Module 1 PRELIM Flashcards
1
Q
entire surgical experience
A
perioperative
2
Q
Begins when decision to proceed with surgery is made and ends when patient is transferred to the operating room (OR) bed
A
preoperative
3
Q
Begins when patient is on the OR bed and ends when patient is admitted into the postanesthesia care unit (PACU)
A
intraoperative
4
Q
Begins with the patient’s admission into the PACU until patient regains optimal functioning
A
postoperative
5
Q
visualization of anatomical area of concern and facilitation of diagnosis
A
diagnostic
6
Q
aim to cure or solve an anatomical problem; usually involves removal of affected organ or tissue
A
ablative
7
Q
Aims to relieve pain and reduce symptoms from the condition by correcting a problem
A
palliative
8
Q
Repair of damaged part of the body for cosmetic purposes
A
reconstructive
9
Q
- requires hospitalization
- long surgery
- prolonged recovery
- higher risk for complications
A
major
10
Q
- may be done outpatient
- lower risk for complications
A
minor
11
Q
requires immediate attention without delay may be life threatening
A
emergent
12
Q
requires prompt attention within 24 to 30 hours
A
imperative/urgent
13
Q
needs the surgery and is planned within a few weeks or few months
A
required
14
Q
should have the surgery, but if unable to, effects will not be catastrophic
A
elective
15
Q
patient decides whether or not to do the surgery based on personal preference
A
optional
16
Q
patient’s autonomous decision whether to undergo the surgery. it protects the healthcare providers and patients
A
informed consent
17
Q
contains all vital information that must be assessed ensuring the safety of the surgical patient
A
preoperative checklist
18
Q
directly involved in the surgical procedure
A
sterile team
19
Q
who are the sterile team?
A
surgeon
first assistant
scrub nurse
20
Q
supports the sterile team; maintains sterile field
A
nonsterile team
21
Q
who are the nonsterile team?
A
anesthesiologist
circulating nurse
technicians
22
Q
- captain of the ship
- performs the surgical procedure
- heads the surgical team
A
surgeon
23
Q
a member of the operating room team whose responsibilities may include handling tissue, providing exposure at the operative field, suturing, and maintaining homeostasis
A
registered nurse first assistant
24
Q
physician trained to deliver anesthesia and to monitor the patient’s condition during surgery
A
anesthesiologist
25
registered nurse who coordinates and documents patient care in the operating room
circulating nurse
26
prevents contamination of surgical wounds
principle of asepsis
27
a state of narcosis or severe central nervous system depression produced by pharmacologic agents, analgesia, relaxation, and reflex loss
anesthesia
28
involves the total loss of body sensation and consciousness induced by anesthetic agents administered primarily by inhalation or intravenous injection
general anesthesia
29
what are the 4 stages of general anesthesia?
onset/beginning anesthesia
induction/excitement
surgical anesthesia
toxic medullary depression
30
*Dizziness and feeling of detachment during induction
*Exaggerated sound perception: ringing, buzzing, roaring; low voices and minor sounds seem loud
*Still conscious, but may sense an inability to move extremities easily
*These sensations may cause agitation. Avoid unnecessary noises and motion when anesthesia begins
onset/beginning anesthesia
31
*Patient may struggle, shout, laugh, or cry
*Pupils dilate, but constrict with light exposure
*Pulse rate is rapid
*Respirations may be irregular
*There may be Uncontrolled movements
*Anesthesiologist must be assisted during administration just in case the patient needs to be restrained
induction/excitement
32
*The stage can be maintained for hours in several planes, depending on the depth of anesthesia needed (light (1) to deep (4))
*The patient is unconscious and lies quietly on the table
*Pupils are small but constrict with exposure to light
*Breathing is regular
*Pulse is normal
*Skin is pink or slightly flushed
surgical anesthesia
33
*Occurs when too much anesthesia has been given
*It is not a planned stage of surgical anesthesia
*Shallow respirations
*Pupils are small and nonreactive to light
*Cyanosis develops. Without prompt intervention, may lead to death
*Discontinue anesthetic agent immediately
*Initiate circulatory and respiratory support
*Stimulants may be given. Narcotic antagonists may be given if causative agent was opioids
toxic medullary depression
34
local anesthesia is injected into epidural space that surround the dura mater of the spinal cord
epidural anesthesia
35
what does epidural anesthesia blocks?
sensory
motor
autonomic
36
epidural anesthesia require higher or lower doses?
higher
37
does epidural anesthesia causes LOC?
no
38
advantage of epidural anesthesia
absence of headaches
39
disadvantage of epidural anesthesia
challenging to inject in epidural space instead of subarachnoid space
40
what could happen if there is an accidental puncture of dura which high spinal anesthesia?
severe hypotension
respiratory depression
arrest
41
treatment for accidental puncture of dura?
airway support
IV fluid
vasopressors
42
local anesthesia is introduced into subarachnoid space usually between L4 and L5
spinal anesthesia
43
where does spinal anesthesia produced?
lower extremities
perineum
lower abdomen
44
WOF in spinal anesthesia
hypotension
N/V
headache
45
WOF spinal headaches
respiratory paralysis
neurological complications
ruptured nucleus pulposus
46
critical areas of assessment during postoperative phase
neurological status
respiratory status
cardiac status
47
WOF postoperative phase
airway obstruction
hypoventilation
48
partial or complete separation of skin edges and suture line; increased wound drainage
dehiscence
49
- internal organs outpouching or protrusion
- increased serosanguinous fluid drainage
- emergency condition
evisceration
50
procedures that use specialized instruments inserted into the body either through natural orifices or through small incisions
minimally invasive surgery
51
surgery that does not require an overnight hospital stay
ambulatory surgery
52
A series of diagnostic tests done before surgery to establish the patient's health status and identify any potential problems that may occur during surgery
preadmission testing
53
appropriate cover when an older patient is moved to and from the OR but never replaces asking patients if they feel sufficiently warm and attending to their needs
lightweight cotton blanket
54
specialty that provides treatment for obesity
bariatric surgery
55
unplanned and occur with little time for preparation of the patient or the perioperative team
emergency surgery
56
the patient concentrates on a pleasant experience or restful scene
guided imagery
57
the patient thinks of an enjoyable story or recites a favorite poem or song
distraction
58
the patient recites optimistic thoughts (I know all will go well)
optimistic self-recitation
59
The patient listens to soothing music (an easy-to-administer, inexpensive, noninvasive intervention)
music therapy
60
the patient inhales aromatic oils to trigger emotional and physical relaxation responses through the olfactory system and brain
aromatherapy
61
The practitioner places hands over the patient to (theoretically) transfer energy to promote healing and relaxation
reiki
62
the substance, such as a chemical or gas, used to induce anesthesia
anesthetic agent
63
advanced practice registered nurse who delivers anesthesia care under the direction of an anesthesiologist
certified registered nurse anesthetic
64
a thin endoscope inserted through a small incision into a cavity or joint using fiber-optic technology to project live images of structures onto a video monitor; other small incisions allow additional instruments to be inserted to facilitate laparoscopic surgery
laparoscope
65
a rare life-threatening condition triggered by exposure to most anesthetic agents inducing a drastic and uncontrolled increase in skeletal muscle oxidative metabolism that can overwhelm the body's capacity to supply oxygen, remove carbon dioxide, and regulate body temperature, eventually leading to circulatory collapse and death if untreated; often inherited as an autosomal dominant disorder
malignant hyperthermia
66
previously referred to as conscious sedation, involves the use of sedation to depress the level of consciousness without altering the patient's ability to maintain a patent airway and to respond to physical stimuli and verbal commands
moderate sedation
67
monitored sedation given by an anesthesiologist or certified registered nurse anesthetist (CRNA)
monitored anesthesia care
68
the intentional practice of using a combination of nonopioid pharmaceuticals and regional anesthesia techniques
multimodal anesthesia
69
area in the operating room where scrub attire and surgical masks are required; includes operating room and sterile core areas
restricted zone
70
registered nurse, licensed practical nurse, or surgical technologist who scrubs and dons sterile surgical attire, prepares instruments and supplies, and hands instruments to the surgeon during the procedure
scrub role
71
area in the operating room where scrub attire is required; may include areas where surgical instruments are processed
semirestricted zone
72
measures taken to prevent the spread of pathogens from the environment to the patient by eliminating all micro-organisms in that environment
sterile technique
73
absence of microorganisms in the surgical environment to reduce the risk of infection
surgical asepsis
74
area in the OR that interfaces with the other departments including the pt reception area and holding areas
unrestricted zone
75
A tool used to assess the dangers of fires for each surgical case
fire risk assessment tool
76
a bacterium is the most common type of particle on dispered skin cells
staphylococcus aureus
77
designated spaces established for sharps to be put down and picked up
neutral zone or safe zone
78
what are the most reliable guides to the patient's condition when given anesthetics?
response of the pupils
blood pressure
respiratory status
cardiac status
79
two types of inhaled anesthetic agents
volatile liquid anesthetic agents
gas anesthetic agents
80
it produces anesthesia when the vapors are inhaled
volatile liquid anesthetic agents
81
it is given by inhalation and are always combined with oxygen
gas anesthetic agents
82
what are the most common gas anesthetic agents
nitrous oxide
sevoflurane
desflurane
83
it is injected around nerves
regional anesthesia
84
largest fibers and have the thickest myelin sheath
motor fibers
85
smallest fibers and have a minimal covering
sympathetic fibers
86
intermediate fibers
sensory fibers
87
used in conjunction with general or MAC anesthesia, or as a stand-alone method
peripheral nerve blocks
88
it produces anesthesia of the arm
brachial plexus block
89
it produces anesthesia of the nerves supplying the chest, abdominal wall, and extremities
paravertebral anesthesia
90
it produces anesthesia of the perineum and, occasionally, the lower abdomen
transsacral (caudal) block
91
injection of a solution containing the anesthetic agent into the tissues at the planned incision site
local anesthesia
92
potentially life-threatening event of a anesthesia
local anesthetic systemic toxicity
93
it intensifies the effects of LAST
hypoxemia
acidosis
94
- flat on the back
- used for most abdominal surgeries except for gallbladder or pelvis
dorsal recumbent position
95
used for surgery on the lower abdomen and pelvis to obtain good exposure by displacing the intestines into the upper abdomen
tredelenburg position
96
used for nearly all perineal, rectal, and vaginal surgical procedures
lithotomy position
97
used for renal surgery
sims or lateral position
98
method of healing in which wound edges are surgically approximated and integumentary continuity is restored without granulation
first-intention healing
99
area designated for care surgical patients immediately after surgery and for patients whose condition warrants close monitoring
phase I PACU
100
area designated for care of surgical patients who have been transferred from a phase I PACU because their condition no longer requires the close monitoring provided in a phase I PACU. The patient is prepared for transfer to an inpatient unit or for discharge from the facility
phase II PACU
101
area where postoperative patients are monitored as they recover from anesthesia
postanesthesia care unit
102
method of healing in which wound edges are not surgically approximated and integumentary continuity is restored by the process known as granulation
second-intention healing
103
patients who have experienced prolonged anesthesia usually are unconscious, with all muscles relaxed. This relaxation extends to the muscles of the pharynx. When the patient lies on the back, the lower jaw and the tongue fall backward and the air passages become obstructed.
hypopharyngeal obstruction
104
what are the signs and symptoms of LAST?
metallic taste
auditory changes
slurred speech
seizures
oral numbness
respiratory arrest
arrythmias
105
what is the initial treatment for LAST?
airway management
106
other term for moderate sedation?
conscious sedation
107
other term for monitored anesthesia care?
monitored sedation
108
what does STOP-bang mean?
snoring
tired
observed
pressured
BMI
age
neck
gender
109
STOP-bang is an assessment for what?
OSA
110
what does OSA mean?
Obstructive Sleep Apnea
111
determinator of nutritional needs
BMI
waist circumference
112
the organ important in the biotransformation of anesthetic compounds
liver
113
the organ involved in excreting anesthetic medications and their metabolites
kidney
114
medication that puts patients at risk for adrenal insuffiency
corticosteroids
115
flattening of the dome of the diaphragm during inspiration, with resultant enlargement of the upper abdomen as air rushes in
diaphragmatic breathing
116
where is PACU located in relation to the OR suite
adjacent
117
when a patient is moved too quickly from one position to another they experience this
orthostatic hypotension
118
reduced oxgen in the blood
hypoxemia
119
excess carbon dioxide in the blood
hypercapnia
120
what is the primary objective in immediate postoperative period?
maintain ventilation
121
how much blood loss requires replacement?
500 mL
122
what are the types of shock?
hypovolemic
cardiogenic
neurogenic
anaphylactic
septic
123
what is the common type of shock in postoperative setting?
hypovolemic
124
how can oxygen be given?
nasal cannula
facemask
mechnical ventilation
