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Adult 1 Unit 2 > unit 2 > Flashcards

unit 2 Flashcards

1
Q

assess pt duting conscious sedation

A

monitor airway, LOC, O2 sat, capnography, ECG, and vital signs q 15min

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2
Q

malignant hypothermia

A
  1. stop all inhalation anesthetic
  2. intubate
  3. vent at 100% at highest rate
  4. give dantolene
  5. terminate surgery is possible
  6. check ABGs and treat
  7. cool pt/ monitor temp
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3
Q

RN interventions during general anestheia

A

stage 1- close OR door, dim lights, control OR traffic, position pt, keep voices low
stage 2- avoid auditory and physical stimulus, protect extremities, assist w suctioning, stay w pt
stage 3- assist w intubation, place in operative position, prep skin
stage 4- prepare/assist w cardiopulmonary arrest, document occurance

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4
Q

7 meds for conscious sedation

A 
etomidate-amidate
diazepam-valium
midazolam-versed
fentanyl-sublimaze
alfentanil-alfenta
propofol-diprivan
morphine
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5
Q

insufflation

A

the practice of injecting gas or air into a cavity before surgery

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6
Q

DVT assessment

A

obese, over 40, cancer, decreased mobility, Hx of VTE, DVT, varicose veins, edema, oral contraceptives, smoke, decreased cardiac output, hip or knee surgery
-sudden swelling in 1 leg, dull ache in calf that worsens w mobility

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7
Q

application of pneumatic pressure device

A

measure legs for proper size, place boots on legs and check compression pressure (35-55), apply preop

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8
Q

deep breathing

A

gentle in and out, hold for 5

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9
Q

post coughing

A

every 1-2 hrs post surgery, expel secrestion, keep lungs clear,allow full aeration, prevent pneumonia and atelactesis

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10
Q

day of surgery meds

A

sedatives, hypnotics, anxiolytics, opoid analgesics, anticholinergic, antibiotic w/n 60 min of surgery

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11
Q

informed consent w nonenglish speaker

A

requires qualified translator and witness

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12
Q

lab assessment preop

A

urinalysis, CBC or HH, clotting studies, electrolytes, BUN and Cr, pregnancy

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13
Q

hypokalemia

A

increased risk for digoxin toxicity, slows recovery from anesthia, increased cardiac irritability

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14
Q

hyperkalemia

A

increased risk for dysrhythmias w anestheia

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15
Q

assessment priorities post op

A

phase 1- airway, vitals, indicators of recovery every 15 min
phase 2- presurgery LOC returned, O2 sat at baseline, vitals stable
phase 3- vitals stable, surgical site bleeding

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16
Q

post op hand off report

A

type and extent of proceedure, anestheia details, allergies, health problems, vitals, fluids, blood loss, complications, communication issues, special requests, resp function, location/type incisions/dressings/drains, I&O

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17
Q

time out

A

verify correct pt, proceedure, position

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18
Q

RN informed consent

A

provide detailed info about proceedure, clarify facts and myths, verify signitures, serve as witness

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19
Q

age related changes to consider pre op

A

chronic illness, malnutrition, more allergies, increased impaired self care, inadequate support system, decrease ability to handle stress of surgery/anestheia, increased risk for cardiac, change in mental status, increased fall risk

20
Q

10 SCIP measures

A
  1. antibiotic wn 60 min
  2. proper antibiotic selection
  3. antibiotic d/c wn 24 hrs post op
  4. cardiac pts w controlled 0600 post op blood glucose
  5. hair removal
  6. urinary cath removal 1-2 days post op
  7. temp management
  8. beta-blockers
  9. VTE prophylactics ordered
  10. VTE pro recieved 24 hrs pre and post surgery
21
Q

diagnostic surgery

A

determine origin and cause of disorder

22
Q

curative surgery

A

resolve health problem by repair or removal of cause

23
Q

restorative surgery

A

improve functionable ability

24
Q

palliative surgery

A

relieve symptoms of dx processbut not cure

25
Q

elective surgery

A

correction of nonacute problem

26
Q

urgent surgery

A

requires prompt intervention, life threatening in 24-48 hrs

27
Q

emergent surgery

A

immediate intervention due to life threatening consequences

28
Q

subcutaneous infusion indications

A
  1. pain and insulin drug infusions
  2. palliative care can’t take oral meds, IM to painful, or vascular access not available
  3. hypodermoclysis- short-term fluid replacement
29
Q

assess post intraosseous device placement

A

no longer than 24 hrs, check for fluid accumulation, any signs of decreased circulation in limb

30
Q

3 potential systemic complications of IV therapy

A
  1. circulatory overload
  2. speed shock
  3. catheter embolism
31
Q

assessing peripheral IV site

A

begin w insertion site and work up, swelling, redness, hardness, drainage, lightly palpate, integrity of dressing, tubing

32
Q

choosing correct IV site

A

superfiscial veins of forearm (bascilic, cephalic, and median), no hands on older pts, avoid arm w mastectomies, stroke, fistulas

33
Q

IV fluid orders

A

type, rate, specific dose to be added to solution

34
Q

IV drug orders

A

name, dose, route, frequency, time of administration, length of infusion time, purpose

35
Q

cholinergic agonists side effects

A

stimulate bladder and GI tone, constrict pupils, increase neuromuscular transmission, decrease HR and BP, increase saliva, GI, and bronchial glandular secretions

36
Q

antichoinergic effects

A

decrease GI motility, saliva, bladder contraction, rigidity and tremmors, dilation of pupils, increase pulse

37
Q

evisceration

A

get help, cover w warm sterile solution dressing, keep dressings moist, assess for shock, supine w knees bent and head raised 15-20 degrees, vitals, emergent surgery

38
Q

dehiscence

A

apply sterile dressing, avoid cough, alert surgeon

39
Q

assess post op wounds

A

dr first dressing change, tissue integrity, type and amt of drainage

40
Q

assess pt w spinal or epidural

A

cardiac depression, restlessness, excitement, incoherent speech, headache, blurred vision, metalic taste, nausea, tremors, seizures, incresed pulse, RR, BP

41
Q

discharge from PACU

A

9-10 rating on recovery scale, stable vitals, no overt bleeding, return gag/swallow, can take liquids, urine output

42
Q

post op ed for home discharge

A

prevention of infection, care and assessment of surgical site, mgt of drains and catheters, nutrition, pain and drug mgt, progressive increase in activity

43
Q

pH and osmolarity w IV site

A

central line needed w pH 5-9 and osmolarity more than 600

44
Q

IV infiltration

A

stop infusion and remove catheter, apply sterile dressing, elevate extremity, warm/cold compress, insert new line in opposite extremity, rate infiltration and document

45
Q

central line bundle to reduce infection

A

use checklist, hand hygiene, maximal barrier precautions, sterile technique, min traffic in room, chlorhexide for skin disinfection, use preferred sites, post-placement care, remove ASAP

46
Q

nonpharmacological pain mgt

A

positioning, massage, relaxation techniques, diversion, ice

47
Q

actions post PICC placement

A

meticulous dressing changes, hang bags w sterile technique, vigorous scrub of catherter hub, chest xray

Adult 1 Unit 2 (20 decks)

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