OR Nursing Flashcards
PRE-OP nursing responsibilities (5, FDITA)
Verbalize feelings Participate in decision making Give necessary info Health teaching Administer pre-op meds as ordered
INTRA-OP nursing responsibilities (5, PARMC)
Proper positioning Asepsis Restraints Monitor responses Comfortable
What is surgical conscience?
When you know you are unsterile, you have to admit it
Period when the px is in the OR up to when he/she is brought to recovery room
Intraoperative period
What are the two types of regional anesthesia?
Spinal and epidural anesthesia
Intact consciousness, loss of motor and sensory perception to a particular area
Regional anesthesia
Where is spinal anesthesia injected?
How does it work?
Subarachnoid space (CSF), L2-3 or L3-4
Stops signals from spinal cord = paralysis in LE
(T/F) The effect of spinal anesthesia is temporary
TRUE
Give the 3 possible complications of epidural anesthesia (HHR)
Hypotension
Spinal headache (brain is pulled down due to low buoyancy)
Respiratory depression
Nursing interventions for epidural anesthesia (VTRFHC)
VS
Reverse trendelenburg (respiratory depression)
Watch for return of sensation and motor function
Flat On Bed for at least 8 hrs until sure they returned
Hydration (loss of CSF)
Catheter (urinary retention)
In any Abdominal surgery, px are maintained on NPO until
You hear a flatus or fart indicating bowel movement
Unconsciousness, blocks motor and sensory pathway to major nerve
General anesthesia
What is the milk of amnesia
Propofol
General anesthesia comes in two forms:
IV injection and inhalation gas
Ability of the drug to reduce or make pain absent
anesthesia
What type of anesthesia is usually used for major surgeries?
General anesthesia
Nursing interventions for general anesthesia (RS)
Prepare resuscitative equip (CNS depression = cardiorespi arrest)
Avoid stimulating (confusion)
Match the stage of anesthesia to its definition
- Analgesic/analgesia
- Paradoxical
- Surgical
- Medullary
A. dangerous stage, affects brainstem = cardiorespi arrest
B. sleepy, absence of pain
C. fight or flight, will try to resist
D. not moving, muscles are relaxed, body is stable, px does not feel anything
1B
2C
3D
4A
Group the surgical team acc to sterile and nonsterile members:
- Surgeon and assistants
- Circulating nurse
- Scrub nurse
- Anesthesiologist
- STERILE
- NON-STERILE
- STERILE
- NON-STERILE
Who is like the captain of the ship, the one performing the surgery?
Surgeon
Who is the one in charge for the equipment in the sterile area?
Scrub nurse
Gives anesthetic and monitors vital status of px
Anesthesiologist
In charge of OR suite and documentation
Circulating nurse
Intraoperative nursing care
Positioning depends on:
Dorsal recumbent is for:
Reverse trendelenburg is for:
Lithotomy:
Lateral:
Surgical asepsis aka:
Equipment needs:
Wound closure is done by:
Need for visualization
Surgery on liver
To allow gravity to move organs
W/stirrups
Side-lying
Handwashing
Proper sterilization
Suturing
The air in the OR is ___ and kept in ___ pressure at a temp of __ to __
Filtered
Positive
<70
Prevent growth of bacteria
Device that uses heat and pressure to destroy microorganisms, also kills spores
Autoclave
What equipment cannot be autoclaved? What do we do with them?
Catheter and scissors
Antiseptic solution
Give the 5 possible intraoperative complications (IFIHM)
infection fluid deficit/overload injury due to positioning hypothermia malignant hyperthermia
Match the ff complications to its interventions
- infection
- fluid volume excess/deficit
- injury r/t positioning
A. monitor iv infusion rate, i&o, blood loss
B. count equipment before and after
C. proper sterilization
1C
2A
3B
What tool can we use to help count blood loss?
sponge
How and when does malignant hyperthermia occur?
Drug reaction to inhaled anesthetic (halothane) + muscle relaxant
Post-op
(t/f) malignant hyperthermia is an idiosyncratic reaction = not all px experience
TRUE
what are early s/sx of malignant hyperthermia
fever and seizures
What do we immediately assess in the post anesthesia care unit (PACU)? 3, ACL
airway
circulation
LOC
What should we monitor if patients are given morphine
RR
Lung collapse is aka
Atelectasis
Threee interventions for airway and breathing post op include:
Deep breathing/coughing exercises
Incentive spirometry
O2
What is the problem with deep breathing exercises post op?
Px may be in pain = not cooperative = give analgesic first
In incentive spirometry, the ball should be
floating and maintained at the marked area
Fever longer than 24 hrs may be explained by ___
The intervention for this is _____
Pneumonia
antibiotics
In the PH setting, who checks the wound and dressing?
doctors
What are the 3 things we should assess in wounds (IID)
infected: inflammed + pus
integrity: wound dehiscence or evisceration (organ come out)
drainage
What do we do in organ evisceration?
Cover with wet gauze to preserve organ and REFER
(T/F) drains allow for good wound healing
TRUE
(T/F) drain increases after 24 hrs
FALSE, it decreases
Reddish fluid for the first 24 hrs
Serosanguinous fluid
factors that increase risk for infection (AM)
aseptic technique
medical condition
Match the form of wound healing to its definition:
- Primary
- Secondary
- Tertiary
A. sutured, thin hairline scar or no scar at all
B. sutured, got infected, opened, sutured again
C. sutured, ulcerations, let heal by itself
1A
2C
3B
