Perioperative Conditions Section 1 Flashcards
What is the perioperative episode?
The entirety of the surgery
What are the 3 phases of the perioperative period?
Preoperative
Intraoperative
Postoperative
What are the 6 reasons that people have surgery?
- Diagnostic
- Curative
- Palliative
- Preventative
- Cosmetic
- Explorative
What is emergence delirium?
- A condition caused by adverse effects of surgery that is often mislabeled as senility or dementia
Describe the scale used to assign a physical status rating to a patient planning to receive anesthesia
P1: Normal, healthy person
P2: Pt with mild systemic disease
P3: PT with severe systemic disease
P4:Patient with severe systemic disease that is a constant threat to life
P5: Moribund patient who is not expected to survive without surgery
P6: Declared brain-dead patient whose organs are being removed for donor purposes
What are the 3 phases of postanesthesia care?
I: Care immediately after postanesthesia; ECG and more intense monitoring
II: Ambulatory surgery patients; fast-tracking (patients who have bypassed phase I)
III: Extended observation; prepare for self-care
What is the first sense to return to the unconscious patient?
Hearing
What PaO2 is considered hypoxemia?
Less than 60 mmHg
What is the most common cause of hypoxemia?
Atelectasis
What is Capnography?
A non-invasive way to measure CO2 exhaled
What is hypercapnia?
Too much CO2 in blood
What are some manifestations of hypoxemia?
Tachypnea, gasping, anxiety, restlessness, confusion, and a rapid or thready pulse
A patient’s blood pressure is dropping and their heart rate is increasing. What is your goal? What can you suspect if this treatment doesn’t work?
To restore circulatory volume by administering fluid or blood products. If this doesn’t fix the problem, then you can suspect heart dysfunction.
What hormones leads to fluid retention?
Antidiuretic hormone (ADH)
Adrenocorticotropic hormone (ACTH)
How does ADH work?
When released, it more water absorption and decreased urine output which increases blood volume
How does ACTH work?
- Stimulates adrenal cortex
- Secretes cortisol and aldosterone
- Causes body to hang onto sodium which draws water in
- Increases blood volume
What is a VTE?
Venous thromboembolism
What can cause a VTE?
- Venous stasis
- Vein injury
- Hypercoagulable state
What patients are more prone to VTE?
- Postop patients
- Older
- Obese
- Immobilized
- History of VTE
- Predisposition to clotting
Which symptoms should cause you suspect a PE in a postop patient? (Especially those receiving O2 therapy)
- Tachypnea
- Chest pain
- Hypotension
- Agitation
- Tachycardia
- Dyspnea
You are watching a postop patient’s vital signs? When should you contact the provider?
Systolic BP:
Pulse rate:
Pulse Pressure:
Heart rhythm:
BP changes:
Systolic BP: Less than 90 or more than 160
Pulse rate: Less than 60 or more than 120
Pulse Pressure: Narrows
Heart rhythm: Changes
BP changes: gradually increases or decreases over several reading
What 4 things does early ambulation do to prevent complication?
1) Increases muscle tone
2) Stimulates circulation (prevents venous stasis, VTE, and promotes wound healing)
3) Increases vital capacity and helps pt breathe better
4) Improves feelings of well-being
What is postoperative cognitive dysfunction? (POCD)
Decline in patient’s cognitive function for weeks to months after surgery. More common in older people
What is multiomodal analgesia?
Use of 2 or more analgesics with different mechanisms of action
What are 3 treatments for malignant hyperthermia?
- Dantrolene
- Cooling measures (ice packs)
- Correcting acid-base imbalances
What is postoperative ileus?
Temporary impairment of gastric and bowel motility after surgery
What are 3 synonyms for anesthesia that does not cause complete loss of consciousness or usually cause respiratory arrest?
- Moderate Sedation
- Conscious sedation
- Procedural sedation
What contraindication are noted for Succinylcholine?
Patients with history of malignant hyperthermia, skeletal muscle myopathies, allergies
What medication acts as an antidote for vecuronium?
Neostigmine
