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AORN Periop class > Post anesthesia care > Flashcards

Post anesthesia care Flashcards

1
Q

What are ERAS (enhanced recovery after surgery) protocols?

A

a prescribed program that patients are to follow after participating in education that is specific to the surgery.

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2
Q

Why are ERAS used?

A

These protocols have been shown to be beneficial to the patient, improve surgical outcomes, and decrease costs.

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3
Q

When do patients and their providers follow the ERAS protocols?

A
  1. prior to surgery
  2. The day of surgery
  3. during surgery
  4. after surgery
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4
Q

What are example of ERAS protocols?

A
  1. strengthening exercises
  2. improving nutritional status
  3. additional prep education
  4. smoking cessation
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5
Q

What is ASA 1 for physical status?

A

a normal healthy patient

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6
Q

What is ASA 2 for physical status?

A

a patient with mild systemic disease

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7
Q

What is ASA 3 for physical status?

A

a patient with severe systemic disease

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8
Q

What is ASA 4 for physical status?

A

a patient with severe systemic disease that is a constant threat to life

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9
Q

What is ASA 5 for physical status?

A

a moribund patient who is not expected to survive without the operation

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10
Q

What is ASA 6 for physical status?

A

a declared brain-dead patient whose organs are being removed for donor purposes

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11
Q

What is the ASA used for?

A

to determine perioperative risk. NOT to determine what anesthesia to use

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12
Q

What are the 3 phases of PACU care?

A
  1. Phase 1
  2. Phase 2
  3. Phase 3
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13
Q

What are the phases of PACU care used to describe? not describe?

A

are levels of care, not physical location.

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14
Q

What are factors that determine the level of patient care in the PACU?

A
  1. type of surgery
  2. length of surgery
  3. type of anesthesia
  4. comorbid conditions
  5. anticipated post-anesthesia requirements
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15
Q

What is post anesthesia phase 1?

A

the post anesthesia phase 1 requires constant vigilance and life-sustaining care

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16
Q

What is post anesthesia phase 2?

A

a period of care that focuses on in-home care

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17
Q

What is post anesthesia extended care?

A

care for the patient requiring continued observation or intervention.

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18
Q

What is the nurses role PACU phase 1?

A
  1. patient assessment and care implementation int he immediate post anesthesia period
  2. preparations for the patient’s transition to the phase II care, the ICU, an inpatient setting, or extended care
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19
Q

What kind of experience does a PACU nurse typically have?

A

critical care experience or ED experience

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20
Q

What kind of certifications does a PACU nurse typically have?

A

ACLS and PALS

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21
Q

What must the PACU nurse have knowledge of?

A

will have knowledge of the care necessary for the patient who has received general, regional, and/or local anesthesia

22
Q

What two other pieces of knowledge is required for the PACU RN?

A
  1. age-specific care knowledge

2. how to care for a patient requiring cardiac and respiratory support

23
Q

What is constantly required by the PACU RN?

A

constant assessment of the post patient is required to ascertain changes in the patient’s condition and respond appropriately to those changes

24
Q

What is a key component of the handover report?

A

completing urgent tasks before doing handoff

25
Q

Describe the phase II staffing and patient acuity?

A
  1. 1:3 for patients older than 8 years

2. 1:2 for patients 8 years of age and younger

26
Q

What are examples of education you might find in Phase II PACU?

A
  1. how to empty the drain reservoir
  2. coughing and deep breathing exercises
  3. how to take the prescribed pain medication
27
Q

What ASA classification would a patient with a BMI of 40 and type 1 diabetes be?

A

ASA 3; diabetes is a systemic disease that limits activity but is not incapacitating

28
Q

What is part of the initial assessment for the PACU RN in phase 1? Not what?

A

airway, breathing, and circulation. NOT pain

29
Q

What is phase II often the last opportunity for?

A

for the nurse to provide education to the patient and their family/support group

30
Q

What is the best kind of education method in phase II patient and family education?

A

teach-back method

31
Q

Why teach-back method the best?

A

reinforces what the patient knows and understands

32
Q

What does the teach-back method involve?

A

asking your patient to teach you what you have just explained

33
Q

What does the teach-back method reinforce?

A

the ability to correctly perform prescribed activities

34
Q

Why is it important for the nurse to identify if the patient can correctly perform prescribed activities?

A

because If the patient misunderstands how to perform an activity, the nurse can provide further education.

35
Q

What does medication reconciliation help ensure?

A

that the patient understands what medication they have been prescribed and why

36
Q

What are 5 nursing actions during medication reconciliation?

A
  • Compare the list to those listed in the preoperative phase.
  • Provide direction on how, when, and why to take the medications.
  • Discuss adverse effects of each medication.
  • Review the written instructions with the patient and/or caregiver.
  • Ask the patient/caregiver if they have any questions.
37
Q

What is Phase II also known as?

A

step down

38
Q

True or false; a patient may bypass phase I PACU and transfer directly to phase II

A

true

39
Q

What is it called when a patient bypasses phase I PACU and transfers directly to phase II?

A

fast tracking

40
Q

What is implemented between patient care providers during fast tracking? why?

A

hand off communication tool; to help ensure continuity of care and patient safety

41
Q

Why is the patient follow-up phone call an important element of post anesthesia care?

A

most surgical complications occur within 48 hours of the procedure

42
Q

What is discussed in the postoperative phone call? 3 things

A
  • Postoperative instructions are reviewed and reinforced.
  • Questions are answered.
  • Reminders are provided concerning follow-up appointments.
43
Q

Who was the first nurse to suggest that a postanesthesia unit be created?

A

florence nightingale

44
Q

What is capnography?

A

The monitoring of the concentration or partial pressure of carbon dioxide (CO2) in respiratory gases (ie, end-tidal CO2 [ETCO2]). Its main use is as a monitoring tool during anesthesia.

45
Q

define aldrete scale

A

anesthesia care unit to either the postsurgical ward or to the second stage recovery area.

46
Q

What is the specialty organization for RNs working in preanesthesia, postanesthesia, pain management, and ambulatory surgery centers?

A

ASPAN; American society of perianesthesia nurses

47
Q

What is ASPAN responsible for?

A

for defining and establishing the scope of perianesthesia nursing and supports nurses through advocacy, research, and clinical education.

48
Q

define extended care unit/phase III?

A

is utilized when additional observation is required before a patient goes home, when waiting for an inpatient bed, or when waiting for the patient’s support system.

49
Q

define post anesthesia phase I?

A

This occurs immediately following surgery. Basic life-sustaining needs are the highest priority. Constant observation is required during this phase.

50
Q

define post anesthesia phase II?

A

This is a transition period between PACU care and discharge to extended care, home, or another facility. If the patient is being admitted to a unit, they will likely bypass Phase II.

51
Q

What is a system developed by the American Society of Anesthesiologists (ASA) that provides uniform guidelines for the evaluation of the severity of systemic diseases, physiologic dysfunction, and anatomic abnormalities?

A

ASA physical status classification

AORN Periop class (23 decks)

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