week 3: surgery Flashcards
what are the five main catastrophes that could happen in the OR
hemmorhage, stroke, MI, hypoxia, arrhythmia
what is an ambulatory surgery
same day admission surgery
how long should a patient be NPO before surgery
around 8 hours
what do we do if a patient has low BP:
give IV fluid bolus
what do we do if a patient has high BP
check to see if theyre in pain or if theyre due for any antihypertensives
which patients are more at risk for respiratory insufficiency after surgery
ppl who are obese, older, hx of smoking, or just had surgery for airway or thorax
how could liver result in delayed awakening after surgery
liver cirrhosis could increase the time it takes for the body to clear out the analgesia
how do we assess vitals post op
rule of 4
when do we start DB + C with patients
as soon as theyre awake
how would we help with an airways obstruction
artificial airway, suctioning, recovery position
what is atelectasis
partial collapse of lung
what device helps with atelectasis
incentive spirometry
what is splinting
helps with breathing, hold the side of the stomach so that coughing is less painful
what is SCD
its a compression stocking that air circulates through and helps with venous return
what is wound dehiscence
wound edges are separated at suture line, can occur 10 days post opw
what is wound evisceratioin
protrusion of internal organs through incision (occurs 5-10 days post op)
what is would dehiscence and evisceration common risk factors
obese clients, clients with recent abd surgery, those with poor wound healing ability
is restlessness a bad sign
yes
whats the difference between general anaesthetic and procedural sedation
general: knocks you out
procedural: used for colonoscopy, conscious sedation (ex. midazolam)
what is the anaesthesia med
propofol
where would one insert a spinal epidural
below L2
what does a spinal epidural do
it mixes with CSF, complete autonomic, sensory, and motor blockade
what is an epidural
blocks sensory fibres (you can still walk and move I think)
what are post op monitoring parameters for spinal/epidural anesthrsa
hypotension, pruritis, urinary retention, N/V, infection, epidural hematoma, spinal headache
which drugs are mixed to create conscious sedation
fentanyl and midazolam
what is “golden time”
if a problem happens it will show up 2 hours after surgery
what is malignant hyperthermia
basically a random adverse reaction to anaesthesia, basically skeletal muscles go rigid.
how do you treat malignant hyperthermia
administer dantrolene sodium (a muscle relaxant)
try and decrease body temperature
what is urticaria
basically little hives that’s an adverse reaction to something (like Dante with penicillin)
what is the first line treatment for anapylactic shock
epinephrine
what are the 3 other meds that may help with anaphylaxis
corticosteroids, Benadryl, bronchodilators
what are early signs of hypovolemic shock
agitation, high HR, low BP, decrease in urine output
what are late signs of hypovolemic shock (may not survive)
cold, clammy skin, Brady cardia, low BP, increased lactate, anuria, ischemic gut, DIC
what are some fluid replacement options for anaphylactic shock
isotonic crystalloids, colloids, blood ,2 large bore IV needles.
