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Perioperative Nursing > Wk 2 > Flashcards

Wk 2 Flashcards

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1
Q

What is anaesthesia

A

Implies a pt is unconscious and all sensation is lost

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2
Q

Types of anaesthesia

A

General: reversible, unconscious state, affects CNS, characterised by amnesia (sleep), analgesia (freedom form pain),depression of reflexes, muscle relaxation
Regional: loss of sensation to specific area or region of the body I.e. Spinal, epidural
Local: administered to one part of the body by local infiltration, purposely blocks nerve fibre in and around operative site

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3
Q

Premedication to surgery

A 
Sedative
Narcotics
Anticholinergics
Anti emetics 
To decrease anxiety,bronchial secretions 
Analgesia
Amnesia
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4
Q

Describe action of sedative and give example

A

Sedate
Amnesia
Calm/hypnotic state
E.g. Benzodiazepines which include Valium and midazolam (amnesia, decrease anxiety and fear), barbiturates (sleeping pills, prolonged sedative state, assists with sleep)

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5
Q

Describe action of narcotics and give example

A

Raise pain threshold
Lower metabolic rate
Decrease amount of anaesthetic required
E.g. Morphine (useful for pt already in pain, prolonged action), fentanyl (short acting, IV admin immediately before induction)

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6
Q

Action of Anticholinergics and example

A

Interfere with stimulation of vagus nerve
Increase HR
Decrease oral and respiratory secretions
Prevent vagal mediated hypotension, cardiac arrhythmia and bradycardia
E.g. Atropine sulfate, gycopyrrolate

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7
Q

What is the action of Antiemetic and examples

A

Minimise nausea and vomiting

E.g. Phenergan, droperidol, ondansetron

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8
Q

Process of general anaesthesia

A

Arrive in OR
Pt identified/consent/lab test reviewed
Monitoring connected
Iv access
Pt preoxygenated with 100% O2 for 3-5mins
Opioids and benzodiazepines administered
1. Induction: administer anaesthesia agents until pt is ready for positioning or surgical prepping
2. Maintenance: from this point until near completion
3. Emergence: pt begins to emerge and pt is ready to leave OR
4. Recovery

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9
Q

Inhalation agents of anaesthesia

A

Nitrous oxide: poor relaxation, minimal nausea and vomiting, increased vol in air pockets
Halothane: non-irritant, little muscle relaxation, potentially toxic to liver, raises ICP
Enflurane: some muscle relaxation, cardiac stability, don’t take if renal disease
Isoflurane: low organ toxicity, expensive, potent muscle relaxation
Thiopentone: short acting, depresses myocardium
Propofol: short half life, hypotension, irritation at injection site

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10
Q

Types of muscle relaxants

A

Depolarising: (suxamethanonium) last 5mins, acts in seconds

No depolarising: (vecuronium) acts over 2-3mins, lasts 30-60mins

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11
Q

What is used in intubation

A

LMA: laryngeal mask airway, inserted without muscle relaxant, posited over larynx and inflated

ETT: endoctracheal tube, women size 8, males 8.5, 7.5mm, ventilation and aspiration, position head (neck flexed, sniffing air, head in straight line)

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12
Q

Laryngoscopes

A

Used to intubate
Consists of a blade (size 1-4), with fibre optic light and handle
Blade is curved
Children blade is straight

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13
Q

Pre-op checklist

A
  1. Pre-op nurse verifies info: consent, correct pt, correct procedure, correct side, side marked by pt, correct time
  2. Pt states name DOB, procedure
  3. Mandatory examination results
  4. Allergies
  5. Patient property/personal effects
  6. Periop fasting
  7. Meds to be administered
  8. Bowel prep completed
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14
Q

Rapid sequence induction

A 
Fats intubation in emergency 
Obese pt
Cricoid pressure to prevent aspiration 
Digital pressure applied to cartilage 
Prevents regurgitation and aspiration (close oesophagus behind it)
Released when ETT cuff is inflated
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15
Q

Aspiration

A

Decreased throat reflex
Acidic gastric contents enter lungs
Impede lung function and gas exchange

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16
Q

Aim to maintain pt’s state during analgesia

A 
Oxygenate 
Unconsciousness
Analgesia
Muscle relaxation
Control autonomic reflexes
17
Q

The anaesthetic machine

A

Delivers o2 and anaesthetic gas mix
Mechanical ventilator
Source of gas
Reservoir bag
Monitors: ECG, BP, inspired o2, end tidal o2
Alarms: apnoea, breathing circuit disconnected
Daily checking procedure

18
Q

What occurs during emergence

A

Recovery of pharyngeal and laryngeal reflexes
Extubation delayed until spontaneous respiration confirmed
Auctioning and oxygenation
Warm blankets

19
Q

Asepsis

A

Without infection

Absence of micro-organisms that cause infection

20
Q

Aseptic technique

A

Microbial contamination is prevented in the environment
Reduce exposure to potentially infectious blood and tissue
Every effort is to minimise and control the microorganism
Handwashing/surgical scrub
Maintain sterile field
Safe operative technique
Barriers
Client prep

21
Q

Principles of asepsis

A

People must wear sterile gown and gloves and only touch sterile items
Unsterile personnel must touch unsterile items
Sterile drapes must be used
Items in sterile field must be sterile
Anything below waists or table level is unsterile
Items to be opened, dispensed and transferred in a sterile way
Must be monitored and never left unattended
Move around the sterile field carefully
Don’t lean across or walk between sterile fields

22
Q

Creating a sterile field

A

Placing sterile towels/drapes around procedure site and stand that will hold sterile instruments
Pt is centre of field
Skin prep clean to dirty
Reusable/disposable drapes

23
Q

Principles of applying drapes

A 
Time and space 
Handle as little as possible
Carry folded drape to operation site
Hold above waist level
No flip, fan or shake
Don't reach across the unsterile area
Non perforating towel clips
24
Q

What is strike through

A

Liquids soak through a barrier from sterile to unsterile area and vice versa

Passage of organisms through the barrier

Sometimes dry and not noticeable so look for stains

25
Q

Steps to maintain a safe environment

A

Limit number of people in and out
Limit talking
Close door and curtains
Enclose areas to minimise dust and insects
Air condition room
Clean and disinfect surfaces between pt’s

26
Q

Surgical conscience

A

Inner morality system and professional honesty which allows no compromise in practice

Perioperative Nursing (7 decks)

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