR)
o 4 G’s need to be avoided (garlic, ginseng, ginger and ginko) Pg. 1,192
o Pre-op phase (H/P, past/ medical surgical procedures)
Intraoperative
o Begins when the client is transferred to the OR
o Ends when the client is transferred to a post anesthesia care unit (PACU)
Postoperative
o Begins when client leaves the OR for the PACU
o Ends when the client is transferred to Med-Surg Unit or discharged home
(outpatient) Assessing risk factors from surgery:
o Infection
o Anemia
o Hypovolemia
o Electrolyte imbalance
o Age
o Pregnancy (fetal risk with anesthesia)
o Chronic Respiratory disease (COPD, pneumonia, asthma)
o CV disease
,NURS 120 MED SURGE-PERIOPERATIVE NURSING CARE
EXAM GUIDE A+ 2023
o Diabetes Mellitus (decrease intestinal motility, altered blood glucose levels,
delayed healing)
o Liver disease (altered medication metabolism, increased risk for bleeding).
o Kidney disease
o Endocrine disorders
o Immune disorders (allergies, immunocompromised)
o Coagulation defect
o Malnutrition (delayed healing)
o Obesity (Hypoventilation, anesthesia elimination, wound healing)
o Current medications (HTN, anticoagulants, NSAIDs, TCA, herbal medications (G’s),
Long-term corticosteroids
o Substance abuse
o Family History (Malignant Hyperthermia)
o Allergies (Latex, anesthetics)
Preoperative Assessment
Allergic to eggs: avoid flu or covid vaccine
o Obtain a detailed history
Past health history:
o Diagnosed medical conditions (previous and current)
o Allergies: Banana or Kiwi – indicative of latex allergy
o Eggs/Soybean – Do not give propofol
o Shellfish – No Iodine – Seafood – No Iodine
, NURS 120 MED SURGE-PERIOPERATIVE NURSING CARE
EXAM GUIDE A+ 2023
o Previous surgeries and problems
o Medication use: how much, when, what, how often, last dose, which route
o Substance abuse
o Reactions/problems to anesthesia (patient or family)
o Assess anxiety level and support systems
▪ Lab results
o Venous Thromboembolism risk: do a physical assess.
o Head to toe assessment, Vital signs, and O2 Sat
o After surgery- 6 hrs to a
chair Diagnostic Tests
Lab profile: PLEASE REVIEW ALL THE NORMAL VALUES
o UA: r/o infections, Renal function
o Blood type & crossmatch: Ready for transfusion – Please go through procedure of
blood transfusion – steps and other Nsg Responsibilities – ATI/Exam
o Complete before surgery:
o CBC: Infection/immune status,
o Hgb and Hct (fluid status, anemia)
o Electrolytes
o Kidney function (Serum Creatinine and BUN)
o Pregnancy tests – Fetal risk for Anesthesia
o Heart and Lung Status (CXR)
