N300 Q#1 Peri-Op

Question 1

What are 4 reasons for surgery?

Answer 1

Diagnostic
Curative
palliative
cosmetic

Question 2

Surgery has both psychological and physical stress impact. Explain physical.

Answer 2

resistance to infection lowered

organ fxn altered due to manipulation

Question 3

psychological stressors from surgery include?

Answer 3

fear,pain, anxiety, loss of control, body image, alterations in ADL

Question 4

Surgical risk is assessed by what factors?

Answer 4

age, nutritional status, fluid and lytes balance

general health, medications

Question 5

____: the term used to describe the wide variety of nursing fans associated with pts surgical experience.

Answer 5

perioperative nursing

Question 6

______: the term for the nursing fans associated with pts care before and after anesthesia.

Answer 6

perianesthesia

Question 7

begins when decision for surgical intervention is made and ends with trx of patient to the operating room table

Answer 7

preoperative phase

Question 8

With pre-op consult, what is important condition to inquire about?

Answer 8

malignant hyperthermia- rxn to anesthesia

Question 9

The following preop meds serve what purpose?

1. Valium (diazepam)
2. midazolam
3. morphine sulfate
4. atropine
5. zantac axid or tagamet

Answer 9

1. antianxiety
2. sedative
3. analgesic
4. anticholinergic: increases HR and reduces oral secretions
5. decreases acidity of stomach contents

Question 10

begins when pt is admitted or transferred to surgery and ends when admitted to recovery area.

Answer 10

Intraoperative phase

Question 11

What is an RNFA

Answer 11

specialized nurse that can close incisions

Question 12

During interoperative care, what activities must be performed?

Answer 12

Ensure safety, positioning
documentation
environment: traffic, infection control, sterilization of supplies
Inadvertent hypothermia

Question 13

ASA classification is a risk grading scale for anesthesia, describe the 1-6 classifications.

Answer 13

1 healthy

2. one medical problem
3. more than one med prob
4. severe systemic disease
5. not expected to survive w/o surgery
6. organ harvest

Question 14

the point at which anesthesia is initiated just prior to the 1st incisional cut

Answer 14

Anesthesia Induction

Question 15

What are the 4 types of anesthesia?

Answer 15

general
regional
MAC monitored anesthesia care (IV)
moderate sedation

Question 16

which type of anesthesia:
controlled LOC
protective reflexes lost
sedation and analgesia
muscle relaxation
IV agents, inhalation agents, narcotics

Answer 16

general

Question 17

What type of Anesthesia agent:

1. thiopental, methohexital
2. propofol
3. ketamine
4. nitrous oxide, halothane, enflurane, isoflane
5. morphine, fentanyl, slfentanyl, demerol
6. naloxone, narcan

Answer 17

1 barbituates

2. non-barbituate hypnotic
3. dissociative agent
4. inhalation agents
5. Narcotics, opioids
6. narcotic antagonists NARCAN

Question 18

Anesthesia agents continued:

7. diazepam (valium), Loraxepam (ativan)
8. romazicon flumazenil
9. muscle relaxants
10. antiemetics
11. Toradol…
12. Zantac, tagamet

Answer 18

7. benzodiazepines (amnesia)
8. benzodiazepine antagonist
9. NSAIDs- equal affect to morphine but doesn’t cause airway issue
10. H2 blockers

Question 19

What complications to general anesthesia can occur w/in the CNS?

Answer 19

emergence delirium

delayed emergence

Question 20

What complications to general anesthesia can occur w/in the Cardiovascular system?

Answer 20

hypotension

dysrhythmias, MI

Question 21

What complications to general anesthesia can occur w/in the respiratory system?

Answer 21

laryngospasm

Question 22

True or False: hypothermia and/or malignant hyperthermia are complication factors to general anesthesia?

Answer 22

True

Question 23

____: 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.

Answer 23

Malignant hyperthermia

caffeine/ Halothane contracture test

Question 24

Malignant hyperthermia can be triggered by what types of agents? what agent does not cause MH?

Answer 24

inhalation agents and depolarizing muscle relaxants.

Nitrous oxide

Question 25

S/s of MH include: muscle ____, tachycardia and dysrhythmias. ___ changes. Tachypnea and ____.

Answer 25

rigidity cutaneous pyrexia

Question 26

____ is the hallmark of MH but it is a late sign.

Answer 26

PYREXIA

Question 27

Management of MH crisis include: 1. D/c ____ /surgery 2. administer 100% ____ 3. Administer ____ ASAP 4. ___ patient

Answer 27

1. anesthesia 2. oxygen 3. DANTROLENE (treats muscle spasms) 4. cool

Question 28

What are types of regional anesthesia?

Answer 28

spinal epidural caudal local

Question 29

Esthers and Amides are agents used for what type of anesthesia?

Answer 29

Regional

Question 30

____ are used to determine the level of block for a spinal and epidural

Answer 30

dermatome

Question 31

With MAC anesthesia, the patient is able to maintain their own ___ and the anesthesia is administered entirely by ___.

Answer 31

airway | IV

Question 32

_____: minimally depressed LOC in which patient retains ability to maintain patent airway independently and continuously and is able to respond to verbal commands.

Answer 32

Moderate sedation

Question 33

Phase that begins with admission of pt to recovery area and ends with f/u evaluation in the clinical setting or at home.

Answer 33

Post-Op

Question 34

What activities are performed in PACU care?

Answer 34

``` airway, O2 vital signs anesthesia report LOC I/O Pain/comfort dressings labs ```

Question 35

True or False: the 1st dressing change post-op must be performed by a physician.

Answer 35

True

Question 36

with wound ___, separation of wound edges occurs, more likely with vertical incisions and may be caused by ___ infections or poor wound ____.

Answer 36

dehiscence, bacterial, healing

Question 37

Wound ____, protrusion of loops of bowel occurs with pink, serous drainage. Occurs more often in ___ obese, diabetic or malnourished pts.

Answer 37

evisceration | older

Question 38

What are preventative measures for dehiscence and evisceration?

Answer 38

splint incision when coughing | monitor for signs of infection, malnutrition, dehydration