1510 Intra-Operative
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| 1-4 points of Surgical Asepsis | show 🗑
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| show | Sterile to sterile, unsterile to unsterile;Movement around sterile field must be restricted to at least one (1) foot away;If sterile barrier is breached, consider contaminated; Prepare sterile field as close as possible to procedure
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| show | Medical asepsis is clean technique whereas surgical asepsis is sterile technique
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| show | Inhalation-Vapors are inhaledPatient is intubated, anesthesiologist administers with oxygenIntravenous-Barbiturates, benzodiazepines, hypnotics, analgesics, muscle relaxantsCan be used with inhalation anesthesia or alone
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| show | Stage 1- Beginning anesthesiaStage 2- ExcitementStage 3- Surgical anesthesiaStage 4- Medullary depression
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| Attributes of Stage 1 Anesthesia | show 🗑
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| Attributes of Stage 2 Anesthesia | show 🗑
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| Attributes of Stage 3 Anesthesia | show 🗑
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| show | CNS is to far depressed. Can be fatal
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| show | TopicalLocalEpiduralSpinalLocal Conduction Block (Nerve Block)
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| show | airway intervention not required; self ventilation; CV function usually maintained; purposeful response to repeated or painful verbaal or tactile stimuli; RN
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| show | Airway intervention may be required; self ventilation may be inadequate; CV function usually maintained; purposeful response after stimulation; CRNA
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| show | Benzodiazepine; sedative/hypnoticUsed to reduce anxiety and induce amnesia/sedation for procedure/testUsual dose IV: 1 mg initially, titrated to patient’s sedation required, total dosage > 4 mg rare; PO 5-10 mg
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| Versed AE | show 🗑
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| show | Opioid analgesicUsed as anesthesia adjunct or for sedationUsual dose IV: 25 mg given in increments
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| Demerol AE | show 🗑
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| Narcan (naloxone | show 🗑
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| show | Side Effects: hypertension, hypotension, tachycardia, N&VMonitor vital signs frequently (every 5-15 minutes) for 3-4 hours after administration
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| show | Universal Protocol (Time-Out) PRIORITY!Two patient identifiers;Question the patient to determine if he/she understands the procedure;Ensure that site is CLEARLY marked
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| show | Signed Informed Consent should be in prominent area of chart – MUST be witnessed by pre-op nurse;Consent should clearly state what procedure is to be done, what site, and what side;Is there an Advance Directive/Living Will/DNR on the chart; Allergies
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| Circulating Nurse Duties 3 | show 🗑
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| Circulating Nurse Duties 4 | show 🗑
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| Patient Safety Precautions | show 🗑
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| Post-op Nausea and Vomiting | show 🗑
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| show | Antiemetic; sedative/hypnoticUse: Prevention or tx of N/V, pre-op sedation, adjunct to anesthesia and analgesiaRoutes: PR, PO, IM, *IVDoes not mix with some meds Usual dose: 12.5 – 50 mg
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| Phenergan (promethazine hcl)AE | show 🗑
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| Vistaril (hydroxyzine pamoate) | show 🗑
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| Vistaril (hydroxyzine pamoate)AE | show 🗑
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| show | AntiemeticUse: Prevention/tx of N/VRoutes: PO, IM, usually IVUse no more than 8 mg/day in hepatic impairmentUsual dose: 4mg
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| Zofran (ondansetron)AE | show 🗑
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| Symptoms of Anaphylaxis | show 🗑
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| Ineffective Airway Clearance | show 🗑
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| show | Individual experiences an actual or potential loss of adequate ventilation related to an altered breathing pattern
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| show | Individual experiences a decrease in oxygenation at the capillary level
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| show | Individual experiences dehydration
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| Hypothermia | show 🗑
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| show | Risk for entry of secretions, solids, or fluids into the tracheobronchial passages
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| Risk for Imbalanced Body Temperature | show 🗑
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| Risk for Fluid Volume Imbalance | show 🗑
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| show | At risk for harm as a result of positioning requirement during surgery, unable to protect self due to anesthesia
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| Risk for Infection | show 🗑
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| Unintentional Hypothermia | show 🗑
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| Malignant Hyperthermia | show 🗑
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| show | Cause: thrombus formation in the microcirculationDepletion of select coagulation proteinsThese processes lead to hemorrhaging
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| Infection/Sepsis | show 🗑
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| show | Increased heart rateRapidly decreasing blood pressureDiaphoresisPatient’s temperature will be elevated, and will continue to rise
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| show | Brain damage from hypoxia occurs within minutesCapillary refill < 3 secs, nail beds pinkCheck peripheral pulses to check perfusion, esp. in vascular surgery
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| Causes of Anaphylaxis | show 🗑
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