foundations Perioperative 2 (exam 3)

what are the three Main Components

1.Preop patient identification

2.Marking operative site

3. Time out

what does timeout mean

when every member stops what their doing and circles around the patient and introduces themselves and ask any last questions

how does the surgeon mark the site

a marker on the correct site with a yes or the surgeons initials

what are the 4 dynamics of general anesthesia

induction

maintenance

emergence

moderate sedation

what is induction for general anesthesia

give medication and it starts to work

what is the maintenance for general anesthesia

the time the patient has their first incision all the way until the procedure is done

what is the emergence for general anesthesia

patient starts to wake up or medication starts to ware off , theyre using new meds which work faster and safer

what is moderate sedation/analgesia

-you have to get additional training as a nurse or physician

the awareness of the person is altered but therye able to protects their airway

-amesics(they forget it happens), this is for short term quick producers that are still invasive

what are some facts about general anesthesia

•Most intensive type because the effects the whole body

•Inhalation or IV

•Causes pain relief, analgesia muscle relaxation, diminished reflex's, and a sleep like state to depress the nervous system

•Cannot breathe on your own so you get a breathing tube/endotracheal tube

why are patients NPO before surgery

so you don't vomit when they put the tube down

what are the three types of regional anesthesia

•Nerve blocks

•Spinal

•Epidural

what are facts about regional anesthesia

•Injected near a nerve root or pathway or in the tissues around the operative site

•Reduced risk of complications compared to general anesthesia by no change of consciousness

•Side effect: decrease in blood pressure and heart rate

•Advantage: small catheter of epidural can be left in the patient for a few days afterwards

what are some facts about Topical and Local anesthesia

•Used on mucous membranes to cause local anaestians which numbs the area

•Any thing that ends in cane

•Multimodal anesthetics like local and regional

what are the there types of anesthesia

general

regional

topical/local

what is a open cholecystectomy

opening the stomach to remove the gallbladder

what is a laparoscopic cholecystectomy

swords which have different jobs like lighting up the area or holding things in place

pump you full of air to get into the stomach easier

what is a circulator nurse

has very little to do to with the patient, they control the environment by temp,humidity,lighting, ensure patients rights are protected, does not scrub in, coordinates care that is happening, helps position patient, documenting everything

what is a scrub nurse

can be a LPN, tech, RN which does scrub in for the surgery, they hand the equipment to the surgeon, prepares the sterile field, complete counts of every equipment every step to avoid a never event

what is a rnfa nurse

registered nurse first assist who completes 6 more semester hours of training with years of of experience in the or and completed the certification exam, they can complete the surgery with the surgeon

what is a crna nurse

certified registered nurse anesthetist who needs a masters, clinical, and exam. They can give anesthesia

what is a grounding pad for

to minimize risk of fire because the cautery cause sparking from oxygen, jewelry cleaning solution

what are some site preps

hair removal or scrubbing

what are SCDs for

to reduce blood clots

what is Malignant Hyperthermia (MH)

A rare inherited autosomal dominant disorder, but life threatening triggered by the exposure of certain anesthetics, tends to be in males, younger generation, increased skeletal muscle metabolism which overwhelms body to supply oxygen and remove CO2 and regulate temp. this leads to circulatory collapse and death.

why should you monitor UOP

creatinine can cause rhabdomyolysis which is a condition that can lead to kidney failure by overload of creatinine or increased skeletal destruction like prolonged immobility, the urine turns a coal color

what does DIC stand for

inseminated coagulopathy

what are Postoperative GI & Nutritional interventions

•Early ambulation

•Antiemetics

•Stool softeners/Laxatives

•NPO

•NGT

•IVF

•Slow progress diet

whats a slow progress diet

•Ice, sips, clears, full liquid, soft, regular

what is a NGT for

suction stomach contents to stop throwing u

what is iieus

•bowel does not wake up, no peristalsis, and pain

what is abd distention

are they passing gas instead of burping

what the issue with dehydration symptoms

these symptoms looks the same as shock/hemorrhage

what are some anticoagulants

heparin or enoxaparin

what are the postoperative respiratory complications

•Aspiration

•Atelectasis

•Respiratory depression

•Pneumonia

•PE

•Stridor

what are the key assesments for postoperative respiratory

•Lung sounds

•RR

•work of breathing

•SpO2

•Signs of respiratory depression

•Sputum

what are the postoperative respiratory interventions

•Elevate HOB

•O2 as ordered

•CPAP if OSA

•C & DB (q2h) - coughing and deep breathing

•Splinting if needed - hold pillow over stomach

•IS (10xq1h)

•Adequate pain control

what are the postoperative cardiovascular complications

•Hemorrhage

•Shock

•Thrombophlebitis

•DVT

what are the Postoperative Hydration complications

•Dehydration

•Fluid overload

•Urinary retention

what are the Postoperative Skin & Wound complications

•Infection

•Dehiscence

•Evisceration

what are the three types of wound closes

sutures

steri-strips

staples