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MEDICAL SURGICAL > Chapter 1 (Part 8) > Flashcards

Chapter 1 (Part 8) Flashcards

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USMLE® Step 1 flashcards
1
Q

Potential Intraoperative complication

A
  1. Anesthetic Awareness
  2. Nausea and Vomiting
  3. Anaphylaxis
  4. Hypoxia
  5. Hypothermia
  6. Malignant Hyperthermia
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2
Q

Pathophysiology of Malignant Hyperthermia

A
  1. Prompts calcium function
  2. Hypermetabolism
  3. Increase muscle contraction
  4. Hyperthermia
  5. Damage to the CNS
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3
Q

Triggers symptoms of malignant hyperthermia

A

Inhalation agents and muscle relaxants

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4
Q

Clinical Manifestation of Malignant Hyperthermia

A
  1. Abnormal Cardiovascular, respiratory, & musculoskeletal activity
  2. Tachycardia
  3. Hypotension
  4. Decreased cardiac output, oliguria, & cardiac arrest
  5. Hypercapnia (increase in CO2)
  6. Abnormal transport of calcium rigidity
  7. Rise of body temperature (can exceed 42 degrees C)
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5
Q

Time to leave the OR Room to last follow-up w/ surgeon

A

Post operative Care

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6
Q

Goals of Post operative care

A
  1. Restore homeostasis & prevent complication
  2. Maintain adequate cardiovascular & tissue perfusion
  3. Maintain adequate Respiratory function
  4. Maintain adequate nutrition and elimination
  5. Maintain adequate fluid and electrolyte balance
  6. Maintain adequate renal function
  7. Promote adequate rest, comfort, and safety
  8. Promote and maintain activity and mobility
  9. Promote adequate psychological support
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7
Q

Transport of client from OR to Resting room

A

PACU CARE

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8
Q

PACU CARE

A
  1. Avoid exposure
  2. Avoid rough handling
  3. Avoid hurried movement and rapid changes in positions
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9
Q

Initial Nursing Assessment in PACU CARE

A
  1. Verify patient’s identity, operative procedure, and the surgeon who performed the procedure
  2. Evaluate the ff signs
    - Respiratory status
    - Circulatory status
    - Pulse rate
    - Temperature
    - Oxygen saturation
    - Hemodynamic values
  3. Determine swallowing and gag reflex, LOC, and patient’s response to stimuli
  4. Evaluate lines, tubes, or drains, estimate blood loss, condition of wound, medication used, transfusion, and output
  5. Evaluate the patient’s level of comfort and safety
  6. Perform safety check
  7. Evaluate activity status
  8. Review the HCP’s order
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10
Q

Nursing Management in PACU CARE

A

 Assess the patient
 Maintain patient’s airway
 Assess status of circulatory system
 Maintaining adequate respiratory function
 Assessing thermoregulatory status
 Maintain fluid volume
 Hypotension & Shock
 Hemorrhage
 Hypertensions & dysrhythmias
 Minimize complication
 Safety

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11
Q

Types of Hemmorhage

A
  1. Primary
  2. Intermediary
  3. Secondary
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12
Q

hemorrhage occurs after time of surgery

A

Primary

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13
Q

occurs during first few hours after surgery

A

Intermediary

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14
Q

occur sometime after surgery

A

Secondary

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15
Q

Types according of vessel

A
  1. Capillary
  2. Venous
  3. Arterial
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16
Q

hemorrhage is characterized by slow, general ooze

A

Capillary

17
Q

darkly colored blood flows quickly

A

Venous

18
Q

Bright red bloos

A

Aterial

19
Q

Types according to visibility

A
  1. Evident
  2. Concealed
20
Q

Gerontological Consideration

A
  1. Keep warm
  2. Change positions frequently (prevent bed sores)
  3. Monitor cardiopulmonary deficits
  4. Changes associated with aging process
    a. Alteration in fluid & nutritional status
    b. Increase use of medications
    c. Post op delirium
  5. Dehydration, constipation, & malnutrition
  6. Sensory Limitation
  7. Maintain Safe environment
21
Q

Parameters for Discharge (Aldrete’s Score)

A
  1. Activity
  2. Respiration
  3. Circulation
  4. Consciousness
  5. Skin color
22
Q

Aldrete’s score for discharge

A

7-10

23
Q

Aldrete’s score for do not discharge

A

Below 7

24
Q

Activity 2

A

Able to move spontaneously or on command four extremities

25
Q

Activity 1

A

Able to move voluntarily or on command two extremities

26
Q

Activity 0

A

Unable to move any extremities

27
Q

Respiration 2

A

Able to deep breath and cough freely

28
Q

Respiration 1

A

Dyspnea, shallow or limited breathing

29
Q

Respiration 0

A

Apneic

30
Q

Circulation 2

A

BP+20 mmHg of pre-sedation level

31
Q

Circulation 1

A

BP+20 - 50 mmHg of pre-sedation level

32
Q

Circulation 0

A

BP+50 mmHg of pre-sedation level

33
Q

Consciousness 2

A

Fully Awake

34
Q

Consciousness 1

A

Arousable on calling

35
Q

Consciousness 0

A

Not responding

36
Q

Skin color 2

A

Normal

37
Q

Skin color 1

A

Pale, dusky, blotchy, jaundiced, other

38
Q

Skin color 0

A

Cyanotic

39
Q

Immediate postoperative assessment intervention

A
  1. Neurological status- Assess LOC (ask name), swallowing, gag reflex
  2. Fluid & Electrolyte Balance
  3. Dressing, tubes, Drains
  4. Pain
  5. Safety & Comfort
  6. Respiratory function
  7. Cardiovascular function

MEDICAL SURGICAL (28 decks)

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