N300 Q#1 Peri-Op Flashcards
What are 4 reasons for surgery?
Diagnostic
Curative
palliative
cosmetic
Surgery has both psychological and physical stress impact. Explain physical.
resistance to infection lowered
organ fxn altered due to manipulation
psychological stressors from surgery include?
fear,pain, anxiety, loss of control, body image, alterations in ADL
Surgical risk is assessed by what factors?
age, nutritional status, fluid and lytes balance
general health, medications
____: the term used to describe the wide variety of nursing fans associated with pts surgical experience.
perioperative nursing
______: the term for the nursing fans associated with pts care before and after anesthesia.
perianesthesia
begins when decision for surgical intervention is made and ends with trx of patient to the operating room table
preoperative phase
With pre-op consult, what is important condition to inquire about?
malignant hyperthermia- rxn to anesthesia
The following preop meds serve what purpose?
- Valium (diazepam)
- midazolam
- morphine sulfate
- atropine
- zantac axid or tagamet
- antianxiety
- sedative
- analgesic
- anticholinergic: increases HR and reduces oral secretions
- decreases acidity of stomach contents
begins when pt is admitted or transferred to surgery and ends when admitted to recovery area.
Intraoperative phase
What is an RNFA
specialized nurse that can close incisions
During interoperative care, what activities must be performed?
Ensure safety, positioning
documentation
environment: traffic, infection control, sterilization of supplies
Inadvertent hypothermia
ASA classification is a risk grading scale for anesthesia, describe the 1-6 classifications.
1 healthy
- one medical problem
- more than one med prob
- severe systemic disease
- not expected to survive w/o surgery
- organ harvest
the point at which anesthesia is initiated just prior to the 1st incisional cut
Anesthesia Induction
What are the 4 types of anesthesia?
general
regional
MAC monitored anesthesia care (IV)
moderate sedation
which type of anesthesia: controlled LOC protective reflexes lost sedation and analgesia muscle relaxation IV agents, inhalation agents, narcotics
general
What type of Anesthesia agent:
- thiopental, methohexital
- propofol
- ketamine
- nitrous oxide, halothane, enflurane, isoflane
- morphine, fentanyl, slfentanyl, demerol
- naloxone, narcan
1 barbituates
- non-barbituate hypnotic
- dissociative agent
- inhalation agents
- Narcotics, opioids
- narcotic antagonists NARCAN
Anesthesia agents continued:
- diazepam (valium), Loraxepam (ativan)
- romazicon flumazenil
- muscle relaxants
- antiemetics
- Toradol…
- Zantac, tagamet
- benzodiazepines (amnesia)
- benzodiazepine antagonist
- NSAIDs- equal affect to morphine but doesn’t cause airway issue
- H2 blockers
What complications to general anesthesia can occur w/in the CNS?
emergence delirium
delayed emergence
What complications to general anesthesia can occur w/in the Cardiovascular system?
hypotension
dysrhythmias, MI
What complications to general anesthesia can occur w/in the respiratory system?
laryngospasm
True or False: hypothermia and/or malignant hyperthermia are complication factors to general anesthesia?
True
____: chain rxn of abnormalities causes pharmoacogenetic disease of the skeletal muscle. This is an inherited disorder (single gene defect) that can only be confirmed with ____ tests after the MH crisis.
Malignant hyperthermia
caffeine/ Halothane contracture test
Malignant hyperthermia can be triggered by what types of agents? what agent does not cause MH?
inhalation agents and depolarizing muscle relaxants.
Nitrous oxide
S/s of MH include: muscle ____, tachycardia and dysrhythmias. ___ changes. Tachypnea and ____.
rigidity
cutaneous
pyrexia
____ is the hallmark of MH but it is a late sign.
PYREXIA
Management of MH crisis include:
- D/c ____ /surgery
- administer 100% ____
- Administer ____ ASAP
- ___ patient
- anesthesia
- oxygen
- DANTROLENE (treats muscle spasms)
- cool
What are types of regional anesthesia?
spinal
epidural
caudal
local
Esthers and Amides are agents used for what type of anesthesia?
Regional
____ are used to determine the level of block for a spinal and epidural
dermatome
With MAC anesthesia, the patient is able to maintain their own ___ and the anesthesia is administered entirely by ___.
airway
IV
_____: minimally depressed LOC in which patient retains ability to maintain patent airway independently and continuously and is able to respond to verbal commands.
Moderate sedation
Phase that begins with admission of pt to recovery area and ends with f/u evaluation in the clinical setting or at home.
Post-Op
What activities are performed in PACU care?
airway, O2 vital signs anesthesia report LOC I/O Pain/comfort dressings labs
True or False: the 1st dressing change post-op must be performed by a physician.
True
with wound ___, separation of wound edges occurs, more likely with vertical incisions and may be caused by ___ infections or poor wound ____.
dehiscence, bacterial, healing
Wound ____, protrusion of loops of bowel occurs with pink, serous drainage. Occurs more often in ___ obese, diabetic or malnourished pts.
evisceration
older
What are preventative measures for dehiscence and evisceration?
splint incision when coughing
monitor for signs of infection, malnutrition, dehydration
