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N233 > Intraoperative Nursing Management > Flashcards

Intraoperative Nursing Management Flashcards

1
Q

do older adults have high risk than younger people when it comes to analgesics?

A

YES

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2
Q

when do preoperative risks increase?

A

each decade after the age of 60

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3
Q

why are older adults at greater risk?

A

due to co-morbidities, more advanced disease, and increased susceptibility to nosocomial illnesses

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4
Q

why do older adults need a lower dose of anesthetic agents?

A

due to the decreased tissue elasticity and reduced lead tissue mass

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5
Q

how is the liver affected as older adults?

A

liver size decreases the rate at which the liver can inactivate many anesthetic agents

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6
Q

how is kidney function affected in older adults?

A

the function decreases so it slows the elimination of waste products and anesthetic agents

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7
Q

what does the inability to increase metabolic rate put older adults at risk for?

A

hypothermia

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8
Q

what is a registered nurse first assistant (RNFA)?

A

they practice under direct supervision of a surgeon

- handle tissue, provide exposure to the operative field, suturing, and maintaining hemostasis

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9
Q

what is the role of the circulating nurse?

A

verifies consent, coordinates the team, and ensuring cleanliness, proper temperature, humidity, lighting, safe function of equipment, and the availability of supplies and materials

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10
Q

what is the anesthesiologist?

A

a physician specifically trained in the art and science of anesthesiology

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11
Q

what is the role of the anesthesiologist?

A

-assess patient before surgery, selects anesthesia, administers, intubates patient if necessary, manages technical problems

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12
Q

what are the three zones what help decrease microbes?

A
  • unrestricted
  • semi-restrictive
  • restrictive
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13
Q

what is the unrestrictive zone?

A

street clothes are allowed

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14
Q

what is the semi-restrictive zone?

A

where attire consists of scrub clothes and caps

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15
Q

what is the restrictive zone?

A

where scrub clothes, shoe covers, caps, and masks

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16
Q

when is double gloving routine?

A

when sharp bone fragments are present

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17
Q

what are the 5 types of anesthesia?

A
  • general anesthesia
  • local anesthesia
  • moderate sedation
  • monitored anesthesia care (MAC)
  • local anesthesia
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18
Q

what is anesthesia a state of?

A

narcosis, analgesia, relaxation and reflex loss

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19
Q

what is narcosis?

A

severe nervous system depression produced by pharmacological agents

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20
Q

are patients arousable while under general anesthesia (GA)?

A

no - not even to pain

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21
Q

what is anesthesia awareness?

A

partially waking while under general anesthesia

22
Q

who are the patients at risk for anesthesia awareness?

A

cardiac, obstetric, and major trauma patients

23
Q

what are the 4 stages of GA?

A
  • beginning anesthesia
  • excitement
  • surgical anesthesia
  • medullar depression
24
Q

what is beginning anesthesia?

A

pt breathes it in, dizziness, warmth and a feeling of detachment may be experience

25
Q

what is excitement?

A

struggling, shouting, talking, singing, laughing, or crying - often avoided if the anesthetic agent is administered smoothly and quckly

26
Q

what is surgical anesthesia?

A

continued administration of anesthetic vapour or gas

27
Q

what is medullary depression?

A

reached if too much anesthetic has been administered

28
Q

is there a sharp division between the stages?

A

not during smooth administration of anesthetic agent

29
Q

what are the most reliable guide to a patient’s condition?

A
  • pupil response
  • BP
  • resp and cardiac rate
30
Q

what is the most common anesthetic agent?

A

nitrous oxide

31
Q

where is regional anesthesia injected?

A

around nerves so that region is supplied by these nerves is anesthetized

32
Q

when is an anesthetic agent considered “worn off”?

A

not until all three systems (motor, sensory, and autonomic) are no longer in affect

33
Q

where is an epidural anesthetic injected?

A

a local anesthetic into the epidural space that surrounds the dura mater of the spinal cord

34
Q

why are epidural doses higher than spinal doses?

A

because they do not come into direct contact with the spinal cord or nerve roots

35
Q

what is spinal anesthesia?

A

an extensive conduction nerve blocker that is produced when a local anesthetic agent is introduced into the subarachnoid space at the lumbar level (between L4/L5)

36
Q

what areas of the body are affected with spinal anesthesia?

A

lower extremities and lower abdomen

37
Q

what are the local conduction blocks with spinals?

A
  • brachial plexus block
  • paravertebral anesthesia
  • transsacral (caudal) block
38
Q

what is moderate sedation used for?

A

reducing patient anxiety and control pain during diagnostic or therapeutic procedures

39
Q

what is the goal of moderate sedation?

A

to depress a patient’s level of consciousness to a moderate level to enable surgical, diagnostic, or therapeutic procedures to take place while ensuring comfort

40
Q

what does the professional monitoring the patient in charge of?

A

monitoring for dysrhythmias, administering oxygen, and performing resuscitation

41
Q

what is monitored anesthesia care (MAC) used for?

A

healthy patients undergoing minor surgical procedures and some critically ill patients who may be unable to tolerate anesthesia without invasive monitoring

42
Q

where is local anesthesia injected (LA)?

A

into the tissues where the incision will be

43
Q

what are the 5 advantages of LA?

A
  • simple, economical and nonexplosive
  • minimal equipment
  • postoperative recovery is brief
  • undesirable effects of GA are avoided
  • ideal for short and minor procedures
44
Q

what may happen to the patients temperature during anesthesia?

A

may drop

45
Q

what is considered hypothermia?

A

36.6 or less

46
Q

what might happen to glucose during anesthesia?

A

glucose metabolism is reduced - might result in metabolic acidosis

47
Q

what causes a drop in temp while under anesthesia?

A
  • low temp in OR
  • infusion of cold fluids
  • inhalation of cold gases
  • open body wounds or cavities
  • decreased muscle activity
  • advanced age
  • pharmaceutical agents used
48
Q

should warming be rapid?

A

no! - gradual

49
Q

what is malignant hypothermia?

A

rare inherited muscle disorder that is chemically induced by anesthetic agents

50
Q

what is the earliest sign of malignant hypothermia?

A

tachycardia

N233 (6 decks)

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