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26 Cards in this Set

  • Front
  • Back
Common fears of surgery
death
pain/discomfort
mutilation/alteration of body image
anesthesia
disruption of life patterns
Nursing assessments
interview with hx
informed consent
use of common language
allergies- allergies vs side effects
Echinacea
prolonged use may suppress immune system
Ephedra
interacts with anesthesia increased in BP and HR
Feverfew
increased risk of bleeding
Garlic
risk of bleeding, excessive response to anticoagulation
Ginger
increaseed risk of bleeding
Pre-op prep
Labs- electrolytes, glucose, EKG, coaulation studies, UA
Preop preparation- sensory, procedural, process
Informed consent
Dr. responisbility/ 14 and older can sign own consent.
Adequate disclosure
clear understanding and comprehension
give consent voluntarily
Bariatrics
equipment rated to 500lb's
be aware of needs and order right equipment.
Preparation of Patient
surgical gown-check about underwear
Nail polish
ID band/allergy band
Jewelry-rings taped
Contact/glasses, dentures, hearing aides
void prior to OR
Preop medication - oral vs IV/IM
Preop Medications
sedatives
anticholinergics-decrease secretions
narcotics-before during after
antiemetics-nausea
antiviotics-only when they need it
eye drops- Clacoma, anthesics will increase eye pressure
certain HTN - cardiac, insulin given dosages may be adjusted/ glucose may be given 1/2 dose.
Operative
in patient/outpatient
3 areas
1- unrestricted -holding area
2- semi-restricted- authorized personnel only /scrubs
3- restricted -sterile area/ OR rooms
Positioning Patient
-allow accessibility to surgical site
-administration and monitoring of anesthesia
-provide correct skeletal alignment-maintain airway
-prevent undue pressure on nerves,skin over bony prominences and eyes
Positioning
-provide adequate thoracic excursion- being able to breath, nothing on chest.
-prevent occlusion of arteries/veins- BP cuffs not too tight
-prevent modesty- this is a person, drape client.
-recognize,respect individual needs- skinny people may need a pad.
-NRS/DX Surgical positioning injury.
Types of anesthesia
-IV induction
-inhalation
-adjuncts-opiods-if started early don't need so much after surgery
-Benzo- midazolam (versed) - amnesia qualities, must be certified to use.
-Flumazenil (romazicon) antagonist for versed
-neuromuscular blocking agents
-antiemetics
Dissociative anesthesia
patient catatonic-Ketamine
still, but not unconscious
Local anesthesia
blocks initiation and transmission of electrical impulses along nerve fibers.
used for arm or foot, client still awake
Problems with anesthetic
Anaphylactic reactions
Malignant hyperthermia- after surgery or during, develop sudden temperature (105) seizure starts @ 105.
Malignant Hyperthermia
-inherited -ask if pt aor fmily has had
-symptoms-tachycardia, tachypnea,hypercarbia, ventricular arrhythmias
-Treatment Dantrolene decrease metabolism, support pt to correct hemodynamic instability, acidosis, hypoxemia, increased temp.
Types of anesthesia
-IV induction
-inhalation
-adjuncts-opiods-if started early don't need so much after surgery
-Benzo- midazolam (versed) - amnesia qualities, must be certified to use.
-Flumazenil (romazicon) antagonist for versed
-neuromuscular blocking agents
-antiemetics
Dissociative anesthesia
patient catatonic-Ketamine
still, but not unconscious
Local anesthesia
blocks initiation and transmission of electrical impulses along nerve fibers.
used for arm or foot, client still awake
Problems with anesthetic
Anaphylactic reactions
Malignant hyperthermia- after surgery or during, develop sudden temperature (105) seizure starts @ 105.
Malignant Hyperthermia
-inherited -ask if pt aor fmily has had
-symptoms-tachycardia, tachypnea,hypercarbia, ventricular arrhythmias
-Treatment Dantrolene decrease metabolism, support pt to correct hemodynamic instability, acidosis, hypoxemia, increased temp.
post-op assessment
ABC;s
oxygenation
Neuro status- are they awake and follow commands
Fluid status-IV's
Surgical site- don't take off dressing, look at dressing and under the pt, ck for blood and bleeding