Week 2: Perioperative and Tracheostomy Flashcards by Bailey Burke

Benzodiazepines

Midazolam, diazepam, lorazepam, barbituates
- reduce anxiety and used fore sedative and amnesic properties

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Anticholinergics

Atropine, glycopyrrolate
- used to reduce respiratory and oral secretions

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Antacids

sodium citrate
- increases gastric pH and decrease gastric volume

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When should oral preoperative medications be given

60-90 minutes

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When should IV preoperative medications be delivered

administered after arrival in the preoperative holding area or the OR

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When should subcutaneous preoperative medications be administered

30-60 minutes before arrival in OR

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What three areas are the suite divided into the suite

Unrestricted: provides all access to people in street clothes who can interact with those in scrub uniform
Semi Restricted: Peripheral support areas, authorized personnel can access
Restricted: OR’s or locations where sterile supplies are open

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Registered nurse role in preoperative

Usually first person to interact with patient and follows them throughout the journey advocating for them
Completes the surgical safety checklist

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Circulating nurse role in preoperative

Is NOT scrubbed, gloved, or gowned and remains in the unsterile field
Documents nursing and medical activities throughout the perioperative period
Names all personnel involved, event times, additional interventions, surgical procedures performed, patient positioning, monitoring devices, equipment used, information on implants, blood loss, any unwanted events etc.
Most commonly helps the anesthesiologist

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Practical Nurse perioperative role

Performs the surgical hand asepsis, gowned and gloved in sterile attire and remains in sterile field assisting the surgical team by preparing and handling instruments
Sets priorities, ensuring aseptic setup, performs surgical count concurrently, acts as patients advocate

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Surgeon and Assistant roles in perioperative

Surgeon responsible for preoperative medical history and physical assessment, informed consent, patient safety, postoperative patient management
Assistant holds retractors (usually a physician, can be a med student)

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Registered Nurse First Assistant role in perioperative care

RNFA facilitates and supports the health care needs of the patient through the perioperative continuum
Handle instruments, provide exposure, assist with maintaining homeostasis, and suture under supervision of the surgeon

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Anesthesiologist role

Physician who is responsible for the administration of anesthetic agents
Protecting vital functions, managing pulmonary and cardiac complications, caring for critically ill
Inserts a laryngeal mask airway (LMA) when patient loses consciousness

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Registered Nurse Anesthesia Assistant role

RN with advanced education, knowledge, and skills in anesthesia who work in collaboration with supervision of an anesthesiologist through the perioperative period

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-ectomy

excision/removal

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-oscopy

looking into

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-ostomy

creation of opening into

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-otomy

cutting into/incision

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-plasty

repair/reconstruction

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Appendectomy

surgical removal of the appendix

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Gastroscopy

examining of upper digestive tract

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Colostomy

surgery to create an opening called a stoma

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Mammoplasty

Breast reduction surgery

Discetomy

surgery to remove damaged part of a disk in the spine

Knee arthroscopy

surgery that uses a tiny camera to look inside the knee

Arthrotomy

surgically opening a joint

Total hip arthroplasty

removing the damaged femoral head and cartilage

Nephrectomy

the surgical removal of a kidney

Cystoscopy

procedure to look inside the bladder using a camera

ureterostomy

creates a new path for urine to leave the outside of the body (through bag on stoma)

cystotomy

surgery performed to enter the bladder

Ureteroplasty

fixing of scar tissue in the urine channel from the bladder out the penis

causes of deviated septum

trauma, childhood growth, congenital abnormalities

Deviated Septum

misalignment of normally straight nasal septum

Unilateral nasal fracture

produces little or no displacement

Bilateral nasal fractures

most common, give nose a flattened look

Complex nasal fractures

may also shatter frontal bones

Clear pink tinged fluid leaking from the nose

CSF leak

Rhinoplasty

surgery performed on the nose to remodel or reconstruct the external nose

Septoplasty

rhinoplasty in addition to reconstruction and remodelling of the nasal septum

Epistaxis

Nosebleed

Allergic rhinitis

inflammation of the nasal mucosa due to a specific allergen

Sinusitis

when inflammation or swelling of mucosa blocks the openings in the sinuses, the secretions accumulate behind the obstruction

Nasal polyps

benign mucus membrane masses that form slowly in response to repeated inflammation of the sinus or nasal mucosa

When are oral preoperative medications administered

60-90 minutes before

When are IV preoperative medications administered

After arrival in preoperative holding area or the OR

when are subcutaneous preoperative medications administered

30-60 minutes before OR arrival

What is a dispersive electrode

a flexible gel pad that is put near the operative site and attached to the ESU (what the surgeon uses to cauterize)

Nursing assessment if there are postoperative alterations in respiratory alterations

1. evaluate the airway patency, chest symmetry, depth, rate, and character of respirations 2. assess for any use of abdominal/accessory muscles 3. Auscultate breath sounds (anterior, posterior, lateral) 4. Monitor VS 5. Note any sputum or mucus

Nursing assessment if there are postoperative alterations in cardiovascular function

1. Monitor Q15 mins until stabilization 2. Assess skin color, temperature, moisture, BP, HR, pulse, circulation, drains and dressings

What cardiac abnormality signs call for the nurse to notify the physcian

a. Systolic BP <90 or > 160 b. Pulse <60 or >120 c. Pulse pressure narrows d. BP gradually decreases during several consecutive readings e. irregular cardiac rhythm develops f. significant variation from preoperative

Nursing assessment if there is postoperative alterations in neurological function

1. Assess LOC, orientation and ability to follow commands 2. Size, reactivity and equality of pupils 3. Sensory and motor status

Functions of the upper airway

heating/cooling inspired gas to body temperature filtering humidification smell phonation passage for ventilation

lower airway functions

conducting airway for ventilation gas exchange

is the insertion of endotracheal and naso-endotracheal tubes in the scope of an RN?

not in the RN scope to insert

Nasal Fracture

likely caused from trauma