perioperative nursing

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  1. GA
    • Administration of drug via inhalation or IV causing CNS
    • depression. Results in LOC, analgesia, relaxed skeletal muscles, depressed
    • reflexes.


    · Rapid excretion and reversal side effects

    · For pts of any age

    · For most surgical procedures

    · Pt unaware of physical trauma of surgery


    · Risk for circulatory depression

    · Risk for respiratory depression

    · post op nausea and vomiting

    · Alteration in thermoregulation
  2. Spinal
    • · Injection of anesthesia in the cerebrospinal
    • fluid in the subrarachnoid space thru a lumbar puncture (L4-L5)

    · Sensory block, motor block, autonomic block

    • Advantages
    • · No LOC

    · Can be used alone or with IV sedation

    · Fast acting


    · Hypotension

    · Headache (raising head off the pillow)

    · Urine retention
  3. Epidural
    • · Insertion of a thin catheter thru the
    • intravertebral spaces into the epidural space

    · Continuously infusion thru cath to produce loss of sensation

    · Does not enter cerebrospinal fluid


    · No LOC

    · Onset slower but has similar affect as spinal

    · Decrease in headache like the spinal one


    · Hypotension

    · Bradycardia

    · Nausea and vomiting

    · Respiratory depression

    • · Slight risk of infection if spinal fluid tap
    • occurred
  4. Moderate sedation/analgesia (conscious sedation)
    · Used for short term procedure and minimally invasive procedures

    · Pt maintains cardio-respiratory function

    • · Pt can respond to verbal commands and can keep
    • airway open

    · IN admins. Of sedative or analgesia increases pain threshold and produces altered mood and some ammesia

    · Pt aware and alert but can be deattached to what is going on
  5. PaCU
    Monitor VS every 10-15 until discharge from the unit

    · Monitor for emergent from anesthesia

    - Emergence delirium

    - Airway maintenance

    - Stable heart/respiratory rate

    - Fluid and electrolyte balance

    - Pain management
  6. Immediate Post op assessment
    • · A airway (any affects from anesthesia,
    • analgesia)

    · B breathing (rr, O2 stat)

    ·  Circulation (CSM, cardiac status, bp, p, T) CNS LOC all VS would include pain

    · D drainage – dressing, drainage from site, wound status

    · E eletrolytes, edema

    · F- fluid status, I&O

    · G GI/GU (urinary output/bowel sounds and bowel movements pass gas)

    ·H hemorrhage

    · I IV- check site

    · P pain stutus

    · S safety
  7. Post op complication Hemorrhage
    • May lead to hypovolemic shock (all systems shut
    • down)      
    • S/s= cool clamy skin,, color chane, low bp, air
    • hunger, increase pulse, LOC
    • Interventions

    • Apply pressure to the operative site       
    • Prepare pt to go back to surgery
Card Set
perioperative nursing
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