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When is the intraoperative period?
begins when the pt enters the OR and ends at transfer to PACU or ICU.
Who is teh members of the surgical team?
surgeon, surgical assistant, anesthesiologist, and the OR nusing staff
Holding area nurse
- work in the operating suites with presurgical holding area; coordinates and manages care of pt while in this area.
- Ex: greets pt, reviewing med record, getting consent forms signed, etc.
- coordinates, oversees, and is involved in the pts nursing care in the OR; actions are vital to the smooth flow of events before, during, and after surgery.
- Ex: prepares operating room
sets up sterile field, drape the pt, and hands sterile suplies, sterile equipment, and instruments to surgeon and assisstent. Is able to hand the surgeon the next instruments cause she is knows about the procedure.
specializes with a particular surgery
What are the benefits to MIS?
reduced surgery time and blood loss, smaller incisions, faster recovery, less pain and other discomfort after surgery.
injecting gas or air into the cavity before the surgery to separate organs and improve visualization during MIS. May contribute to complications and pt discomfort.
for abdominal surgery
for joint surgery
for urinary tract surgery
Who must perform a surgical scrub?
surgeon, all assistants, and the scrub nurse perform a surgical scrub after putting on a mask and before putting on the sterile gown and gloves
Who does not perform a surgical scrub?
anesthesia provider, circulating nurse may wear cover scrub jackets that are snapped or buttoned closed.
what is anesthesia for?
to block nerve impulses transmission, suppress reflexes, promote muscle relaxation, and achieve a controlled level of unconciousness.
pain relief or pain suppression occurs during anesthesia
memory loss of the surgery occurs during analgesia
- recovery from anesthesia; retching, vomiting, and restlessness may occur during this time
- Suction equip must be available to prevent aspiration.
- shivering, rigidity, and slight cyanosis may occur due to temporary changes in the body's temp control: provide warm blankets, radiant light, and oxygen to decrease the effects of emergence.
What does the speed of emergent depend on?
the type of anesthetic agent, the length of time the pt is anesthetized, and whether a reversal agent is used
Malignant hyperthermia (MH)
an acute, life-threatening complication of certain drugs used for general anesthesia.
reversible loss of conciousness induced by inhibiting neuronal impulses in several areas of the CNS; includes inhalation intravenous and balanced
Advantages of Inhalation
most controlled method; induction and reversal accomplished with pulmonary ventilation; few side effects
Advantages to intravenous anesthesia
rapid and pleasant induction; less postoperative nausea and vomiting; required little equip
Advantages to balanced anesthesia
minimal disturbace to physiologic function; minimal side effects; can be used w/ older and high risk pts
What is the drug of choice for MH
Dantrolene sodium, a skeletal muscle relaxant, along with other interventions
delivered topically (applied to the skin or mucous membranes of the area) or by local infiltration (injected directly into the tissue around an incision, wound, or lesion.
type of local anesthesia that blocks multiple peripheral nerves in a specific body region. Types include field block, nerve block, spinal, and epidural
- IV delivery of sedative, hypnotic and opioid drugs to reduce the level of consciousness but allow the pt to maintain a patent airway and respond to verbal commands.
- Used for endoscopy, cardiac catheterizaion, closed fx reduction, cardioversion
may be used in addition to standard sutures for pts at high risk for impaired wound healing (major ab surgery, obese, diabetics, and pts taking steroids)
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