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39 Cards in this Set
- Front
- Back
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Surgery is the best treatment when |
repairing, removing, or replacing body tissues or organs. Invasive process |
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perioperative |
time span that includes preperation for, the process of , and recovery from surgury |
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Perioperative time span includes 3 phases |
-preoperative -intraoperative -postoperative |
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Optional/Elective surgery |
the condition is not life threatening. The client may choose to have it or not. -plastic surgery -tubal ligation -vastectomy |
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required / non-elective surgery |
the surgery is necessary at some time. The client has some choice as to when the procedure will be done. -hernia repair -prolapsed uterus -hip joint replacement |
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urgent/non-elective surgery |
The surgery must be performed within a short time, to prevent further damage to the client. -malignancy -removal of inflamed appendix |
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Emergency surgery |
The surgery must be performed immediately to save the client's life. -ectopic pregnancy -severe internal hemorrhage -ruptured appendix -angioplasty after a heart attack |
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Nursing interventions that are common for the post operative patient (3) |
-providing emotional support to client and family -preparing client physically for surgery -ensuring that all legal matters , such as signing the surgical consent are carried out -ensuring exam and tests are carried out -family caregiving/teaching -providing routine preoperative and post care |
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minimal sedation client can |
respond to commands |
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moderate sedation client can |
-depressed LOC -client can breathe without assistance -respond to pain -follow some commands
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deep sedation client |
-cannot be easily aroused -can respond after repeated stimulation -may need to be supported |
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In Conscious sedation |
-IV sedative medications are used alone or in conjuction with local anesthetics -depressed LOC -can breathe and is able to respond to verbal stimuli |
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Midazolam (HLC) is frequently used for |
conscious sedation for procedures like endoscopy |
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anesthesia |
-partial loss of sensation
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General anesthetics |
-block all body sensations and cause unconsciousness, relaxation, and loss of reflexes |
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These anesthetics disrupt sensation to specific body areas or parts, without causing unconsciousness |
-local anesthesia -regional anesthesia -conduction blocks -spinal anesthetics |
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analgesia |
absence of pain |
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general anesthetics are administered by these routes |
-IV -Rectally -Inhalation sometimes -IM -GI tract |
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local anesthetic is usually administred |
topically by injection sometimes freezing with ethyl chloride |
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Lidocaine (Xylocaine) procaine (Novocaine) tetracaine (Pontocaine) are examples of |
drugs used as local anethetics |
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Common procedures done under local anesthesia are |
-dental work -many types of plastic surgery -skin suturing -some types of eye surgery -most brain surgery |
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lower extremeties, perineum, and lower abdomen will use this kind of anesthesia |
spinal anesthesia |
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General anesthesia is most often given by |
inhalation |
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general anesthesia |
-unconsciousness induced -cannot be aroused, breathing artificial -sometimes cardiovascular function is impaired
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local anesthesia |
-pain and sensation blocked in a limited area -via injection or topical -used usually for dental or for sutures for wound |
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Regional anesthesia |
-type of local anesthesia, pain blocked in region -induced by interuption of sensory nerve conductivity
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Conduction block anesthesia |
-Field block encircles operative area with injection -Nerve block injection near nerve supply -commonly used for obstetrics or for back pain |
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spinal anesthesia |
-extensive conduction nerve block -injection into subarachnoid space of spinal cord -must be done by an anesthesiologist rather than anesthetist |
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With slow acting anesthesia client passes thru _________ goal is to ________ |
smooth progression in and out of stage 1-3 and to provide anesthesia without going to stage 4 |
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Stage 1 Gen Anesthesia |
-beginning anesthesia -reflexes present -heart rate normal -slower respiration rate and depth -normal blood pressure -some dilation of eyes and reaction to light
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Stage 2 Gen Anesthesia |
-Dreams and excitement -active reflexes -increased heart rate -irregular breathing -increased blood pressure -pupils widely dilated and divergent |
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Stage 3 Gen Anesthesia |
-surgical anesthesia -progressive loss of reflexes -decreased heart rate -apneic -normal to decreased BP -constricted to slightly dilated centrally fixed pupils
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Stage 4 Gen Anesthesia |
-toxic or extreme medullary depression -no reflexes -weak and thready pulse -respirations flaccid -decreased BP -widely dilated pupils -prompt intervention to prevent irreversible coma and death |
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In most cases a client will be asked to stop taking _______ 14 days before surgery to prevent excessive bleeding |
aspirin and anti-coagulants (blood thinners) maybe some herbal supplements |
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Preoperative checklist |
-before patient going to surgery or ECT -make sure all items are checked off before client is transported to surgical suite |
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Nursing Alert for permit for operating |
-the client must sign it before receiving medications -obtaining client permission for operating is responsiblity of surgeon -nurse must double-check to make sure it is done |
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If surgery must be cancelled because of error such as innapropriate signing of operative permit or absence of name bands this is considered a __________ |
a sentinel event and must be reported and investigated |
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Nurse must interview preoperative client to make sure_____ |
All steps in the preoperative preparation have been completed |
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Nursing Alert for discharge/transportation for postoperative |
-All post up must provide name of driver for post op -
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