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Med-Surg > Intraoperative Carlos > Flashcards

Intraoperative Carlos Flashcards

1
Q

What is the most important effect during moderate and deep sedation?

A

Respond purposefully to verbal commands

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2
Q

It is given by the nurse under the direct supervision of physician

A

Moderate and deep sedation

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3
Q

This is the stage where anesthetic administration is done

A

Stage I: Beginning Anesthesia (ONSET)

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4
Q

What happens during the “end” of the anesthetic administration in Stage I

A

During loss of consciousness

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5
Q

What are the nursing interventions done during Stage I?

A

1 Close the OR door
2 Avoid unnecessary noises or motions
3 Stand by to assisst client

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6
Q

This is the stage where the patient experiences loss of consciousness

A

Stage II: Excitement (Delirium)

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7
Q

What are the nursing interventions done during Stage II?

A

1 Assisst anesthesiologist in restraining the client

2 Touch the client only for purpose of restraint

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8
Q

This is the stage where there is loss of eyelid reflexes

A

Stage III: Surgical Anesthesia

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9
Q

What happens during the “end” of Stage III

A

1 There is loss of most reflexes
2 Depression of vital functions
3 Client is unconscious, relaxed muslces, blink and gag reflexes are present

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10
Q

What are the goals of anesthesia?

A

1 Control excessive biologic responses

2 Protection of patients from stress-induced complications

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11
Q

Define general anesthesia

A

1 Reversible state consisting of complete loss of consciousness and sensation
2 Protective reflexes such as cough and gag are lost
3 Produces amnesia and hypnosis
4 Can be administered through IV or inhalation

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12
Q

This is the stage where fuctions are expressively depressed

A

Stage IV: Medullary Depression (Stage of Danger)

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13
Q

What happens during the end of Stage IV?

A

1 There is respiratory and circulatory failure
2 Client is not breathing
3 Heartbeat may not be present

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14
Q

What are some nursing interventions done in Stage IV?

A

1 Respond immediately to assisst in establishing airway
2 Provide cardiac arrest tray, dru, syringes, etc.
3 Assisst with closed or open cardiac massage

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15
Q

1st Induction

A

Pulse: Irregular

B.P.: Normal

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16
Q

2nd Excitement

A

Pulse: Irregular and fast
BP: High

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17
Q

3rd Operative

A

Pulse: Steady and slow
BP: Normal

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18
Q

4th Danger

A

Pulse: Weak and thready
BP: Low

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19
Q

Types of general anethsesia

A

1 Intravenous Anesthesia

2 Inhalation Anesthesia

20
Q

What happens during intravenous anesthesia?

A

`1 Px is unconscious over 30 seconds after the administration
2 Rapid transmission from consicous to surgical anesthesia stage

21
Q

Example of IV anasthesia

A

Thiopental Sodium and Ketamine

22
Q

What happens during inhalation anesthesia?

A

1 Ease administration and elimination through the respi system
2 Maintain client stage III anesthesia following induction

23
Q

Example of inhalation anesthesia

A

Halothane and Isoflurane

24
Q

What are adjuncts to GA?

A

Drugs are added to an inhalation anesthetic other than IV induction drug

25
Q

What is dissociative anesthesia?

A

1 Interrupts associative brain pathways

2 Reduce painful sensation in one region

26
Q

What is local A?

A

1 Does not involve sedation or LOC

2 Block only peripheral nerves

27
Q

What is filled block A?

A

Injected and infiltrated into area proximal to the planned incision

28
Q

What is peripheral nerve block A?

A

Anesthetizes nerve or nerve plexus

29
Q

What is spinal A?

A

Surgical procedure involving the lower half of the body

30
Q

What are the advantages of spinal anesthesia?

A

1 Reduces N and V
2 Lowers respi complication
3 Early post-op recovery
4 Better pain control

31
Q

What is epidural block?

A

Involves an injection of a local anesthetic into an epidural space

32
Q

What are the nursing managements of spinal and epidural anesthesia

A

1 Closely observe the manifestation of ANS blockage such as hypotension, bradychardia, N/V
2 Patient may have tingling in the arms and feet
3 Post dural puncture headache such as back pain, isolated nerve injury, and meningitis

33
Q

What are the classifications of complications of major surgery?

A

1 Due to Anesthesia
2 Due to Surgery
3

34
Q

What are some common complications of general anesthesia?

A

1 Direct trauma to the mouth
2 Hypothermia due to long operations
3 Allergic reaction to anesthetic agent

35
Q

What are some complications due to surgery?

A

1 Peri-op complications

2 Post op complicatons

36
Q

What are some periop complications?

A 
1 Hypotension
2 Inc. BP
3 Cardiac Arrest
4 Hypoxia
5 Asphyxia
6 Chemical causes
37
Q

What are the signs of chemical causes?

A

1 Noisy breathing during partial obstruction

2 Cyanosis

38
Q

How to maintai safety and prevent injury?

A 
1 Position the client
2 Provide quipment safety
3 Maintain surgical asepsis
4 Assist with wound closure
5 Monitoring
39
Q

What are the things that needs to be documented?

A

1 Drains, tubes and other devices
2 Types of closure and dressing used
3 Post op diagnosis

40
Q

What are some gerontologic considerations?

A

1 Carefully monitor the response to anesthetic agents
2 Consider using warming devices
3 Increase the need for clear and concise communuication
4 Anesthetic drugs nned to be carefully titrated

41
Q

What are some anaphylactic reactions?

A

1 Hypotension

2 Tachycardia

42
Q

What happens during malignant hyperthermia?

A

1 Characterized by hyperthermia with skeletal muscle rigidity that can result to death

43
Q

What are other factors of malignant hyperthermia?

A

1 Stress
2 Trauma
3 Heat

44
Q

What is the treatment of malignant hyperthermia?

A

1 Dantrolene (Dantrium)

45
Q

What does Dantrolene do?

A

Reduces muscle contraction

Med-Surg (6 decks)

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