med surg

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  1. When is the intraoperative period?
    begins when the pt enters the OR and ends at transfer to PACU or ICU.
  2. Who is teh members of the surgical team?
    surgeon, surgical assistant, anesthesiologist, and the OR nusing staff
  3. 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.
  4. Circulating Nurse
    • 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
  5. Scrub nurse
    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.
  6. Specialty nurses
    specializes with a particular surgery
  7. What are the benefits to MIS?
    reduced surgery time and blood loss, smaller incisions, faster recovery, less pain and other discomfort after surgery.
  8. insufflation
    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.
  9. laparoscope
    for abdominal surgery
  10. arthroscope
    for joint surgery
  11. ureteroscope
    for urinary tract surgery
  12. 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
  13. Who does not perform a surgical scrub?
    anesthesia provider, circulating nurse may wear cover scrub jackets that are snapped or buttoned closed.
  14. what is anesthesia for?
    to block nerve impulses transmission, suppress reflexes, promote muscle relaxation, and achieve a controlled level of unconciousness.
  15. analgesia
    pain relief or pain suppression occurs during anesthesia
  16. amnesia
    memory loss of the surgery occurs during analgesia
  17. emergence
    • 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.
  18. 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
  19. Malignant hyperthermia (MH)
    an acute, life-threatening complication of certain drugs used for general anesthesia.
  20. general anesthesia
    reversible loss of conciousness induced by inhibiting neuronal impulses in several areas of the CNS; includes inhalation intravenous and balanced
  21. Advantages of Inhalation
    most controlled method; induction and reversal accomplished with pulmonary ventilation; few side effects
  22. Advantages to intravenous anesthesia
    rapid and pleasant induction; less postoperative nausea and vomiting; required little equip
  23. Advantages to balanced anesthesia
    minimal disturbace to physiologic function; minimal side effects; can be used w/ older and high risk pts
  24. What is the drug of choice for MH
    Dantrolene sodium, a skeletal muscle relaxant, along with other interventions
  25. Local anesthesia
    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.
  26. Regional anesthesia
    type of local anesthesia that blocks multiple peripheral nerves in a specific body region. Types include field block, nerve block, spinal, and epidural
  27. Conscious sedation
    • 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
  28. retention sutures
    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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med surg
med surg: Ch. 17
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