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Preop > Preop > Flashcards

Preop Flashcards

1
Q

-centesis

A

puncture of a cavity

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2
Q

-cholangio

A

bile vessel

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3
Q

-chole

A

bile or gall

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4
Q

cyst-, -cyst

A

urinary bladder or a cyst

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5
Q

ecto-

A

outside

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6
Q

ectomy-

A

removal

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7
Q

endo-

A

within

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8
Q

entero-

A

intestines

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9
Q

gaster-, gastro-

A

stomach or ventral

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10
Q

hepat-, hepato-

A

liver

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11
Q

ileo-

A

area of the abdomen from the lowest rib to the pubes. Prefex meaning ileum

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12
Q

-itis

A

inflammation

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13
Q

laparo-

A

flank or abdominal wall

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14
Q

lith-, litho

A

stone or calculus

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15
Q

-lysis

A

reduction or relief of

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16
Q

-oma

A

tumor

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17
Q

-plasty

A

surgical repair

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18
Q

post-

A

behind, after, posterir

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19
Q

pre-

A

infront of, before

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20
Q

retro-

A

backward, back, behind

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21
Q

-rrhage, -rrhagia

A

rupture, profuse fluid discharge

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22
Q

-rrhaphy

A

suture, surgical repair

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23
Q

-scopy

A

examination with a device or tool

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24
Q

sub-

A

under, beneath, in small quantity, <normal

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25
Q

stoma

A

small opening

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26
Q

super-, pura-

A

above, beyond, superior

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27
Q

-tomy

A

cutting, incision

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28
Q

Anesthesia

A

reflex loss, not arousable, no reaction to painful stimuli, they loose the ability to maintain ventilatory function & require assistance in maintaining a patent airway

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29
Q

How are anesthesia agents inhaled or given?

A

Inhaled or IV

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30
Q

Inhaled anesthesia pros

A

important in situations where there is a lack of venous access & anticipated airway difficulty, easy to administer, inexpensive, & reliable

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31
Q

Local Anesthesia

A

used to block nerves in the peripheral and CNS. It blocks the transmission of pain sensation. Degree of blockage depends on both drug concentration & volume

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32
Q

Sinal, epidural, peripheral nerve blocks are examples of what?

A

Regional Anesthesia

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33
Q

Local anesthesia route?

A

topical or local infiltration

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34
Q

How is a Reginal Anesthesia administered

A

anesthesia agent is injected around the nerves

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35
Q

Morphine, Fentanyl, sufentanil, alfentanil are examples of what?

A

Opiod Analgesics

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36
Q

Rocuronium (Zemuron) & Vecuronium (Norcuron) are examples of what?

A

Nondepolarizing muscle relaxers

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37
Q

Etomidate (Amidate), Diazepam (Valium), Midazolma (Versed), & Propofol (Diprivan) are examples of what?

A

Intravenous Anesthetics

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38
Q

Where is the local anesthetic introduced during a Spinal Anesthesia?

A

into the subarachnoid space

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39
Q

Which type of anesthesia is a local anesthetic introduced into the subarachnoid space at the lumbar level?

A

Spinal Anesthesia

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40
Q

An after-effect of spinal anesthesia

A

Headache

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41
Q

How is Epidural anesthesia achieved?

A

by injecting a local anesthetic into the epidural space

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42
Q

Advantages to peripheral nerve blocks (PNB)

A
  1. )reduces physiological stress compared to having a spinal or epidural
  2. ) avoids any potential complications with intubation & side effects of anesthesia
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43
Q

Moderate sedation (conscious sedation) involve what?

A

IV administration of sedatives and/or analgesics

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44
Q

Clues you may need more sedation or alnalgesia include:

A
  1. Hypertenstion
  2. Tachycardia
  3. Patients report of pain
  4. Distressed facial expression
45
Q

For moderate sedation the patient should not have eaten for how many hours?

A

4-6 hrs

46
Q

How do you prevent hypoventalation?

A

Ask the patient to take deep breaths at least every 5 mins

47
Q

Retained CO2 is a sign of what?

A

hypoventilation

48
Q

What is the goal of moderate sedation?

A

to depress a patient’s LOC to a moderate level while ensuring the patient’s comfort

49
Q

Moderate Sedation allows the patient to maintain what?

A

a patent airway, protective reflexes, respond to verbal & physical stimuli and recover more rapidly post procedure, may be drowsy

50
Q

Hypothermia is indicated if temp falls below:

A

36.6 C or 98 F

51
Q

Muscle disorder that is chemically induced by anesthetic agents

A

Malignant hyperthermia

52
Q

Outpatient

A

admitted & discharged on the same day - from hospital, clinic, office

53
Q

Admitted the day before major surgery, alternative is an AM admission with a post op stay

A

Inpatient

54
Q

important rule when getting Informed consent

A

Dr. MUST talk to patient about the risks not the nurse

55
Q

Factors affecting adaptation for surgery

A

Age, Neuroendocrine stress response, surgical procedure, previous hospitalization, spiritual beliefs, type of admission for surgery

56
Q

Preadmission requirements

A

obtain history & preform physical, establish baseline data, review results of any tests, prioritize nursing care, listen to verbal /nonverbal messages

57
Q

Preadmission interventions

A

Pre-op teaching, physical prep (meds), infor for family, teaching about day surgery, teaching about post-op care & operative permit

58
Q

responsibilites of circulating nurse

A

keeps track of everything in room, makes sure sterile procedures are done

59
Q

Surgical scrub should last for how many mins?

A

5-10mins

60
Q

unrestrictive surgical attire

A

street clothes, hospital attire

61
Q

semi-restrictive surgical attire

A

scrubs, shoe covers, cap/hood

62
Q

restrictive surgical attire

A

masks, sterile gown, gloves

63
Q

Which kind of soap do you use for a surgical scrub

A

antimicrobial soap

64
Q

Steps of the universal protocol

A

Preopertive verification process, marking the operative site, “Time Out” immediately before starting the procedure

65
Q

Why are the tools & spounges counted before and after a surgical procedure?

A

To make sure nothing is left in the patient

66
Q

Deep sedation

A

may sleep but can be aroused without difficulty, minimal depression of protective reflexes

67
Q

Trendelenburgh position

A

laying supine upsidedown slanted downward with head towards floor

68
Q

Intraop complications

A

hemmorrhage, cardiac dyshythmias, diminished circulation, respiratory depression, lack of response to pain

69
Q

clinical manifestations of malignant hyperthermia

A

hyperpyrexia, tachycardia, cardiac dysrhythmias, unstable BP, muscle stiffness, cyanosis, respiratory & metabolic acidosis, hyperkalemia

70
Q

What do you do if malignant hyperthermia occurs?

A

stop surgery ASAP, administer 100% oxygen, Administer Dantrolene Na (Dantrium) IV, Cool-iced IV solutions/NG lavages, treat acidosis/hyperkalemia, monitor temp/output

71
Q

Dantrolene Na (Dantrium)

A

Administered IV for Malignant Hyperthermia

72
Q

Benefits of Cyberknife surgery

A

Painless, no sedation, no incisions, no blood loss, no recovery time (patient goes home same day), lower risk of fewer complications than open surgery

73
Q

Inhalation anesthetics and muscle relaxants can trigger the symptoms of what?

A

Malignant Hyperthermia

74
Q

What causes hyperthermia and damage to CNS?

A

sustained muscle contractions in patients with Malignant Hyperthermia

75
Q

Pathophysiology of Malignant Hyperthermia

A

is related to a hypermetabolic condition in skeletal muscle cells that involves altered mechanisms of calcium function at the cellular level. The disruption of calcium causes clinical symptoms of hypermetabolism, which in turn increases muscle contraction (rididity)

76
Q

Postanesthesia care phase I (phase I PACU) is the..

A

immediate recovery phase, intensive nursing care is provided

77
Q

In the Postanesthesia care phase II (phase II PACU) the patient is..

A

prepared for self-care or care in the hospital, an extended care setting, or discharge. Recliners rather than stretchers or beds are standard in phase II

78
Q

Primary Hemmorrhage occurs

A

at the time of surgery

79
Q

Intermediary hemmorrhage occurs

A

during the first few hours after surgery when the rise of BP to its normal level dislodges insecure clots from untied vessels

80
Q

Secondary Hemmorrhage may occur

A

some time after surgery if a suture slips b/c of a blood vessel was not securely tied, became infected or was eroded by a drainage tube

81
Q

First-intention healing

A

grannulation tissue is not visible & scar formation is minimal

82
Q

Second-intention healing

A

granulation occurs, skin grows over scar

83
Q

Third-intention healing

A

used for deep wounds. Late suturing with wide scar

84
Q

Goals of postop

A

1.) Promote healing & recovery 2.) Prevent complications

85
Q

OR -> _____ -> ______ -> Home

A

OR -> PACU -> Nursing Unit -> Home

86
Q

Considerations in Post-op Care- What did we do to the patient during surgery?

A
  1. )Because tissue is removed during surgery - need to be concerned about fluid/blood loss
  2. )The patient will be immoble - need to be concerned about blood stasis - clotting
87
Q

When does Post-op care begin?

A

when patient transfers from OR to PACU

88
Q

PACU stands for

A

post anesthesia care unit

89
Q

What gets reported to the PACU nurse?

A

Diagnosis & surgery preformed, Age &general condition, type of anesthesia, meds given, problems, malignancy & if family knows, I&O, any drains, who to notify c problems

90
Q

During Post-op what should be assessed?

A

Airway, resp effort, cardio function, LOC, movement & sedation, pain, surgical site, N/V

91
Q

What hould be assessed q15m post op?

A

Vital signs: resp effort, cardio effort, LOC

92
Q

What is the main cause of airway obstruction post-op?

A

the tongue

93
Q

Causes of compromised airway

A

tongue & secretions

94
Q

What do you do when assessing airway post-op?

A

LOC - awake enough to maintain airway? Able to clear airway/cough?

95
Q

signs of compromised airway post op

A

snoring, choking, irregular respirations, SPO2 decreasing, cyanosis

96
Q

Interventions for compromised airway post op

A
  1. ) Maintain airway 2.) position on side 3.) cough

4. )supply O2 5.)insert oral airway 6.) suction 7.) Call anesthesiologist

97
Q

What are you doing when assessing respiratory effort post-op

A

patient airway, resp, O2 stat (>93) & lung sounds

98
Q

post op Cardiac assessment in order

A

rate & rhythem then check perfusion then check BP

99
Q

When checking perfusion post op what are you assessing?

A

skin color, capillary refill, urine out put, mentation

100
Q

Why is checking mentation post op important?

A

Because mental status gives a good indicattion of O2 perfusion of the brain

101
Q

What does it mean when a patient has orthostatic hypotension post op?

A

There is an imbalance of fluid somewhere

102
Q

Serous fluid

A

Blood plasma. Clear. Ex fluid in blister

103
Q

Sanguinous fluid

A

Bloody. Bleeding out

104
Q

Serosanguineous

A

Blood plasma + blood. Ex if yup start an Iv and they bleed

105
Q

Fibrinous

A

Yellow thick sticky. Eye infection

106
Q

CMS stands for

A

color, movement, sensation

107
Q

Potential respiratory complications post op

A

Pneumonia, atelectasis

108
Q

Potential cardiovascular complications post op

A

Shock, DVT, pulmonary embolism

Preop (1 decks)

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