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NRSG 302 > Lab 3 post operative complications > Flashcards

Lab 3 post operative complications Flashcards

1
Q

what would a mild fever within the first 2 days post op indicate

A

could be a normal finding since a mild fever comes along with the normal inflammatory response after surgery

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2
Q

When is a patient most at risk for dizziness and fainting

A

24-48 hours post op

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3
Q

what types of anesthetic puts the patient at the most risk for dizziness and fainting and why

A

spinal and epidural anesthetic since it block autonomic muscle tone so blood vessels don’t constrict as they should to maintain blood pressure

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4
Q

If there is a change in cardiac or neurological functioning what is often the first vital sign to change

A

usually respiratory rate

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5
Q

how long does it usually take for acute respiratory syndrome to present after surgery

A

24-48 hours

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6
Q

what are signs and symptoms of ARDS

A

-Rapid shallow breathing
-severe hypoxemia
-crackles in lungs
-no cough
-chest pain
-hemoptysis

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7
Q

what are signs and symptoms of hypovolemic shock

A

-decreasing blood pressure
-increasing pulse
-cold, clammy, pale skin

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8
Q

what is paralytic ileus

A

the delayed return of GI peristalsis

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9
Q

What are some interventions to prevent paralytic ileus

A

-encourage early ambulation
-encourage splinting of abdomen after surgeries
-Start bowel protocol early on with patients especially with narcotic use
-keep patients on fluids until active bowel sounds

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10
Q

when does dehiscence usually occur post op

A

usually 7-10 days post operativley

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11
Q

what is a hematoma?

A

Area immediate to the surgical site which fills with blood causing swelling and discoloration

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12
Q

what are the three different types of pain?

A

-Nociceptive
-Visceral
-Neuropathic

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13
Q

What is nociceptive pain

A

pain that results from damage to body tissue

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14
Q

what is visceral pain

A

pain that comes from the visceral organs

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15
Q

what is neuropathic pain

A

pain that originates from a central or peripheral nerve

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16
Q

what are the different phases of pain transmission

A

Transduction
transmission
perception
modulation

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17
Q

what is the onset of action of morphine

A

17 min

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18
Q

what is the onset of action of hydromorphone

A

15 min

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19
Q

what is the onset of action of fentanyl

A

4-5 min

20
Q

what medication may be used if a patient is experiencing pruritus

A

Diphenhydramine (benadryl)

21
Q

when would a nurse administer narcan

A

-respiratory rate of less than 8
-sedation scale score of 4 or less

22
Q

if a patient does not wake up after the first dose of naloxone what should a nurse do

A

continue to administer 0.1 mg every two minutes four time or until the patient wakes up

23
Q

why is it important for patients on PCA to have a patent IV

A

if they overdose IV is the prefered route to give naloxone

24
Q

when would you notify the physician that you had to give your patient naloxone

A

if you had to give more than 5 doses

25
Q

who is allowed to push the control button on a PCA pump

A

only the patient (family or friends should be instructed not to touch the pump)

26
Q

how often should a nurse check how much medication a patient has received from a PCA pump

A

should be checked every 4 hours and totaled up at the end of shift

27
Q

which would be more potent spinal or epidural analgesic

A

spinal since it is injected closer to the spinal cord where the opioid receptors are

28
Q

how do spinal and epidural anesthetics affect motor function

A

with an epidural the goal is still to have motor function while with a spinal motor function is absent

29
Q

what is the most effective way to assess dermatome levels

A

using ice since temperature and pain sensation utilize the same spinal pathways

30
Q

what spinal nerves innervate from the collarbone down to the belly button

A

T1-T10
“T10 to the belly button”

31
Q

what area of the body does L1-L3 innervate

A

From the groin to the knee
“L3 to the knee”

32
Q

what spinal nerves innervate from the groin to the top of the foot

A

L1-L4
“L4 to the floor”

33
Q

what spinal nerve inervates the buttox

A

S1
“S1 around the bum”

34
Q

which spinal nerves innervate the diaphragm

A

C3
C4
C5
“C3, 4, 5 keep the diaphragm alive”

35
Q

between hydromorphone morphine and fentanyl put them in order of lipid solubility

A
  1. Fentanyl
  2. Hydromorphone
  3. morphine
36
Q

how much further does autonomic blockade extend above sensation blockade while a patient is receiving epidural analgesia

A

autonomic blockade usually extends about 2 dermatomes above sensation

37
Q

what is the onset of epidural blockade (ie what functions of the body does it block first)

A

-sympathetic nerve functioning (since they are the smallest)
-sensation
-motor function (if the patient started to receive too much)
*remember with an epidural they should NOT have a block of motor function just with a spinal

38
Q

how does an epidural blockade spread through the body

A

starts at the insertion site and then spreads out from there toward the feet and toward the head

39
Q

what is the onset of epidural blockade recovery (ie what functions of the body would come back first after stopping the anasthetic)

A

-motor nerves recover first since they are the largest
-sensation
-autonomic nerves (since they are the smallest)

40
Q

how far can an epidural catheter migrate before you have to alert the physician

A

NONE and epidural catheter is not allowed to migrate at all

41
Q

what things should be assessed with an epidural

A

-external length of cath
-exit site and dressing
-degree of motor and sensory block
-pain levels
-sedation score

42
Q

where is the tip of the catheter located in spinal anesthesia

A

within the subarachnoid space

43
Q

how is the level of a spinal block assessed

A

by touching the patients skin

44
Q

how is the level of an epidural block assessed

A

by touching ice to the patient’s skin

45
Q

what kind of medication is used in a spinal

A

local anesthetic

46
Q

what level is a spinal usually injected at

A

usually injected into the lumbar level and around L4/L5

NRSG 302 (4 decks)

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