Exam 7 Intra - Op Care Flashcards
0
Q
Neuroleptanalgesic agent such as; fentanyl citratedroperidol (Innovar) is use for?
A
To cause a general state of calmness and sleepiness.
1
Q
Histamine - 2 receptor blockers such as; cimetidine( Tagament) and ranitidine (Zantac) are used for?
A
To decrease gastric acidity and volume.
2
Q
Anesthetic agent
A
The substance used to induce anesthesia, gas or chemical
3
Q
Epidural anesthesia
A
Injecting an anesthetic agent into epidural space of the spinal cord causing a lost of feeling and control of lower body.
4
Q
P1
A
Completely healthy. No problems
5
Q
P2
A
Health condition well maintained (one health problem)
6
Q
P3
A
Health condition not as well maintain (2 health problems)
7
Q
P4
A
Health with multiply problems
8
Q
P5
A
At end of life emergency
9
Q
P6
A
Dead, brain dead for organ donations
10
Q
Sedatives such as: diazepam (Valium), midazolam (Versed) or lorazepam (Ativan) are used for?
A
To alleviate anxiety and decrease recall of events related to the surgery.
11
Q
In the OR patient is identified again with the OR team using two identifiers.
A
Name, DOB, and/or medical record number.
12
Q
Time Out
A
In OR everyone stops. Patient is identified with 2 identifiers, The correct procedure is identified, The correct site is verified, Everyone has to agree.
13
Q
Local anesthesia
A
Injection of a solution containing the anesthetic into the tissue at the planned injection site
14
Q
Regional anesthesia
A
Just block a specific area
15
Q
Regional anesthesia
A
Anesthetic injected around nerves to deaden area supplied by these nerves. (Nerve block)
16
Q
Moderate sedation or conscious sedation
A
Patient is in depressed level of consciousness but able to maintain airway and respond to commands, usually monitored by RN.
17
Q
Spinal anesthesia
A
A local anesthetic agent is introduced into the subarachnoid space of spinal cord.
18
Q
General anesthesia
A
Lost of reflexes, total relaxation, and analgesia produced by pharmacologic agents.
19
Q
Evaluating the plan of care for the ______________________ is based on the _________________________.
A
Preoperative phase
Expected outcomes.
20
Q
Evaluating the ____________________ for the _____________________ is based on the __________________________.
A
Plan of care
Preoperative phase
Expected outcomes
21
Q
Malignant hyperthermia
A
Rare inherited muscle disorder that is chemically induced by anesthetic agents.
Signs of hyperthermia are rigid muscles, tachycardia, and a sudden spike in temperature.
22
Q
The three zones for surgery are to help decrease microbes in the surgical suite.
A
Unrestricted, semirestricted, restricted zones.
Only approved personnel are allowed in the semirestricted and restricted areas.
23
Q
Unrestricted zone
A
Street clothes are allowed.
24
Semi restricted zone
Scrub attire and cap are required.
25
Restricted zone
Scrub attire and surgical mask, shoe covers and hat a required.
26
The _______________________ of surgery begins with ________________of the patient to surgical area and lasts until the patient is transferred to _________________.
Intraoperative phase
Admission
PACU
27
The universal protocol has 3 components:
Preoperative verification process
Marking the operative site
Final verification just prior to beginning of a procedure
28
Circulator
RN who coordinates and documents patient care in the OR
29
Circulator's role
Measure blood loss and fluid loss. Record label and send tissue samples, keep family informed, count sponges, needles and instruments with scrub tech, accompany to PACU, notify family.
30
Circulators role
Positions the patient and protects them from positional harm, provide modesty and comfort, prep the skin, insert foley, monitor draping, complete OR record,
31
Circulatory role
Assist with applying monitors, protects the patient during induction of anesthesia,
32
Circulatory role
Has to be RN, helps set up OR, monitors sterility, ID patient, check chart, admits client to OR, transfer from stretcher to OR table,
33
Preoperative verification in holding area
```
Identify patient (name, DOB, surgical procedure, and site).
Assess client (pain level, BP, pulse, O2 stat, listen to lungs)
Check chart.
```
34
Surgical asepsis
Absence of microorganism in the surgical environment to reduce the risk of infection.
35
The first room the patient enters when arriving in the surgical area is?
The preoperative holding area.
36
Check patient chart for:
H&P, UA, CBC, Electrolytes, CXD, Dx test, surgical consent signed, Ht & W, VS, allergies, NPO p midnight,
Medications, medical conditions.
No dentures, no contact lenses, no underwear.
37
Surgical tech
Assist with preparation of OR, scrubs, gown and gloves self and the surgeon, prepares instruments table, assist with draping, pass instruments, counts instruments, needles and sponges with circulator.
38
Perioperative nurse has ________________________ and roles in __________________ meeting _____________ needs.
Critical responsibilities
Collaboratively
Patient
39
Surgeon has a?
Dominant role
40
anesthesiologist:
physician trained to deliver anesthesia and to monitor the patient’s condition during surgery
41
anesthesia:
state of narcosis, analgesia, relaxation, and loss of reflexes
42
Sterile
Waist to shoulder, gloves to 2 inches above the elbows.
43
Nursing process uses the _______________ ___________ and ____________ as a basis for the ________________ ___________of care.
Preoperative data
Plan
Intraoperative plan
44
Monitored anesthesia care
Moderate sedation by an anesthetist.
45
Scrub person
Must stay in room after attired
46
What is SCD'S, what are they used for and what part of the body are they put on?
Sequential Compression Device.
To prevent deep vein thrombosis
Put on the calfs of the legs.
47
In the OR patient is identified again with the OR team using two identifiers.
Name, DOB, and/or medical record number.
48
Narcotic analgesics such as; morphine and meperidine hydrochloride (Demerol) to help?
Facilitates patient sedation and relaxation and to decrease the amount of anesthetic agent needed.
49
Moderate sedation or conscious sedation
Patient is in depressed level of consciousness but able to maintain airway and respond to commands, usually monitored by RN.
50
Check patient chart for:
H&P, UA, CBC, Electrolytes, CXD, Dx test, surgical consent signed, Ht & W, VS, allergies, NPO p midnight,
Medications, medical conditions.
No dentures, no contact lenses, no underwear.
51
Anesthetist
Person trained to deliver anesthesia and to monitor patient during surgery. Usually CRNA.
52
The _______________________ of surgery begins with ________________of the patient to surgical area and lasts until the patient is transferred to _________________.
Intraoperative phase
Admission
PACU
53
Evaluating the ____________________ for the _____________________ is based on the __________________________.
Plan of care
Preoperative phase
Expected outcomes
54
Restricted zone
Scrub attire and surgical mask, shoe covers and hat a required.
55
The universal protocol has 3 components:
Preoperative verification process
Marking the operative site
Final verification just prior to beginning of a procedure
56
Epidural anesthesia
Injecting an anesthetic agent into epidural space of the spinal cord causing a lost of feeling and control of lower body.
57
Sterile
Waist to shoulder, gloves to 2 inches above the elbows.
58
Malignant hyperthermia
Rare inherited muscle disorder that is chemically induced by anesthetic agents.
Signs of hyperthermia are rigid muscles, tachycardia, and a sudden spike in temperature.
59
Neuroleptanalgesic agent such as; fentanyl citratedroperidol (Innovar) is use for?
To cause a general state of calmness and sleepiness.
60
Time Out
```
In OR everyone stops.
Patient is identified with 2 identifiers,
The correct procedure is identified,
The correct site is verified,
Everyone has to agree.
```
61
The first room the patient enters when arriving in the surgical area is?
The preoperative holding area.
62
Evaluating the plan of care for the ______________________ is based on the _________________________.
Preoperative phase
| Expected outcomes.
63
The three zones for surgery are to help decrease microbes in the surgical suite.
Unrestricted, semirestricted, restricted zones.
| Only approved personnel are allowed in the semirestricted and restricted areas.
64
Perioperative nurse has ________________________ and roles in __________________ meeting _____________ needs.
Critical responsibilities
Collaboratively
Patient
65
Sedatives such as: diazepam (Valium), midazolam (Versed) or lorazepam (Ativan) are used for?
To alleviate anxiety and decrease recall of events related to the surgery.
66
What is SCD'S, what are they used for and what part of the body are they put on?
Sequential Compression Device.
To prevent deep vein thrombosis
Put on the calfs of the legs.
67
anesthesiologist:
physician trained to deliver anesthesia and to monitor the patient’s condition during surgery
68
Regional anesthesia
Just block a specific area
69
Scrub person
Must stay in room after attired
70
Monitored anesthesia care
Moderate sedation by an anesthetist.
71
Preoperative verification in holding area
```
Identify patient (name, DOB, surgical procedure, and site).
Assess client (pain level, BP, pulse, O2 stat, listen to lungs)
Check chart.
```
72
Local anesthesia
Injection of a solution containing the anesthetic into the tissue at the planned injection site
73
Surgeon has a?
Dominant role
74
Spinal anesthesia
A local anesthetic agent is introduced into the subarachnoid space of spinal cord.
75
Nursing process uses the _______________ ___________ and ____________ as a basis for the ________________ ___________of care.
Preoperative data
Plan
Intraoperative plan
76
Surgical asepsis
Absence of microorganism in the surgical environment to reduce the risk of infection.
77
Surgical tech
Assist with preparation of OR, scrubs, gown and gloves self and the surgeon, prepares instruments table, assist with draping, pass instruments, counts instruments, needles and sponges with circulator.
78
anesthesia:
state of narcosis, analgesia, relaxation, and loss of reflexes
79
Regional anesthesia
Anesthetic injected around nerves to deaden area supplied by these nerves. (Nerve block)
80
Circulating Nurse
RN Assist w/ devices
Helps set up OR Position pt
Monitor sterility Prep skin
ID client Insert foley
Admit to surgery Monitor draping
Transfer Complete OR record
Provide warmth Measure blood loss
Record/label/send tissue samples
Count Accompany to PACU
81
Classification of Anesthesia
Stage 1-warm/fuzzy & ringing in ears
Stage 2-inc heart rate, irregular resp, excitement
Stage 3-Surgical anestesia-unconscious
Stage 4-Medullary depression-hard to recover
82
Malignant hyperthermia
Inc heart rate and temperature
83
PPE in Restricted Area
Mask
Hair Covering
Shoe covering
84
Basic Guideline for maintaining surgical asepsis
Sterile surface or articles may touch other sterile only
85
Potential complications
N/v Anaphylaxis Hypoxia Hypothermia
Malignant hyperthermia
Disseminated Intravascular Coagulation
86
Holding area
```
ID client
Assessment
No dentures/contacts/underwear
NPO p midnight
Consent
```
87
Draping
Held above surface & position from front to back
Only top of table or client is consider sterile
Hanging over edge unsterile
Tear/Puncter is unsterile
88
Guidelines for Maintaining Surgical Asepsis
Sterile to Sterile
Unscrubbed personnel remain at safe distance
Scrub person must in room after attire
Sterile from waist up
89
Anesthesiology physical classification
```
P1-No medical problems
P2-Well controlled medical problems
P3-More than one problem & one not controlled
P4-Nothing controlled
P5-Harvesting organs
```
90
General Anesthesia
Depresses CNS
Slow GI motility
Loss of consciousness
Loss of muscle tone
91
Supplies & Solutions
Wrapped and Sealed
Pour solutions into sterile w/out splashing
Solution-saline
Do not use warm solution
92
Traditional OR
Unique
Unrestricted
Semi restricted
Restricted
93
Surgical team
```
Assist w/ prep Doesn't have to be RN
Must be trained
Scrub/Gown/Glove self & others
Prep instrument tables
Assist w/ draping Pass instruments
Count sponges, needles
```
94
OR Safety
Lighting
Intercom
Laser
