PHASES OF PRE-OP Flashcards
- OPERATIVE PHASES
Consents signed in preop
- Informed consent (Surgical)
- Anesthesia consent
- Blood transfusion consent
is used as anti-emetic
Ondansetron and Metoclopramide
is used to decrease anxiety or for relaxation
Midazolam and Dormicum
refers to the time during surgery. Intra-operative care is patient care during an operation and ancillary to that operation
intra-operative
The purpose of intra-operative care is
- To maintain patient safety and comfort during surgical procedures.
- Maintaining homeostasis during the procedure,
- Maintaining strict sterile techniques to decrease the chance of cross-infection,
- Ensuring that the patient is secure on the operating table,
- Taking measures to prevent hematomas from safety strips or from positioning.
temperature in the intraoperative area
20-23°c
humidity should be maintained at
30%-60%.
Intra-operative complications are:
- Surgery related,
- Anesthesia related,
- Position related.
Abbreviation for electrocardiograph. Electro-cardiograph is a tracing of electrical activity of the heart obtained through electrodes placed on a person’s skin in certain areas where electrical activity can be easily detected.
ECG
Care provided to a patient during surgery that is ancillary to a surgery.
- Intraoperative care
a state of shock caused by the sudden loss of large amounts of blood.
- Hypovolemic shock
written or oral permission given by a patient or guardian for medical or surgical treatment after a complete explanation is given and any questions the patient has are answered. If consent is given orally, documentation must have two witnesses.
- Informed consent
a chain reaction triggered in susceptible people by commonly used general anesthetics. Signs include greatly increased body metabolism, muscle rigidity, and eventual hyperthermia which may exceed 110. Death may be caused by cardiac arrest, brain damage, internal hemorrhage, or failure of other body systems.
- Malignant hyperthermia
tests used to determine ventilation and perfusion capabilities of the lungs.
- Pulmonary function test
A method of measuring a patient’s blood oxygenation status. A measure of 100% is optimal.
- Pulse oximetry
is to provide the patient with as quick, painless and safe recovery from surgery as possible
post-operative care
Phases of post op
(1) Immediate
Post-anesthetic | Phase 1
(2) Intermediate
Hospital stay | Phase 2
(3) Convalescent
After discharge to full recovery | Phase 3
Aim of Phase I & II
- Homeostasis
- Treatment of pain
- Prevention & early detection of complication
DISCHARGE FROM RECOVERY SHOULD BE AFTER COMPLETE STABILIZATION OF CARDIO-VASCULAR, PULMONARY AND NEUROLOGICAL FUNCTIONS WHICH USUALLY TAKES _____________ HOURS IF NOT SPECIAL CARE IN ICU
2 - 4
MONITOR these in post op
- Vital signs
- ECG
- Fluid balance
- Other types of monitoring (arterial pulses after vascular surgery, level of consciousness after neurosurgery)
RESPIRATORY CARE needed in post op
- Oxygen mask
- Ventilator
- Tracheal suction
- Chest physiotherapy
POSITION IN BED AND MOBILIZATION in post op
- Turning in bed usually every 30 minutes until full mobilization
- Special position required sometimes
- DVT prevention mechanically (intermittent calf compression)
_________ (FRC) and ____________ (VC) decrease after major intra-abdominal surgery down to ______% of pre-operative level
Functional residual capacity , vital capacity, 40
Functional residual capacity (FRC) and vital capacity (VC) go up slowly to_____________ by 6th - 7th day and to normal pre- operative level after that
60-70%
especially deep inspiration helps to decrease atelectasis
Post-operative physiotherapy
WHEN CAN PATIENT LEAVI RECOVERY ROOM?
- Patient is fully conscious
- Respiration and oxygenation are adequate
- Patient is normotensive
- Not in pain nor nauseous
- Cardiovascular parameters are stable
- Oxygen, fluids and analgesics have been prescribed
- There are no concerns related to the surgical procedure
Pain in post-op: Nociceptive pain arises from ________ and __________
inflammation and ischemia
_______arises from a dysfunction in the central nervous system
Neuropathic pain
_______________ is modified by the mental state of the patient Surgical patients may have persistent pain from a variety of disorders including chronic inflammatory disease, recurrent infection, degenerative bone or joint disease, nerve injury and sympathetic dystrophy
Psychogenic pain
Commonly inexpensive opiates are __________&__________
pethidine and morphine
antiemetics
i. HT receptor antagonists (e.g. ondansetron)
ii. Steroids (e.G. Dexamethasone)
iii. Phenothiazines (e.G. Prochlorperazine)
iv. Antihistamines (e.G. Cyclizine)
_________ should be checked regularly in the first 24 hours after surgery.
patient’s blood pressure, pulse, urine output
