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Nursing 3rd quarter > intra op pp > Flashcards

intra op pp Flashcards

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1
Q

Members of the Surgical Team

A

Surgeon and surgical assistantAnesthesia providersHolding area nurseCirculating nurseScrub nurseSurgical technologist Specialty nursesORTs/surgical technologists may be used in addition to nursing staff

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2
Q

Minimally Invasive and Robotic Surgery (MIS)

A 
Now common practice
Preferred technique for many surgery types, including
Cholecystectomy
Joint surgery
Cardiac surgery
Splenectomy
Spinal surgery
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3
Q

Environment of the Operating Room

A

Preparation of surgical suite, team safety
Layout
Health and hygiene of surgical team
Surgical attire and scrub
Remember
People are a source of bacteria in the surgical setting!
Special health care standards, dress are needed
Watch for nosocomial infections, identify source of pathogens

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4
Q

Surgical Scrubbing

A

Surgical ScrubbingBroad-spectrum, surgical antimicrobial solution Vigorous rubbing that creates friction used from fingertips to elbowScrub continues for 3 to 5 min

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5
Q

Anesthesia

know kinds

A

Induced state of partial or total loss of sensation, occurring with or without loss of consciousness
Used to block nerve impulse transmission, suppress reflexes, promote muscle relaxation, achieve controlled level of unconsciousness (in some cases)

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6
Q

General Anesthesia

A

Reversible loss of consciousness induced by inhibiting neuronal impulses in several areas of central nervous system (CNS)
Involves single or combination of agents
Depresses CNS, resulting in analgesia, amnesia, and unconsciousness with loss of muscle tone and reflexes
Administered via
Inhalation
IV injection
Balanced anesthesia

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7
Q

Four Stages of General Anesthesia–dont need to know

A

Stage 1—Analgesia and sedation, relaxation
Stage 2—Excitement, delirium
Stage 3—Operative anesthesia, surgical anesthesia
Stage 4—Danger
Emergence—Recovery from anesthesia

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8
Q

Balanced Anesthesia

A

Combination of IV drugs and inhalation agents used to obtain specific effectsExample: Thiopental for induction, nitrous oxide for amnesia, morphine for analgesia, pancuronium(paralyzing agent) for muscle relaxation- (on ventilator needs to be paralyzed-so wont fight breathing) (dont want to be conscious)

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9
Q

examples of intra-operative medications–look at
know meds
know what catagorys they are-anxietys, etc…

https://nursing.com/lesson/pharm-01-02-54-common-medication-prefixes-and-suffixes/

A

on slides
sevoflurane–Sevoflurane is administered in a mixture with nitrous and oxygen for induction and maintenance of general anaesthesia. It has a pleasant smell.

midazolam
fentanyl
propofol
lidocaine
pancuronium
ondanestron
examethasone
neostigmine
glycopyrrolate
cefotetan
hydromorphone
famotodine
0.9%NaCl
phenyephrine

MAC-monitored anesthesia care(breathe on own-conscious sedation)might still fal asleep
GA- general anesthesia-not breathing on own

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10
Q

Complications from General Anesthesia

A 
Malignant hyperthermia
Overdose
Unrecognized hypoventilation
Problems with specific anesthetic agents
Intubation problems
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11
Q

Malignant Hyperthermia

A

Acute, life-threatening complication
rare-
med they give?
worst complication
May be genetic
Begins with skeletal muscle exposed to specific agent
Causes increased metabolism, calcium levels in muscle cells
Leads to acidosis, high temperatures, dysrhythmias

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12
Q

Clinical Manifestations of Malignant Hyperthermia

A 
Tachycardia
Skin mottling
Cyanosis
Myoglobinuria(moscle in urine?)
Rise in end tidal carbon dioxide
Elevated temperature
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13
Q

Local Anesthesia

A

Briefly disrupts sensory nerve impulse transmission from specific body area/region
Delivered topically and by local infiltration
Patient remainsconscious, able to follow instructions

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14
Q

Regional Anesthesia

A 
Blocks multiple peripheral nerves in specific body region
Field
Nerve
Spinal
Epidural
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15
Q

Spinal and Epidural Anesthesia

A

pics on slides

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16
Q

Complications of Local or Regional Anesthesia

A 
Anaphylaxis
Incorrect delivery technique
Systemic absorption
Overdose 
Local complications
17
Q

Treatment of Complications

A 
Establish open airway
Give oxygen
Notify surgeon
Fast-acting barbiturate is usual treatment
Epinephrine for unexplained bradycardia
18
Q

Moderate Sedation

A

IV delivery of sedative, hypnotic, opioid drugs to reduce level of consciousness
Patient maintains patent airway, can respond to verbal commands
Amnesia action is short

19
Q

Interprofessional Collaborative Care

A

Assessment: Noticing
Electronic health record review
Advanced directives
Allergies and previous reactions to anesthesia or transfusions
Autologous blood transfusion
Laboratory and diagnostic test results
Medical history and physical examination findings

20
Q

Analysis: Interpreting

A

The priority collaborative problems for patients during surgery are
Potential for injury related to improper perioperative positioning
Potential for infection related to invasive procedures Compromised GASEXCHANGErelated to anesthesia, pain, reduced respiratory effort

21
Q

Preventing Injury

A

Interventions
Proper body position
Prevent pressure ulcer formation
Prevent obstruction of circulation, respiration, nerve conduction

22
Q

common surgical positions-dont need to know

A 
supine, trendelenburg
lithotomy
lateral
jacknife
prone
23
Q

Preventing Infection

A

Interventions
Plastic adhesive drape
Skin closures, sutures and staples, nonabsorbable sutures
Insertion of drains
Application of dressing
Patient transfer from OR table to stretcher

24
Q

common skin closures-dont need to know

A 
interrupted sutures
continuous sutures(interlocking stitch, staples, tapes, retention bridge
stay(retention) sutures
25
Q

Preventing Hypoventilation–anesthesia monitors

A

Continuous monitoring ofBreathingCirculationCardiac rhythmsBlood pressure and heart rateContinuous presence of anesthesia provider

26
Q

Evaluation: Reflecting

A

The nurse evaluates the care of the patient during surgery based on the identified priority patient problems. The expected outcomes include Safe anesthesia care provided without complicationsRemains injury free related to surgical positioning or equipmentRemains free of skin or tissue contamination and infection during surgery Maintains normal body temperature

27
Q

A nursing student is assessing a student upon entry to the surgical suite. Which statement by the nurse would cause the nurse to intervene?A.“Are you Mr. Green?”B.“What kind of operation are you having today?”C.“Do you have any allergies?”D.”Have you donated blood for this surgery?”

A

A.“Are you Mr. Green?”B.“What kind of operation are you having today?”C.“Do you have any allergies?”D.”Have you donated blood for this surgery?”

A..

28
Q

During a surgical procedure, the nurse notices the sponge count is incorrect. One sponge is missing. What is the priority nursing intervention?A.Communicate the discrepancy to the surgical team immediately.B.Complete appropriate documentation concerning the error in sponge count.C.Examine the environmental distractions, refocus, and count the sponges again.D.Anticipate that the surgeon will order an x-ray to look for the sponge postoperatively.

A

A.Communicate the discrepancy to the surgical team immediately.B.Complete appropriate documentation concerning the error in sponge count.C.Examine the environmental distractions, refocus, and count the sponges again.D.Anticipate that the surgeon will order an x-ray to look for the sponge postoperatively.

A,

29
Q

The nurse is aware that a patient having surgery is at risk for infection if which additional factor is present?A.Diabetes mellitusB.Age greater than 65C.Impaired liver functionD.Insertion of a surgical drain

A

A.Diabetes mellitusB.Age greater than 65C.Impaired liver functionD.Insertion of a surgical drain

A biggest one-keep CBG in normal range

Nursing 3rd quarter (13 decks)

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