Intra-op care

Question 1

anesthesia

Answer 1

state of narcosis, analgesia, relaxation, and loss of reflexes

Question 2

Anesthesiologists

Answer 2

physician trained to deliver anesthesia and monitor pts condition during surgery

Question 3

Anesthetic

Answer 3

substance such as gas or chemical used to induce anesthesia

Question 4

Surgical asepsis

Answer 4

Absence of microorganisms in surgical environment to reduce infection
principles:
- prevents contamination of surgical wounds
- all supplies must be sterile
- team wears long sleeved gowns, masks, gloves

Question 5

circulating nurse role

Answer 5

unsterile, does not go into OR, manages OR, verify consent

Question 6

scrub nurse role

Answer 6

prepares sterile field, assists surgeon, labels tissue specimens, counts all needles and instruments used

Question 7

General Anesthesia

Answer 7

Choice for lengthy surgical procedures that require relaxation of skeletal muscles
Loss of conciousness
amnesia and analgesia
pt is non-arousable to painful anesthesia
pt needs airway assistance
generally more than one agents
- IV: benzo, IV opioids, neuromuscular blocking, antiemetics)
- inhalation: mixed vapors and O2 via ETT, mask or trach

Question 8

Local Anesthesia

Answer 8

Blocks the initiation and transmission of electrical impulses along nerve fibers
no loss of consciousness
topical applications
injection of agent into tissues

Question 9

Regional Anesthesia

Answer 9

Injection of local anesthetic into or around nerve or group of nerves
2 types:
- spinal and epidural

Question 10

Spinal Reginal Anesthesia

Answer 10

subarachnoid space (CSF) and lumbar area
blocks initiation and transport of electric pulses along nerve fibers
no loss of consciousness
alternative to GA

Question 11

Epidural Reginal Anesthesia

Answer 11

epidural space of either thoracic or lumbar area of spine
DOES NOT ENTER CSF but binds to nerve roots
low dose = sensory pathways blocked but not motor fibers
high dose = both sensory and motor blocked

Question 12

Spinal vs Epidural

Answer 12

epidural has advantage because decreased incidence of post-spinal anesthetic headache

Question 13

Procedural Anesthesia

Answer 13

Conscious
administration of sedatives with or without analgesia
decreased anxiety and discomfort during non-invasive or minimally invasive

ex. endoscopy, interventional radiology, central line, chest tube

Question 14

Complications during surgery

Answer 14

Major blood loss
Anaphylactic Rxns
hypothermia
malignant hyperthermia
N+V

Question 15

Major blood loss interventions

Answer 15

monitor and record fluid accumulation in suction
circulating nurse and anesthesiologist must replace blood loss

Question 16

Anaphylactic rxn interventions

Answer 16

IV fluids, antihistamines, steroids

Question 17

Hypothermia interventions

Answer 17

d/t decreased temp, cold room, gases, open body wounds, decreased muscle activity
if the body decreases to lower than 36.6 than it is an emergency
IV fluids and irrigating fluids are warmed, wet gowns and drapes are removed and replaced ASAP and warm blankets

Question 18

Malignant hyperthermia

Answer 18

inherited muscle disorder caused by anesthetic agents
susceptible persons: bulky muscles, hx of muscle cramps, unexplained temp elevations, unexplained deaths in family due to surgery

Question 19

N+V interventions

Answer 19

If gagging occurs, turn pt on side, suction prn
if pt aspirates, pulmonary compactions may occur and cause pneumonia