Periop 2 Flashcards
poor oral hygiene, management: mouth wash with diluted hydrogen peroxide
Acute parotitis
Nurse assesses the patient’s decision-making capacity, confirms that patient has been given the necessary information to give informed consent and clarifies any misconception
patient’s advocate
what to assess in consciousness
GCS scoring, checking for reflexes unless contraindicated, monitor LOC or patient’s responsiveness
last sense to be depressed is
hearing
o Explaining the risks and benefits of the surgical procedure to thepatient/legal guardian
surgeon
begins with the cessation of
respiration and leads to death.
Stage IV (stage of danger/ medullar stage)
authorizes the attending physician and staff to render standard day-to day treatment or to perform generalized treatment and care as the physician deemed
advisable
general consent
s/s for Hemorrhage and Shock
Decreased BP
Rapid, thread pulse
Apprehension
Restlessness
Weakness
o Ensures that sponge, instruments and sharp counts are completed
and appropriately documented
Circulating Nurse
fever etiologies
atelectasis
dehydration
wound infection
UTI
Thrombophlebitis
legal aspects PURPOSE:
o Ensure patient understanding to the nature of the treatment
o Indicate patients, decision
o Protect patient from unauthorized procedure
o Protect the surgeon and hospital against legal action
scrub nurse may be performed by
RN, licensed Practical Nurse (LPN), or OR scrub technologist
o In the immediate postoperative period, the anesthesiologist assumes medical responsibility for the patient
Anesthesiologist
where the patient is minor, unconscious or mentally unsound, the following may give consent (arranged according to legal interstate succession):
o Spouse
o Adult child
o Parent
o Sibling
o For minors: legal guardian
GI complications
Abdominal distention
constipation
paralytic ileus
types of regional anesthesia
Topical Surface
Local
Peripheral Nerve Block (tetracaine)
Spinal anesthesia
Epidural block
Acupuncture
Cryothermaia
pstn for hemorrhoidectomy, repair of vaginal laceration
Lithotomy
position: prone position with extremities lowered and hips over center break of table (i.e. oral surgeries)
Kroske/Jack Knife
o Anesthetizing the patient, provide appropriate levels of pain relief
Anesthesiologist
Urine output should be at least
at least 30 mL/h
begins with the onset of regular
breathing and ends with the cessation of respirations.
Stage III (stage of surgical anesthesia)
o Documenting intraoperative nursing care and ensuring surgical specimens are identified and placed in the appropriate media
Circulating Nurse
examples of inhalation general anesthesia
halothane, ether, nitrous oxide, cyclopropane
Secondary to decreased activity, decreased peristalsis
constipation
manifestations of thrombophlebitis
Pain in the part of the body affected
Skin redness of iflamation( not always present)
Swelling (edema) of the extremities ( ankle and foot)
Post-operative psychosis manifestations
Insomnia, restlessness, anorexia, irritability/suicidal tendency
Must have a thorough knowledge and understanding on the specific surgical procedure and the anatomy and physiology of the involved system.
scrub nurse
General anesthesia is accomplished in 4 phases:
Pre-induction
Induction
Maintenance.
Reversal/extubation
what to give for patients with decreased level of consciousness
mouth guard
etiologies that varies in fever types
dehydration, wound infection, thrombophlebitis
position: the patient lies flat on bed with the patient facing the bed (i.e. spinal operation, posterior leg)
Prone
an RN whose responsibility is to serve as the patient’s advocate while coordinating events before, during and after a surgical procedure
circulating nurse
o Monitoring patients’ physiologic status
Anesthesiologist
intervention of thrombophlebitis
Bed rest with feet elevated
o Monitoring the scrubbed team members for breaks in the sterile technique
scrub nurse
pstn for biliary tract surgery
Reverse Trendelenburg
Components of a consent:
o Patient’s full legal name
o Surgeon’s name
o Specific procedures to be performed
o Signature of the patient, next of kin, legal guardian
o Witnesses
o Date
has the obligation to provide the patient or legal guardian full disclosure regarding the risk and benefits of anesthetic agents that are to be used to the patient
anesthesiologist
phase that Begins as soon as the patient is brought to the procedure room and ends immediately before the induction of the anesthesia
pre-induction
o Providing nursing care to the patient
Circulating Nurse
late sign of atelectasis
cyanosis
Manifestation:
Productive cough
High Grade fever accompanied by chills
pneumonia
phase that Begins with the induction of anesthetic agents and ends with stabilization of the patient. Involves putting the patient safely to sleep. A patent airway and adequate ventilation must be ensured
induction
length of stay in the PACU is generally ***; for a patient to be transferred to the ward, the patient should be stable and free form signs and symptoms of postoperative complications
less than 24 hours
o Preparing supplies and equipment in the sterile field
scrub nurse
mgt thrombophlebitis
Bed rest with the affected limb elevated
Warm compress
Administration of thrombolytics or anticoagulants as ordered
o Providing appropriate sterile instrumentation, sutures, and supplies to the operating surgeon.
scrub nurse
Paralysis of the intestinal peristalsis
paralytic ileus
abdominal distention mgt
Insertion of NGT
Lavage
IVFluid replacement of electrolytes
intervention of atelectasis
Cough, deep breathing
exercises
o Determining the pre-operative diagnosis
surgeon
may be attributed to grief of lost body part, body image disturbance, standing emotional problem, exhaustion
Post-operative psychosis
An inflammatory condition of lung (alveoli) characterized by consolidation of the lungs
pneumonia
o Managing post-operative care
surgeon
evisceration mgt
Position patient flat or low fowlers position
Cover the protruding organ with sterile moist dressing
Instruct patient not to cough
NPO
Notify the surgeon STAT
Prepared the patient for surgery for immediate closure of wound
Types of general anesthesia
Inhalation
Intravenous anesthesia
Rectal anesthesia
pstn for spinal operation, posterior leg)
prone
anesthesia commonly employed as induction agent prior to inhalation anesthesia
intravenous anesthesia
Factors to consider in determining the type of anesthesia:
- Age and physical condition of the patient
- Type, location and duration of surgery
- Degree of technical intricacy of surgery
- Previous anesthetic history
- Personal preference, expertise and judgment of anesthesiologist
- Patient’s preference
