Surgery Flashcards

1
Q

when should abx be given and when stopped

A

1 hr before and after procedure unless IV abx which is 48hrs before and after

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2
Q

abx given for prophylaxis

A

vancomycin, levoquin IV 2 hrs prior

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3
Q

blood glucose rate should be under what value?

A

200 mg/dL

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4
Q

how does high bg put the pt at risk

A

increased infection
less likely to get renal failure and receive ventilation support

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5
Q

when should urinary catheters be removed by

A

within 48hours

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6
Q

how does hypothermia put pt at risk

A

below 36 (97F)
risk for infection, impairs healing, affects drug metabolism, adverse cardiac events

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7
Q

why is beta blockers given during pre-op

A

to regulate heart rate and decrease mortality

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8
Q

VTE prophylaxis and post sx
how long before and after
what is done

A

24 hrs before and after
compression hose or SCD
lovenox, coumadin given

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9
Q

what lab tests are done for pre-op

A

pregnancy test
glucose
electrolytes
CBC
BUN/creatinine/eGFR/urinalysis
Coags PT/PTT/INR
CXR/ECG

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10
Q

why is atropine sulfate given pre-op

A

to decrease resp secretions

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11
Q

what is the purpose of anticholinergics

A

blocks acetylcholine which prevents muscle spasms
relieve cramps or spasms of the stomach, intestines, and bladder

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12
Q

S/S of malignant hypothermia

A

tachycardia
muscle stiffness
unstable or increased BP
increased temp
hypercalcemia
met/resp acidosis
increased CK

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13
Q

treatment for malignant hyperthermia

A

dantrolene (dantrium)
sodium bicarbonate for met. acidosis
iced saline inj
d/c triggering agent
transfer to ICU 24hrs

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14
Q

when is orientation given when a pt arrives in PACU

A

first arrival as their hearing is returned first

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15
Q

D/C criteria for O2 saturation

A

90-92%

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16
Q

what is UOP

A

intraoperative urine output given to PACU

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17
Q

what is assessed first when arriving to PACU

A

ABCs
response to reversal of anesthesia
spinal block

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18
Q

RR range for PACU and what to do

A

12-30 max
give O2 cannula regardless of O2 saturation help to get rid of anesthesia gases

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19
Q

how often are VS done in PACU

A

q15mins for an hour

20
Q

when are narcotics given in PACU and range

A

48hrs of narcotics and then NSAIDS

21
Q

what meds are given for antiemetics

A

zofran, reglan

22
Q

what is the most common cause of hypoxia during anesthesia recovery

A

atelectasis

23
Q

Criteria for systemic inflammatory response syndrome

A

temp: <36 or >38 (97-100 good)
HR: >90
RR: >20 with PaCO2 <32mmHg
WBC: <4,000 or >12,000

24
Q

D/C criterias

A

No IV narcotics last 30mins
can ambulate
minimum N&V

25
who gives report to PACU nurse
anaesthesiologist verbal report
26
what is emergence delirium
pt can wake up agitated typically due to hypoxemia
27
what is considered hypoxemia
PaO2 <60mmHg
28
position of unconscious vs conscious pts
on the lateral side - unconscious supine with head elevated - conscious
29
how often should DB&T and IS be used
DB 10 times/hour while awake. turn q1-2hrs IS used 10-15 times and cough, q2-3hrs while awake
30
cause of cardiovascular issues post-surg
sympathetic nerve stimulation from pain, anxiety, bladder distension, or resp compromise
31
when is anaesthesiologist or surgeon notified for BP & HR
systolic below 90 or above 160 HR less than 60 or above 120
32
residual vasodilating effects of anesthesia vs/ impending hypovolemic shock
OK - hypotension, normal pulse, warm and dry pink skin hypov shock - hypotension, tachycardia, cold & clammy skin
33
how often should pts flex and extend all joints
10-12 times every 1-2 hrs while awake
34
nursing assessment for neuro in PACU
PERRLA pupils sensory & motor status
35
what is used to check motor block as the effects of spinal anesthesia is resolving
ice packs
36
fever in PACU
mild elevation up to 38 first 48 hrs - stress response higher than 38 - respiratory congestion or atelectasis after 48hrs - infection
37
response to fever in PACU
CXR, wound culture, urine, blood
38
large intestine vs small intestine response post-op
large intestines slow for 3-5 days small intestine should return within 24hrs
39
hiccups cause
irritation of phrenic nerve which innervates diaphragm
40
why is NG tube used post-op
decompress stomach to prevent N&V, abdominal distension
41
how to prevent abdominal distension
frequent ambulation
42
what drug is used to encourage flatus, feces, and colonic peristalsis
bisacodyl (Dulcolax)
43
when should catherization be considered in PACU
after 8-12 hours of not voiding
44
expected drainage from wound
go from sanguineous to serosanguineous to serous (clear yellow)
45
sign of wound dehiscence
separation of wound edges with sudden discharge of brown, pink, or clear drainage
46