Chapter 30 Flashcards
Preoperative
Begins with decision to have surgery, lasts until client is transferred to the holding room/operating room or procedural bed
Intraoperative
The client is transferred to the holding room or procedural bed until transfer to the postanesthesia care unit (PACU) Recovery room.
Postoperative
Last from admission to the PACU recovery area and lasts until the final follow up health care provider visit
Diagnostic surgical procedure
Screening, identify cause (Ex: Laparoscopy)
Curative surgical procedure
Removal of tissue (Ex: Tumor)
Preventative surgical procedure
Controversial (Ex: Mastectomy to prevent breast cancer)
Ablative surgical procedure
Removal of this disease (Ex: Amputation)
Palliative surgical procedure
Relieve or reduce the intensity of an illness (Ex: Debrieve dead skin)
Reconstructive surgical procedure
Restore function of tissue (Ex: Skin graph)
Constructive surgical procedure
Restore function with congenital anomalies
General (systemic) Anesthesia
Administration of drugs by inhalation or IV route, asleep (INTUBATED) This produces CNS depression. There are 3 phases of general anesthesia:
Induction, maintenance, emergence
Induction
From administration of anesthesia to ready for incision
Maintenance
From incision to near completion of procedure
Emergence
When patient emerges from anesthesia and is ready to leave operating room
Analgesia
Moderate sedation.
Also called conscious sedation and is used for short term, minimally invasive surgery (NOT INTUBATED) (Colonoscopy)
Regional anesthesia
Anesthetic agent inject near nerve and is good for older adults. Patient is awake and loses feeling in area (Spinal epidural)
Nerve blocks include:
Major nerve (Peripheral): Jaw and face
Spinal anesthesia (Subarachnoid): Lumbar puncture (hypotension and headaches)
Caudal anesthesia (Pudendal): Lower abdomen
Epidural anesthesia: C-section
Topical and Local anesthesia: Numb, used of mucous membranes and opens skin, wounds or burns
CHANGE PATIENTS POSITION
EVERY TWO HOURS
Normal WBC count
5,000 – 10,000
Normal RBC count (platelets)
100,000 – 400,000
Anticoagulants
Anticoagulants aspirin, heparin– increases hemorrhage
Adrenal Steroids
abrupt withdrawal causes cardiovascular collapse
Tranquilizers
increase hypotension (lowers BP)
Antibiotics mycin
Respiratory paralysis when combined with muscle relaxant
Incentive spirometers
Several times per hour we have the patients use the incentive spirometer after surgery (up to 10 times an hour). We also ask the patient to cough. This is done so they exercise their lungs after surgery.
Sedatives
valium – alleviates anxiety, decreases recall of events of surgery
Anticholinergics
Allergy medicine, Atropine – decreases pulmonary and oral secretions. Makes mouth dry
Narcotic Analgesic
morphine
sedation and relaxation, decreases amount of anesthesia needed
Neuroleptanalgesic agents
Innovar
causes state of calmness and sleepiness
Histamine 2 receptor blockers or antihistamines
Zantac – decreases gastric acidity and volume
Thrombophlebitis
inflammation of vein due to blood clot
Pulmonary Embolus (PE)
foreign object lodges in small vessel, causes feeling of doom
Diuretics
Electrolyte imbalances, respiratory depression from anesthesia
