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26 Cards in this Set
- Front
- Back
Common fears of surgery
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death
pain/discomfort mutilation/alteration of body image anesthesia disruption of life patterns |
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Nursing assessments
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interview with hx
informed consent use of common language allergies- allergies vs side effects |
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Echinacea
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prolonged use may suppress immune system
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Ephedra
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interacts with anesthesia increased in BP and HR
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Feverfew
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increased risk of bleeding
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Garlic
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risk of bleeding, excessive response to anticoagulation
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Ginger
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increaseed risk of bleeding
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Pre-op prep
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Labs- electrolytes, glucose, EKG, coaulation studies, UA
Preop preparation- sensory, procedural, process |
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Informed consent
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Dr. responisbility/ 14 and older can sign own consent.
Adequate disclosure clear understanding and comprehension give consent voluntarily |
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Bariatrics
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equipment rated to 500lb's
be aware of needs and order right equipment. |
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Preparation of Patient
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surgical gown-check about underwear
Nail polish ID band/allergy band Jewelry-rings taped Contact/glasses, dentures, hearing aides void prior to OR Preop medication - oral vs IV/IM |
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Preop Medications
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sedatives
anticholinergics-decrease secretions narcotics-before during after antiemetics-nausea antiviotics-only when they need it eye drops- Clacoma, anthesics will increase eye pressure certain HTN - cardiac, insulin given dosages may be adjusted/ glucose may be given 1/2 dose. |
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Operative
in patient/outpatient |
3 areas
1- unrestricted -holding area 2- semi-restricted- authorized personnel only /scrubs 3- restricted -sterile area/ OR rooms |
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Positioning Patient
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-allow accessibility to surgical site
-administration and monitoring of anesthesia -provide correct skeletal alignment-maintain airway -prevent undue pressure on nerves,skin over bony prominences and eyes |
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Positioning
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-provide adequate thoracic excursion- being able to breath, nothing on chest.
-prevent occlusion of arteries/veins- BP cuffs not too tight -prevent modesty- this is a person, drape client. -recognize,respect individual needs- skinny people may need a pad. -NRS/DX Surgical positioning injury. |
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Types of anesthesia
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-IV induction
-inhalation -adjuncts-opiods-if started early don't need so much after surgery -Benzo- midazolam (versed) - amnesia qualities, must be certified to use. -Flumazenil (romazicon) antagonist for versed -neuromuscular blocking agents -antiemetics |
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Dissociative anesthesia
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patient catatonic-Ketamine
still, but not unconscious |
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Local anesthesia
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blocks initiation and transmission of electrical impulses along nerve fibers.
used for arm or foot, client still awake |
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Problems with anesthetic
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Anaphylactic reactions
Malignant hyperthermia- after surgery or during, develop sudden temperature (105) seizure starts @ 105. |
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Malignant Hyperthermia
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-inherited -ask if pt aor fmily has had
-symptoms-tachycardia, tachypnea,hypercarbia, ventricular arrhythmias -Treatment Dantrolene decrease metabolism, support pt to correct hemodynamic instability, acidosis, hypoxemia, increased temp. |
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Types of anesthesia
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-IV induction
-inhalation -adjuncts-opiods-if started early don't need so much after surgery -Benzo- midazolam (versed) - amnesia qualities, must be certified to use. -Flumazenil (romazicon) antagonist for versed -neuromuscular blocking agents -antiemetics |
|
Dissociative anesthesia
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patient catatonic-Ketamine
still, but not unconscious |
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Local anesthesia
|
blocks initiation and transmission of electrical impulses along nerve fibers.
used for arm or foot, client still awake |
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Problems with anesthetic
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Anaphylactic reactions
Malignant hyperthermia- after surgery or during, develop sudden temperature (105) seizure starts @ 105. |
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Malignant Hyperthermia
|
-inherited -ask if pt aor fmily has had
-symptoms-tachycardia, tachypnea,hypercarbia, ventricular arrhythmias -Treatment Dantrolene decrease metabolism, support pt to correct hemodynamic instability, acidosis, hypoxemia, increased temp. |
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post-op assessment
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ABC;s
oxygenation Neuro status- are they awake and follow commands Fluid status-IV's Surgical site- don't take off dressing, look at dressing and under the pt, ck for blood and bleeding |