Flashcards in Care of the Surgical Patient Deck (52):
from the decision of surgery to transfer into the operating room
from transfer to the operating room to admission to the PACU
starts at admission to the PACU and ends when completely recovered from surgery.
needed to be done immediately; life threatening situation
not an emergency; requires prompt intervention 24-48 hours
non urgent, non acute problem, not life threatening but surgery is preferred treatment
not critical to survival or function
to make or confirm a diagnosis
to remove a diseased body part
to restore function to a traumatized or malfunctioning tissue
to relieve or reduce intensity of an illness; is not curative
to restore function in congenital anomalies Ex. cleft palate
to replace organs or structures that are diseased or malfunctioning.
Minor degree of risk
low risk to patient; fewer complications; often same day surgery
Major degree of risk
high risk to patient; more complicated; increased blood loss; vital organs involved; increased risk of post operative complications
What are some advantages of same day surgery?
Same day procedures-cheaper
less risk of HAI'sq
What are some disadvantages of same day surgeries
need more knowledge base & proper education
limited activity at home and need more social support
What are some components of pre-surgical testing?
CBC, Basic metabolic panel, chest X-Ray, EKG/ECG,
What information would be included in a current problem nursing assessment?
What are they having surgery on
What information would be included in a vital signs nursing assessment
mycins--potentiate MS relaxants
Increase bleeding time, problem with cloting, should be stopped several days prior to surgery
same as anticoagulants
When used with anesthetics can cause hypotension
Loss of K+ . Hypokalemia will cause cardiac problems and arrhythmia. (getting rid of excess water)
Steroids--when stopped suddenly will cause CV collapse; also anti-inflammatory and will delay wound healing.
potentiate narcotics and barbiiturates which will decrease BP and cause CNS depresssion
diazepam (Valium); midazolam (versed), lorazepam (Ativan) to alleviate anxiety and decrease recall of events related to surgery
Atropine and Glycopyrrolate (Robinul) decrease pulmonary/oral secretions and prevent laryngospasm
Morphine to facilitate patient sedation and relaxation and to decrease the amount of anesthetic agent needed.
fentanyl citrate-droperidol (Innovar) cause a general state of calmness and sleepiness
H2-histamine receptor antagonist
cimetidine (Tagamet) and ranitidine (zantac) to decrease gastic acidity and volume
Inhalation or Intravenous--produces CNS depression, analgesia, relaxation and reflex loss.
Patients are not arousable, are unable to maintain breathing and require mechanical ventilation. Cardiovascular function may be impaired.
Beginning stage of anesthesia
initial feeling of detachment as the client is receiving the medication and is starting to work on the body.
Excitement stage of anesthesia
the person is excited and may be taking, crying or shouting
the patient is unconscious and still the medication is doing what it is suppossed to do.
too much anesthesia has been administered or it is being broken down differently in the body.
Local anesthetic injected around nerves
Patient is awake and aware of surroundings. This has a less systemic effect. it is good for the elderly and those with cardiac and respiratory problems.
agent is injected into the epidural space that surrpounds the dura mater of the spinal cord.
what is an advantage of epidural anesthesia
what are some disadvantages of an epidural
need more precise technical administration. Can be used post operative also for pain control.
agent injected through the dura mater and into the subarachnoid space surrounding the spinal cord.
Produces anesthesia to lower extremities, perineum and lower abdomen. Side effects are headache and hypotension
inadequate ventilation due to airway occlusion, anadvertent intubation of esophagus instead of trachea.
What are some causes of respiratory depression
medications, aspiration of secretion or vomitus, the positioning of the patient on the table.
Hypoxia can cause
brain damage in minutes-patient must be monitored carefully-O2 levels, pulse ox, peripheral circulation.
how is Hypothermia intenionally cuased
how is hypothermia unintentionally caused
low room temp, cold IV fluids, inhaling cold gases, open body cavity, decreased muscle activity, age, medications,