365 CH Intra and Post OP
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| scrub nurse | sterile, prepare and manage field; help gown and glove, count
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| circulating nurse | unsterile, manage OR conditions, in charge of one room; coordinate personnel moving in and out; send specimens, chart updates
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| scrubbing, gowning and gloving | wet scrubbing with soap and water, waterless alcohol based agents
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| preparing the surgical site | shave surgical areas, scrub or cleanse around site with antimicrobial agent, drape site
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| safety risk of staff | blood and body fluids, latex and adhesive, radiation, lasers
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| safety risk of patient | infection, physical trauma, physiologic effects of surgery
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| SCIP guidelines | protect patient from harm during surgery
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| time out procedure | identify correct procedure, correct patient and consent
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| universal protocol | right person, site and procedure
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| moderate sedation | bedside procedures, RN administered; patient is awake
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| MAC (monitored anesthesia care) | decreased LOC, able to maintain airway
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| general anesthesia | patient is unconscious, IV or inhaled, at risk for aspiration; muscle relaxant
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| local anesthesia | applied locally, blocks nerve impulses to localized area, loss of sensation only; RN administered
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| local anesthesia types | topical, opthalmic, injected, inhaled
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| regional anesthesia | local anesthetic drug injected into a central nerve or group of nerves; administered by ACP
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| spinal regional anesthesia | loss of motor and sensory function, enters CSF
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| epidural regional anesthesia | patient is awake, does not enter CSF, blocks sensory pathways but motor fibers are intact; often used for post op pain management
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| peripheral block regional anesthesia | injected into peripheral nerve clusters
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| regional anesthesia adverse reaction | ANS blockade; bradycardia, hypotension, nausea/ vomiting
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| risks associated with aspirating vomitus | bronchial spasm, pneumonitis, pulmonary edema; silent regurgitation
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| hypothermia | body temp < 36.6; warm and monitor core temp
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| malignant hyperthermia | caused by exposed anesthetics; muscle rigidity leads to arrhythmias, acidosis, hypoxia and renal damage
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| malignant hyperthermia antidote | dantrolene
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| post anesthesia recovery unit | maintain stable vital signs, adequate pain control, no signs of respiratory compromise, or complications
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| incision assessment | manage the dressing; monitor any drainage, swelling, redness, warmth
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| potential post op complications | blood clot in lower extremity, delirium, fever
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| hypoxia | restlessness, agitation, delirium and confusion, increased RR, decreased O2
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| atelectasis | decreased breath sounds, crackles, cough
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| pneumonia | fever, increased RR, decreased O2, crackles
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| VTE | extremity swelling, pain and warmth
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| signs of PE | sudden SOB, increase RR and HR, chest pain, LOC change
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| hemorrhage | change in LOC, cold, moist, pale skin, decrease BP, increase HR
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| cardiovascular assessment | pulses, respirations, capillary refill
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| GI complications | post op nausea and vomiting, constipation, ileus
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| postoperative ileus | temporary impairment of gastric and bowel motility after surgery; abdominal pain, cramping, hypoactive bowel sounds, distention
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| urinary complications | retention caused by anesthesia or constipation
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| bladder scan if more than 6 hr since last void | more than 400, straight cath
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| signs of wound infection | redness, swelling, purulent or foul drainage, increased pain, warmth, fever, leukocytosis
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| dehiscence | incision starts to seperate
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