Med Surg :Intraoperative Flashcards
What are the basic principles in the OR
Safety; as a safety checklist
Antiseptic technique; sterile field is in force, protection from blood-borne pathogens, everyone is checked for breaks in the sterile field, PPE
Surgical site prep; mechanical having a site with antimicrobial agent, area draped by members of team
Patient positioning; allows for access to surgical site, administration of anesthetic agent and maintain airway
What happens when the surgical client what happens when the patient arrives in the OR suite
Name bracelet is checked and verified with patient
chart is reviewed for on needed documentation
orders are checked and implementing
surgeon and nurse ensure that the client is marked with an indelible ink
surgical timeout has taken place just before procedure
anesthesia team administers anesthesia
What is anesthesia
Induced state of partial or total loss of sensation that occurs with or without the loss of conscious, used to block nerve impulse transmission suppress reflexes, promote must relaxation, and achieve a control level of unconsciousness.
What are the types of anesthesia
General,
regional
local,
monitored anesthesia care which is a constant sedation
How is anesthesia selected
Patient preference and fears health problems duration of procedure area of the body involved emergency options for pain management postop NPO status position
What general anesthesia?
Reversible loss of consciousness induced by inhibiting neural impulses and several areas of the central nervous system,
involves a single agent or combination of agents,
inhalation and meds together,
loss of muscle tone reflexes
What are the goals of general anesthesia
Cause loss of conscious, prevent or reduce pain, eliminate normal reflexes, relaxed skeletal muscles, cause amnesia, maintain physiologic stability
What are the four stages of general anesthesia
Stage one; analgesic and sedation, relaxation
stage two; excitement, delirium
stage III; operative anesthesia, surgical anesthesia
stage four; danger
emergency; recovery from anesthesia
What are complications from general anesthesia
Malignant hyperthermia; tachycardia, dysrhythmia, muscle rigidity in the jaw and upper chest, hypotension, tachypnea, skin molting and cyanosis, myoglobinuria
overdose
Unrecognized hypoventilation
Complication of intubation
What is local anesthesia
Briefly disrupt sensory nerve impulse transmission for my specific body area,
delivered topically and by local infiltration,
patient remains conscious and able to follow instructions,
may give hypnotic or opioid to decrease anxiety
What is regional anesthesia
Type of local anesthesia that box multiple peripheral nerves in a specific body region
What are the type of fields for regional anesthesia
Field Block; infiltrate around the field
Nerve block; into and around specific nerve, chronic pain or limb anesthetic
Spinal block; local anesthetic in the intrathecal or subarachnoid lower part of the body,
Epidural; local anesthetic, opiod or both. Birth or lower extremity surgery
What are some complications of local or regional anesthesia
Anaphylaxis Incorrect delivery technique Systemic absorption Overdose Local complications
What is moderate sedation
Conscious sedation
IV delivery of sedative, hypnotic and opioid drug
Similar to general in a seizure but at lower doses
Patients remain responsive and breathe without assistance
Relieves anxiety and provides analgesia
May be used with local or regional anesthetic
Frequently used for minor surgical procedures
What are complications of moderate sedation
Airway instruction; oral airway section Respiratory depression: reversible agents Cardiac arrhythmias; EKG, Hypotension; vasosuppressors Anaphylaxis; epinephrine
