Intraoperative Care (Chapter 19)

Vocabulary flashcards covering key terms and definitions from the intraoperative nursing notes.

Unrestricted zone

A surgical area where street clothes are permitted and nonsterile activities occur (e.g., holding areas, staff stations) before entering more restricted zones.

Semirestricted zone

Area near the sterile core where authorized personnel wear surgical attire (scrubs, caps) and access is controlled.

Restricted zone

The sterile core of the OR where strict aseptic technique is required and entry is highly controlled.

Preoperative Holding Area (AOD)

Admission, observation, and discharge area used to identify, assess, and prepare clients before entering the OR.

PACU

Post-Anesthesia Care Unit; area where patients recover from anesthesia after surgery.

Circulating Nurse

Nonsterile perioperative nurse who coordinates the room, monitors asepsis, maintains documentation, and facilitates patient transport.

Scrub Nurse

Sterile team member who scrubs in, prepares the instrument table, and passes instruments to the surgeon.

Scrub Tech (Surgical Technologist)

Professionally assists with sterile technique and instrument handling during surgery.

Preoperative Nurse (Preop RN)

Nurse responsible for the patient’s preparation and readiness before surgery.

OR Nurse (OR RN)

Nurse working in the operating room, can function as circulating or scrub nurse.

Anesthesia Care Provider (ACP)

Provider responsible for anesthesia management; collaborates with surgeon and patient and holds ultimate anesthesia responsibility.

Surgical Care Improvement Project (SCIP)

A set of safety measures aimed at preventing perioperative complications.

Time Out

A safety pause where the team verifies patient identity, site, procedure, and anticipated critical events before incision.

Sign In

WHO surgical safety checklist step before induction; team verifies patient details, procedure, consent, and site.

Sign Out

WHO checklist step before leaving the OR; counts, specimen labeling, and recovery plan are reviewed.

World Health Organization Surgical Safety Checklist

Global safety protocol used in the OR to enhance patient safety through Sign In, Time Out, and Sign Out.

Induction

Phase of general anesthesia from administration of induction agents to airway securement.

Maintenance (General Anesthesia)

Phase during which anesthesia is maintained; airway support and monitoring continue.

Emergence

Phase when anesthetic effects wear off and the patient wakes from anesthesia.

Monitored Anesthesia Care (MAC)

Sedation with analgesia under monitoring, not full general anesthesia.

Moderate to Deep Sedation

Level of sedation between minimal sedation and general anesthesia, typically under ACP supervision.

General anesthesia

Controlled loss of consciousness with airway management, using IV and/or inhaled agents.

Local anesthesia

Numbing of a small, localized area by injecting local anesthetic near nerves; patient awake.

Regional anesthesia

Blockade of sensation in a region of the body via nerve block or neuraxial technique.

Spinal anesthesia (Subarachnoid block)

Neuraxial block delivered into the subarachnoid space to achieve sensory/motor loss below the level of injection.

Epidural space

Space outside the dura mater within the vertebral canal used for epidural anesthesia.

Subarachnoid space

Space between arachnoid and pia mater where spinal anesthesia is injected.

Succinylcholine (depolarizing NMBA)

Depolarizing neuromuscular blocker used to facilitate intubation; can trigger malignant hyperthermia.

Nondepolarizing NMBA

Neuromuscular blocking agents (e.g., atracurium, cisatracurium, pancuronium, rocuronium, vecuronium) that cause skeletal muscle paralysis; reversed with neostigmine.

Neostigmine

Anticholinesterase reversal agent used to reverse nondepolarizing NMBA effects.

Desflurane

Volatile inhaled anesthetic with rapid onset/offset; used for rapid anesthesia control.

Isoflurane

Volatile inhaled anesthetic with stable hemodynamics; used for longer procedures.

Sevoflurane

Volatile inhaled anesthetic suitable for induction; non-irritating to airways and rapidly acting.

Nitrous oxide

Inhaled gas that speeds induction when used with volatile agents; provides analgesia but is not potent alone.

Propofol

IV hypnotic agent used for induction and maintenance; rapid onset with antiemetic properties.

Etomidate

IV hypnotic agent with minimal cardiovascular effects; used in hemodynamically unstable patients.

Methohexital

Barbiturate used for rapid induction with very short duration of action.

Ketamine

Dissociative anesthetic with analgesic and amnestic properties; may cause vivid dreams or hallucinations.

Ondansetron

Antiemetic used to prevent perioperative nausea and vomiting.

Prochlorperazine

Antiemetic with antipsychotic properties used to prevent nausea and vomiting.

Diazepam

Benzodiazepine for anxiety reduction and amnesia.

Lorazepam

Benzodiazepine for sedation and anxiolysis.

Midazolam

Benzodiazepine used for sedation, amnesia, and anxiolysis.

Fentanyl

Opioid analgesic used for intraoperative analgesia; potential respiratory depression and pruritus.

Hydromorphone

Potent opioid analgesic used intraoperatively and postoperatively.

Morphine

Opioid analgesic; provides pain relief but can cause histamine release and respiratory depression.

Dexmedetomidine

Sedative with analgesic properties; can cause bradycardia and hypotension.

Atropine

Anticholinergic to reduce secretions and prevent bradycardia; can cause dry mouth and tachycardia.

Glycopyrrolate

Anticholinergic similar to atropine with fewer central effects; reduces secretions.

Naloxone

Opioid antagonist used to reverse opioid-induced respiratory depression.

Malignant hyperthermia

Life-threatening reaction triggered by certain anesthetics; characterized by hyperthermia and rigidity; requires prompt treatment.

Anaphylactic reactions

Severe allergic reaction that can occur intraoperatively and require immediate management.

Specimen labeling

Proper labeling of surgical specimens to ensure correct patient and specimen tracking.

Instrument count

Verification that all surgical instruments, sponges, and needles are accounted for before and after the procedure.

Antibiotic prophylaxis

Administration of antibiotics within 60 minutes before incision to reduce infection risk.

Aseptic technique

Procedures and practices to prevent contamination and maintain sterile conditions.