chapter 18: intraoperative care Flashcards
____ _____ _____ project focuses on improving surgical care by significantly reducing the number of complications from surgery
surgical care improvement
_____ _____ started 30-60 mins before surgical incisions
prophylactic antibiotic
in the or the _____ nurse serves as the pts advocate
circulating
_____ ______ ____ ______ has improved compliance with standards and reduced complications from surgery
WHO surgical safety checklist
_____ position used for some types of pelvic organ surgery
lithotomy
______ of ____ under pressure in immobile pts plays major role in the development of pressure ulcers in the OR
hypo perfusion of tissue
general anesthesia causes peripheral blood vessels to _____
dilate
general anesthesia causes what to dilate?
peripheral blood vessels
___-_____ ________ based technology allows ACP’s to track the level of pt awareness during surgery and adjust the anesthesia as needed
non-invasive electroencephalogram
______ ____ is most common approach for general anesthesia
balanced technique
inhalation agents can cause:
_____
__________
increased ______
cough
laryngospasms
increased secretions
the choice for delivering inhaled agents is through an _____ tube or ______
ET tube
LMA
___ ___ permits control of inhalation and protects airway from aspiration
ETA tube
_____ is an important option for pts with difficult airways
LMA
____ is a commonly used dissociative anesthetic
ketamine
______ anesthesia interrupts associative brain pathways while blocking sensory pathways
dissociative
ketamine used in asthmatic pts undergoing surgery bc it promotes _______
bronchodilation
regional blocks used as _____ preop, to manage ____ ____ intraop, and postop to ___ _____
-analgesic
-surgical pain
-control pain
_____ anesthesia interrupts generation of nerve impulses by altering the flow of sodium into nerve cells
local
some local anesthetics are mixed with ______ to provide vasoconstriction
epinephrine
some local anesthetics are mixed with epinephrine to provide _______
vasoconstriction
topical local anesthetic applied how long before procedure?
30-60 mins
with ____ ____ anesthesia the pt has a double cuff tourniquet applied as a safety measure
IV regional
2 types of regional anesthesia
spinal
epidural
pts given ____ anesthesia experience vasodilation and may become hypotensive
spinal
pts given spinal anesthesia experience ______ and may become _______
vasodilation
hypotensive
______ anesthesia is an injection of local anesthesia into cerebrospinal fluid in subarachnoid space
spinal
an _______ is an injection of local anesthetic into the epidural space via thoracic or lumbar approach
epidural
observe for signs of autonomic nervous system blockade in pts given an ______
epidural
when a pt is given an epidural observe for signs of _____ _____ ___ blockade
autonomic nervous system
signs of autonomic nervous system blockade (4)
bradycardia
hypotension
nausea
vomiting
onset of _____ anesthesia more rapid than _______
spinal
epidural
older adults at greater risk for postop ______
hypothermia
in an epidural ______ pathways are blocked but _____ fiber still intact
sensory
motor
initial clinical manifestations of an ________ ________may be masked by anesthesia
anaphylactic reaction
anaphylactic reactions cause (4)
bronchospasms
tachycardia
hypotension
pulmonary edema
the altered control of intracellular calcium is seen with
malignant hyperthermia
_____ appears to be the primary trigger for malignant hyperthermia
succinylcholine
which stage of general anesthesia is this?
beginning analgesia and relaxation. the client feels dizzy and detached with reduced sensation to pain. clients are sometimes sensitive to noise and stimuli
stage 1
which stage of general anesthesia is this?
the client might feel delirious, act excited, or could be loud or crying. this stage can be bypassed if meds are given quickly enough. pupils dilate but still respond to light
stage 2
which stage of anesthesia can be bypassed if meds are given quickly enough?
stage 2
which stage of general anesthesia is this?
operative or surgical anesthesia. the client has relaxed muscles and eventually loses reflexes. vital functions begin to reduce, sensation is lost, and the client cannot hear. pupils are small but reactive
stage 3
which stage of general anesthesia is this?
dangerous levels of anesthesia. vital organ function is depressed to the point of respiratory failure and cardiac arrest. pupils are fixed and death can occur. anesthesia must be stopped immediately. the client might receive stimulant meds and narcotic agonists
stage 4
anticholinergics decrease the risk of bradycardia during surgery due to the _______ response to surgical manipulation
parasympathetic
avoid giving sedatives within 14 days of starting or stopping an _____
MAOI
____ _____ can cause restlessness, altered speech, blurred vision, metallic taste, tremors, and tachycardia
systemic toxicity
treatment for systemic toxicity
administration of rapid acting barbiturate
