Intraoperative chapter review
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| What is the intraoperative period? | show 🗑
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| What are the main concerns during the intraop period? | show 🗑
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| What are some of the “at risks” in the OR? | show 🗑
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| show | b/c the patients physical needs, spiritual needs, comfort, safety, dignity, and psychological status depends on the periop nurse
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| Surgeon | show 🗑
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| Surgical assistant | show 🗑
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| show | This is a physician who specializes in giving anesthesic agents
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| CRNA | show 🗑
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| show | Level of anesthesia, cardiopulm functions, vital signs, and I&O
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| show | This person used clinical decision-making skills, deveolpe a plan of nursing care, and coordinates care delivery to patient and their families
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| show | They coordinate and manages the care while the patient is in this area. Greeting the pt, reviewing records, and preop checklist, verify consent signed, and document risk assessment
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| show | coordinate, oversee, and are involved in the pt care in the OR, coordinate activities for the OR- all supplies, blood, diagnostic supports are available and inspected. Helps maintain count of scrubs, instruments, sharps, amt of irrigated fluids and drugs
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| Throughout surgery, the circ nurse has what responsibilities? | show 🗑
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| Scrub nurse/operating rooms tech, surgical tech, certifies surg tech (CST) | show 🗑
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| show | Particular type of surg (ortho, cardiac, ophthalmologic). They are responsible for care specific to patients needing that type of surg. Maintains, recommends equip, instruments, and supplies.
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| show | Specially trained in the use, care and maintenance of the laser
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| What does laser mean? | show 🗑
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| show | Scrub and circulating nurse
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| What are the 3 zones of the OR? | show 🗑
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| Define- minimally invasive surgery (MIS) | show 🗑
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| show | Cholecystectomy, cardiac surgery, splenectomy and spinal surg
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| Define- endoscope | show 🗑
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| What are the different endoscopes and the uses? | show 🗑
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| show | organ removal, reconstructions, blood vessel grafting, cutting, suturing, stapling, cautery, laser surg and injecting gases
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| show | insufflation
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| show | injecting gas or air into the cavity before the surgeru to separate organs and improve visualization
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| show | this is endoscope technology. The surgeon inderts the instrument and positions the articulatinf arms and then breaks scrub and performs surg while sitting at the console. A 3D view is on screen of anatomy.
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| A periop nused specialist | show 🗑
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| show | cost of special equip, or OR setting
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| Define- nosocomial infections | show 🗑
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| List what does the surgical scrub consists of? | show 🗑
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| show | “negative sensation,” is an induced state of partial or total loss of sensation, occurring with or without LOC
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| show | to block nerve impulse transmission, suppress reflexes, promote muscle relazation, and in some cases, achieve a controlled LOunC
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| What are some factors in the selection and dose of anesthesia? | show 🗑
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| What are the 6 rankings for the physical status of a patient according to the ASA? Why is it used? | show 🗑
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| Define- general anesthesia | show 🗑
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| How is general anesthesia achieved? | show 🗑
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| When is general anesthesia most given? | show 🗑
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| show | pain relief or pain suppression
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| show | memory loss of the surgery
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| Define- emergence | show 🗑
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| What does emergence depend on? | show 🗑
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| show | retching, vomiting, and restlessness. In recovery shivering, rigidity and light cyanosis- due to the temporary changes in the body;s temp control
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| show | Stage1-analgesia and sedation, relaxation; stage2- excitement, delirium; stage3-operative anesthesia, surgical anesthesia; stage4 danger
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| show | Begins with induction and ends with loss of consciousness, Pt feels drowsy and dizzy, reduced sensation to pain, and is amnesic. Hearing is exaggerated.
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| What happens in stage 2 of general anesthesia? | show 🗑
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| show | Begins with muscle relaxation and ends with loss of reflexes and depression of vital functions, jaw is relaxed, and breathing is quiet/regular, cannot hear, sensations are lost.
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| show | Begins with depression of vital functions and ends with respiratory failure, cardiac arrest, and possible death. Respiratory muscles are paralyzed; apnea occurs, pupils are fixed/dilated.
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| What are the ADV of General inhalants anesthetics? | show 🗑
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| show | DIS: Must be combination with other agents for painful/prolonged procedures, limited muscle relaxant effects, Postoperative nausea and shivering common, Explosive
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| What are the ADV of General Intravenous anesthetics? | show 🗑
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| What are the DISADV of General Intravenous anesthetics? | show 🗑
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| What are the ADV of General Balanced anesthetics? | show 🗑
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| show | DIS: Drug interactions can occur, Pharmacologic effects on the body may be unpredictable
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| What are the ADV of Regional or Local anesthetics? | show 🗑
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| show | DIS: Difficult to admin to an uncoop/upset pt, No way to control agent after admin, Absorbs rapidly into blood and causes cardiac depression or OD, Increased Nerv sys stimulation (OD), Not good for extensive surg b/c of the amt need to maintain anesthesia
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| show | ADV: Reflexes remain intact, Decreases chance of adverse reactions, Decreased intraoperative stress; DIS: No way to control depth of anesthesia, Not used in long or extensive procedures, May not be appropriate for an anxious patient
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| What are the ADV/DISADV of hypnosis/hypnoanesthesia? | show 🗑
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| show | MEDICAL SURGICAL- INTRAOPERATIVE CHAPTER
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| show | this is an acute, life-threatening complication to certain drugs used for general anesthesia. This can occur immediately after onset, or several hrs into surgery.
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| show | the rxn brgins with skeletal muscle exposure to the specific agents, causing increased Ca levels in the muscle clls and increased muscle metaboloism
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| What are the manifestations of malignant hyperthermia | show 🗑
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| show | this is the presence of protein in the urine
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| What drug is used for malignant hyperthermia? | show 🗑
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| What is the mechanism and the effects of unrecognized hypoventilation? | show 🗑
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| What are the reasons for intubation complications? | show 🗑
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| What are the intubation complications? | show 🗑
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| Define- local | show 🗑
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| Define- regional anesthesia? | show 🗑
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| When is regional anesthesia preferred? | show 🗑
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| How does general anesthesia work? | show 🗑
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| How is local and regional anesthesia achieved? | show 🗑
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| show | digital blocks, nerve block, spinal or epithelial.
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| Define- digital block, when is it used? | show 🗑
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| Define- nerve block, when is it used? | show 🗑
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| show | Injection of an anesthetic agent into the cerebrospinal fluid in the subarachnoid space. used for lower abdominal, pelvic, hip, and knee surgery
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| Define- epidural anesthesia, when is it used? | show 🗑
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| Medications for Inhalation anesthetics | show 🗑
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| show | Etomidate (Amidate),Ketamine (Ketalar), Midazolam (Versed), Propofol (Diprivan), Methohexital sodium (Brevital), Thiopental sodium (Pentothal)
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| Medications for neuromuscular blocker anesthetics | show 🗑
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| show | Alfentanil (Alfenta), Fentanyl (Sublimaze), Remifentanil (Ultiva), Sufentanil (Sufenta)
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| show | All but Midazolam (Versed), Methohexital sodium (Brevital), Pancuronium (Pavulon), Fentanyl (Sublimaze), Remifentanil (Ultiva)
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| show | Etomidate (Amidate)
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| show | Methohexital sodium (Brevital)
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| show | Desflurane (Suprane), Enflurane (Ethrane), Halothane (Fluothane), Isoflurane
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| show | this is the IV delivery of sedative, hypnotic, and opioid drugs to reduce the LOC but allow the patient to maintain a patent airway and to respond to verbal commands
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| What procedures use conscious sedation? | show 🗑
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| What medications are used in conscious sedation? | show 🗑
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| What are the nurse’s roles in the delivery of regional anesthesia? | show 🗑
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| show | a credentialed nurse( advanced IV drug delivery training, airway management, advanced cardiac life support) under the supervision of a physician and within the state-defined scope of nursing
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| What should the nurse monitor when conscious sedatives are given? | show 🗑
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| What is the actions for advanced directives, DNR orders during surgery? | show 🗑
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| show | these are digested over time by body enzymes
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| Define- Nonabsorbable sutures | show 🗑
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| When are retention (stay)sutures used? | show 🗑
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| show | Is safely anesthetized without complications?
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