EMAIL US :
Med Surge 331 Exam 1
STUDY GUIDE: Cardiac,
Neuro & Renal
Systems Survival Kit
*(300+ NCLEX®-Style
Practice Questions,
ABG Interpretation
Cheat Sheets, Pharm
Mnemonics & 97%
First-Try Pass Rate
Tactics)
Med Surge 331 Exam 1
STUDY GUIDE
Perioperative
1
,EMAIL US :
module 1
Perioperative
module
I. Preoperative care: Can be months long or emergent- ends when they enter
the OR
II. Preop Checklist
a. Complete physical exam
b. Review of systems
c. Medical and surgical history
d. Evaluate laboratory findings
i. Include pregnancy test-we do not operate (especially electively) on
pregnant women
e. Make sure labs are normal going in
III. Preop teaching- good to teach what they need to do postop before surgery
IV. Informed consent
a. Surgeon explains procedure and ensures Pt understands.
b. Nurse is the witness to the Pt signature, that they aren’t being
coerced. Need to make sure patient understands the surgery
V. Surgical risk: health concerns, older adult
I. Factors that Increase Surgical Risk
a. Age: very young and older population-more at risk
b. Obesity: extra tissue/skin, extra pressure on the heart, extra stress on
the body
c. Malnutrition: lack muscle mass, underweight, not enough protein for
healing, anemic
d. Dehydration: maintain fluids and electrolytes, affects circulation
e. Cardiovascular & Respiratory disease: extra stress of heart and body
2
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f. Diabetes: Don’t heal well, circulatory and cardiovascular issues,
circulation, blood sugar
g. Renal & liver disease: responsible for medication/anesthesia
metabolism/breakdown
i. Alcoholism: decreased liver function, prolonged anesthetic,
altered nutritional status
h. Nicotine: stop smoking 6 weeks before surgery due to risks of
pulmonary complications during and after surgery.
i. Medications
i. Nicotine use
ii. Medications
iii. Anticoagulants
iv. Diuretics
v. Phenothiazines
1. used to treat psychiatric illness ie schizophrenia; other
psychotic disorders; dangerous because can cause
increased CNS depression and hypotension when used
during surgery; similar with MAOIs
vi. MAOI’s
vii. Antidepressants: Some can potentiate the effects of opioids
viii. Antihypertensives: Predispose the patient to shock from
combined effect of drug and the vasodilator effect of some
anesthetic agents
ix. insulin coin may require adjustments due to increased body
metabolism, decreased oral intake, stress, anesthesia
3
, EMAIL US :
II. preop diagnostic studies [Lewis table 17.5]
a. Evaluate laboratory findings-
i. Include pregnancy test-we do not operate (esp electively) on
pregnant women
b. Make sure labs are normal going in
c. BGs
III. Intraoperative care
a. Roles of the nurse
i. Can be circulating nurse, scrub nurse or assists- know these jobs
ii. Circulator: usually does Time Outs- do them several times and out
loud
1. Documents everything
iii. Circulating nurse
1. Remains in unsterile field, monitor, call time-outs,
document, assist, grabs other instruments, label for
pathology, count instruments
2. Usually in charge of Time Outs- do them several times and
out loud
a. Documents everything
iv. Scrub nurse/Tech:
1. Designated surgical hand antisepsis procedure, gowned and
gloved in sterile attire.
v. Surgeon
1. Physician who performs procedure. Responsible for
preoperative medical history, physical assessment,
discussing risks and alternatives , patient safety,
4
Med Surge 331 Exam 1
STUDY GUIDE: Cardiac,
Neuro & Renal
Systems Survival Kit
*(300+ NCLEX®-Style
Practice Questions,
ABG Interpretation
Cheat Sheets, Pharm
Mnemonics & 97%
First-Try Pass Rate
Tactics)
Med Surge 331 Exam 1
STUDY GUIDE
Perioperative
1
,EMAIL US :
module 1
Perioperative
module
I. Preoperative care: Can be months long or emergent- ends when they enter
the OR
II. Preop Checklist
a. Complete physical exam
b. Review of systems
c. Medical and surgical history
d. Evaluate laboratory findings
i. Include pregnancy test-we do not operate (especially electively) on
pregnant women
e. Make sure labs are normal going in
III. Preop teaching- good to teach what they need to do postop before surgery
IV. Informed consent
a. Surgeon explains procedure and ensures Pt understands.
b. Nurse is the witness to the Pt signature, that they aren’t being
coerced. Need to make sure patient understands the surgery
V. Surgical risk: health concerns, older adult
I. Factors that Increase Surgical Risk
a. Age: very young and older population-more at risk
b. Obesity: extra tissue/skin, extra pressure on the heart, extra stress on
the body
c. Malnutrition: lack muscle mass, underweight, not enough protein for
healing, anemic
d. Dehydration: maintain fluids and electrolytes, affects circulation
e. Cardiovascular & Respiratory disease: extra stress of heart and body
2
,EMAIL US :
f. Diabetes: Don’t heal well, circulatory and cardiovascular issues,
circulation, blood sugar
g. Renal & liver disease: responsible for medication/anesthesia
metabolism/breakdown
i. Alcoholism: decreased liver function, prolonged anesthetic,
altered nutritional status
h. Nicotine: stop smoking 6 weeks before surgery due to risks of
pulmonary complications during and after surgery.
i. Medications
i. Nicotine use
ii. Medications
iii. Anticoagulants
iv. Diuretics
v. Phenothiazines
1. used to treat psychiatric illness ie schizophrenia; other
psychotic disorders; dangerous because can cause
increased CNS depression and hypotension when used
during surgery; similar with MAOIs
vi. MAOI’s
vii. Antidepressants: Some can potentiate the effects of opioids
viii. Antihypertensives: Predispose the patient to shock from
combined effect of drug and the vasodilator effect of some
anesthetic agents
ix. insulin coin may require adjustments due to increased body
metabolism, decreased oral intake, stress, anesthesia
3
, EMAIL US :
II. preop diagnostic studies [Lewis table 17.5]
a. Evaluate laboratory findings-
i. Include pregnancy test-we do not operate (esp electively) on
pregnant women
b. Make sure labs are normal going in
c. BGs
III. Intraoperative care
a. Roles of the nurse
i. Can be circulating nurse, scrub nurse or assists- know these jobs
ii. Circulator: usually does Time Outs- do them several times and out
loud
1. Documents everything
iii. Circulating nurse
1. Remains in unsterile field, monitor, call time-outs,
document, assist, grabs other instruments, label for
pathology, count instruments
2. Usually in charge of Time Outs- do them several times and
out loud
a. Documents everything
iv. Scrub nurse/Tech:
1. Designated surgical hand antisepsis procedure, gowned and
gloved in sterile attire.
v. Surgeon
1. Physician who performs procedure. Responsible for
preoperative medical history, physical assessment,
discussing risks and alternatives , patient safety,
4
