AANA Structure Flashcards
Standard for Nurse Anesthesia Practice
a) Assist the profession in evaluating the quality of care provided by practitioners
b) Provide a common base for practitioners to use in their development of a quality practice
c) Assist the public in understanding what to expect from the practitioner
d) Support and preserve the basic rights of the patient.
CRNAs responsible for:
-the quality of the service rendered
CRNA should document any
a) Deviations from the standards of care and
b) STATE deviations on the patient’s anesthesia record
Standard #1
Perform and document a THOROUGH PRE-anesthesia assessment and evaluation.
Standard #2
Informed consent
A procedure with NO INFORMED CONSENT, you can be charged with
Assault /Battery
Standard #3
Anesthesia Care plan
Standard #4
Adjust plan based on PHYSIOLOGIC Status.
Standard #5
Monitor/Evaluate physiologic condition Attend patient until other anesthesia arrive a)Oxygenation b)Ventilation c) CV: Cardiovascular d)Thermoregulatio e) Neuromuscular f) P ositioning
Circles for anesthesia
Every 5 minutes
Heparin (Vascular surgery):
State main pharmacokinetics to remind surgeon
3 (peak)
30 (half life)
1 hour (Drug elimination)
Monitor and document every BP and HR
5 minutes
Alarms max silence time
Max alarms silenced 2 minutes
Look at the patient to determine oxygenation
Skin color ; continuously monitor with SPO2
Placement of Endotracheal tube, STANDARD OF CARE is _________
ETCO2
Kids with high metabolism rate
Inspired air vs expired air
INTUBATION : CAFE
Chest excursion
AUCSCULTATION
Fog in the mask
End tidal CO2
CV - 2 assessments (major)
Heart sounds
ECG
Thermoregulation is used for
CV/ Neuro procedure
Warm fluids for machine
NEED TO FUNCTION on HIGH FLOW
PUT PRIOR TO INDUCTION
Neuromuscular blocking agents : 2 things to assess
- assess depth of blockade
- degree of recovery.
Positioning
Patient and protective measures
FOCUS on continuous clinical observation primarily.
OBSERVATION and VIGILANCE
Signature required
LEGIBLE LAST NAME.
Handoff
DO NOT LEAVE THE PATIENT UNTIL PACU REPORT
Continuity of care
FOLLOW UP on cases.
ASSESS QUALITY –>
Ongoing review and evaluation of anesthesia care
Adopted in 1974
Standards of care for Nursing Practice
Scope of Anesthesia practice
CRNAs are APRNS
Education, accountability and leadership
Graduate
Pass NCE
Lifelong learning
Recertification
Most specific
1- FACILITY
State licensure
Credentialing
CERTIFICATION and RECERTIFICATION
Most specific for requirements
FACILITY
Have card for
CENTRAL LINE INSERTIONS
Post graduate pain fellowships
USF
Texas (TCU)
Middle tennessee
Undermining
Low H&H
wait a few hours after blood