Perioperative nursing

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Perioperative nursing
2013-03-31 19:30:08

Perioperative nursing study cards
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  1. How do anti coagulants affect anesthesia
    they can can cause hemorrhage
  2. how do antidepressants affect anesthesia namely MAOI's
    They can increase hypotensive effects of anesthesia
  3. How do anti hypertensives effect anesthesia
    they increase hypotensive effects of anesthesia
  4. how do antibiotics effect anesthesia
    may cause apnea and respiratory paralysis
  5. How do diuretics effect anesthesia
    may lead to fluid and electrolyte imbalances producing altered cardiovascular response and respiratory depression
  6. How do herbal supplements affect anesthesia
    may prolong effects of anesthesia, may increase bleeding or raise blood pressure
  7. how do immunosuppressants affect anesthesia
    may increase risk of infection and hypothermia
  8. what test is done to determine clotting ability of blood prior to emergent surgery
    PTT, PT, INR
  9. how soon should clot affecting drugs and herbals be stopped before surgery
    2 weeks
  10. what drugs can be used to help prevent DVT's
    low dose heparin or warfarin.  Aspirin is NOT considered adequate protection
  11. Which patients should you not use inhalation agents  for general anesthesia with
    Patients with a history of malignant hyperthermia
  12. What is succinylcholine
    A neuro musclular blocking drug
  13. characteristics of conscious sedation
    patient can maintain open airway, use of opiods and sedatives, patient can respond to verbal and physical stimulants. RN must be on hand to administer reversal agent if necessary.  Narcan
  14. Circulating nurse duties
    assist with transferring, counts all sponges and instruments, prepares patients skin, ensures no break in aseptic technique occurs and plays DJ
  15. Scrub nurse
    handles sutures, instruments, and other equipment
  16. Dorsal recumbent position (laying flat on back)
    abdominal surgeries  as well as thoracic surgeries such as open heart
  17. Semi sitting position (neck hyper extended)
    thyroid and neck areas (can lead to venous pooling in legs)
  18. Prone position (stomach with buttocks propped up)
    for spinal infusions and removal of hemorrhoids
  19. Lateral chest position (side lying with pillows between legs)
    for some thoracic surgeries and hip replacements
  20. lithotomy position (flat on back with legs up in sling)
    For gynecological procedures, perineal or rectal surgeries
  21. Jackknife position (prone with bends at hips and knees)
    for removal of hemorrhoids and some spinal surgeries
  22. Trendelenberg (flat on back with head of bed slightly tilted downward)
    • used for most surgeries (pros- good for emergency hypotension and cardiac return)
    • (cons- puts pressure on diaphram and restricts ventilation)
  23. hearing aids
    leave in place if patient cannot hear with out it and notify operating room nurse
  24. when does intraoperative phase begin
    when patient enters operating room (75 Lemone) and end when patient is transferred to PACU
  25. what should post op out put be
    30 ml an hour average with foley
  26. how often should nurse asses patient after surgery
    every 15 mins for first hour and if patient is stable every 30 mins for next 2 hours then q4
  27. what causes shock
    insufficient blood flow to vital organs
  28. Healing by primary intention
    Clean incision, clean well approximated suture edges, minimal tissue loss,
  29. Secondary intention healing
    large, gaping irregular wound (perhaps with blood clot) Tissue loss prevents would from approximating therefore granulation tissue fills wound, takes longer to heal and more prone to scar
  30. Healing by tertiary intention
    Infection more likely to occur, edges are not approximated, tissue is regenerated by granulation process, and large amount of scar tissue forms
  31. What is protrusion of organ from a wound
  32. What is disruption of suture of a wound (split open)
  33. Elective surgery
    is by choice (can improve quality of life)
  34. Urgent surgery
    needs to be done asap within 1-2 days (remember heart bypass surgery is urgent not emergent)
  35. emergent surgery
    needs to be done now Bowel obstruction, tubal pregnancy life threatening
  36. Antidote to blood thinner is
    protamine sulfate
  37. Antihypertensives and beta blockers may cause what condition when mixed with anesthesia
  38. What meds are allowed on morning of surgery
    Blood pressure medications
  39. what can bradycardia and hypotension cause
    can cause impaired circulation which can cause DVT and PE
  40. What are infants and elderly predisposed to
    dehydration and hypothermia due to less sub-Q fat
  41. what can hypothermia associated with bleeding from surgical site lead to post surgical
    increased cardiac ischemia which could lead to cardiac morbity
  42. what is atelectasis
    lung collaspe
  43. what is rhinospasm
    airway collapse during intubation
  44. pre op teaching is best when
    a week before surgery
  45. what can cause hypovolemic shock
    metabolic alkalosis
  46. what procedures do you need informed consent for
    surgery, receiving blood, chemo therapy, anesthesia, invasive procedures and for PICC line
  47. when are antibiotics given before surgery
    30 mins to an hour before in surgery holding area (preoperative)
  48. Skin markers are done by
    surgeon in preoperative phase
  49. what do we shave with
    clippers not blades
  50. who calls timeout
    usually circulating nurse but any one can call it
  51. What do adjunct drugs do
    assist with general anesthesia, such as NMBD (paralyzers), opiod analgesics, sedative hypnotics, and anticholenergics
  52. what is malignant hyperthermia
    occurs during or after general anesthesia, temp spikes to 104 or higher,  elevated CO2, condition is genetic, tachycardia, tachpnea and muscle rigidity are also signs. Can cause metabolic acidosis. relieved by DANTROLENE and cold IV fluids and ice
  53. type of general anesthetics

    • (gases)
    • isoflurane
    • sevoflurane
  54. what reverses NMBD
  55. what keeps stomach contents from coming up
    chrochoid pressure
  56. what is aldrete scale
    scale to determine if patient is stable enough for transfer out of PACU
  57. if patient is cold with low blood pressure what to avoid
    applying warm blankets to quick, could cause vasodialation and make blood pressure drop lower
  58. what is convalescence
    when patient goes to floor continue to monitor for things from PACU
  59. what would healing issue is common with diabetics