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Flashcards in Anesthesia plan Deck (11)
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1

What does the Council on Accreditation say?

  • We should provide nurse anesthesia care based on sound principles and research evidence.
  • Perform a pre-anesthetic assessment and formulate an anesthesia care plan for patients to whom they are assigned to administer anestesia

2

What information are you going to use to adjust your anesthetic care plan?

What should you have ready in case your plan changes?

  • reassess vital signs
  • airway status
  • response to pre-procedure medications
  • make sure all anesthesia equipment, supplies, and medications are checked and immediately available in case the pt needs change

3

What are the components of the anesthetic plan?

  • Drug plan/ anesthetic technique
  • airway plan
  • ventilation plan
  • fluid plan/IV access plan
  • monitoring plan
  • positioning plan 

4

What will influence your plan?

  • current physical status
  • histor and physical assessment
  • co-existing disease
  • airway assessment/difficult airway?
  • previous anesthesia complications
  • family history of anesthesia problems
  • planned surgery

5

What are the choices of anesthetic technique?

  • GA 
  • regional
  • combined GA/Regional
  • MAC
  • Local

6

What should your airway plan include?

  • Type of airway
    • ETT, LMA, NC, face mask
    • ETT size (armored, oral rae, nasal rae, etc.)
    • LMA size
  • Blade- miller, mac, glidescope,e tc
  • Vent settings: TV, RR, FiO2, I:E, spontaneious vs assisted
  • difficult airway cart
  • airway blocks

7

What is Standard 1 of monitoring?

  • Qualified anesthesia personnel shall be present in the room throughout the conduct of all general anesthetics, regional, and MAC cases

8

What is standard 2 of monitoring?

How is this done?

  • During all anesthetics, the pt's oxygenation, ventilation, circulation, and temperature shall be continually evaluated.
  • Oxygenation
    • Oxygenanalyzer for inspired gasses
    • Pulse oximetry, observation of pt
  • Ventilation
    • Auscultation of BS
    • observation of pt and reservoir bag
    • capnography
  • Circulation
    • ECG
    • HR and BP recorded every 5 minutes
    • listen to Heart sounds, feel pulse
    • pulse ox
    • art line
  • Temperature

9

What are some other monitors that may be used?

Art line

CVP/PA

TEE

PNS

BIS

glucometer

EEG/SSEP

EMG

10

What are the intraoperative fluid requirements?

  • maintenance
  • fluid deficit
  • blood loss
  • evaporative loss

11

What are the most common operative positions?

  • Supine
    • trendelenburg
    • reverse trendelenburg
  • Lithotomy
  • prone
  • lateral decubitus
  • sitting