week 3: surgery

Question 1

what are the five main catastrophes that could happen in the OR

Answer 1

hemmorhage, stroke, MI, hypoxia, arrhythmia

Question 2

what is an ambulatory surgery

Answer 2

same day admission surgery

Question 3

how long should a patient be NPO before surgery

Answer 3

around 8 hours

Question 4

what do we do if a patient has low BP:

Answer 4

give IV fluid bolus

Question 5

what do we do if a patient has high BP

Answer 5

check to see if theyre in pain or if theyre due for any antihypertensives

Question 6

which patients are more at risk for respiratory insufficiency after surgery

Answer 6

ppl who are obese, older, hx of smoking, or just had surgery for airway or thorax

Question 7

how could liver result in delayed awakening after surgery

Answer 7

liver cirrhosis could increase the time it takes for the body to clear out the analgesia

Question 8

how do we assess vitals post op

Answer 8

rule of 4

Question 9

when do we start DB + C with patients

Answer 9

as soon as theyre awake

Question 10

how would we help with an airways obstruction

Answer 10

artificial airway, suctioning, recovery position

Question 11

what is atelectasis

Answer 11

partial collapse of lung

Question 12

what device helps with atelectasis

Answer 12

incentive spirometry

Question 13

what is splinting

Answer 13

helps with breathing, hold the side of the stomach so that coughing is less painful

Question 14

what is SCD

Answer 14

its a compression stocking that air circulates through and helps with venous return

Question 15

what is wound dehiscence

Answer 15

wound edges are separated at suture line, can occur 10 days post opw

Question 16

what is wound evisceratioin

Answer 16

protrusion of internal organs through incision (occurs 5-10 days post op)

Question 17

what is would dehiscence and evisceration common risk factors

Answer 17

obese clients, clients with recent abd surgery, those with poor wound healing ability

Question 18

is restlessness a bad sign

Answer 18

yes

Question 19

whats the difference between general anaesthetic and procedural sedation

Answer 19

general: knocks you out
procedural: used for colonoscopy, conscious sedation (ex. midazolam)

Question 20

what is the anaesthesia med

Answer 20

propofol

Question 21

where would one insert a spinal epidural

Answer 21

below L2

Question 22

what does a spinal epidural do

Answer 22

it mixes with CSF, complete autonomic, sensory, and motor blockade

Question 23

what is an epidural

Answer 23

blocks sensory fibres (you can still walk and move I think)

Question 24

what are post op monitoring parameters for spinal/epidural anesthrsa

Answer 24

hypotension, pruritis, urinary retention, N/V, infection, epidural hematoma, spinal headache

Question 25

which drugs are mixed to create conscious sedation

Answer 25

fentanyl and midazolam

Question 26

what is “golden time”

Answer 26

if a problem happens it will show up 2 hours after surgery

Question 27

what is malignant hyperthermia

Answer 27

basically a random adverse reaction to anaesthesia, basically skeletal muscles go rigid.

Question 28

how do you treat malignant hyperthermia

Answer 28

administer dantrolene sodium (a muscle relaxant)
try and decrease body temperature

Question 29

what is urticaria

Answer 29

basically little hives that’s an adverse reaction to something (like Dante with penicillin)

Question 30

what is the first line treatment for anapylactic shock

Answer 30

epinephrine

Question 31

what are the 3 other meds that may help with anaphylaxis

Answer 31

corticosteroids, Benadryl, bronchodilators

Question 32

what are early signs of hypovolemic shock

Answer 32

agitation, high HR, low BP, decrease in urine output

Question 33

what are late signs of hypovolemic shock (may not survive)

Answer 33

cold, clammy skin, Brady cardia, low BP, increased lactate, anuria, ischemic gut, DIC

Question 34

what are some fluid replacement options for anaphylactic shock

Answer 34

isotonic crystalloids, colloids, blood ,2 large bore IV needles.