Exam 3 Flashcards
(54 cards)
Blockage of multiple nerves around surgical site
Regional Anesthesia
- A series of injections around the operative field
- Most commonly used for chest procedures, hernia repair, dental surgery, and some plastic surgeries
Field Block
- Injection of the local anesthetic agent into or around one nerve or group of nerves in the involved area
- Most commonly used for limb surgery or to relieve chronic pain
Nerve Block
- Injection of an anesthetic agent into the cerebrospinal fluid in the subarachnoid space
- Most commonly used for lower abdominal, pelvic, hip, and knee surgery
Spinal Anesthesia
- Injection of an agent into the epidural space
- Most commonly used for anorectal, vaginal, perineal, hip, and lower extremity surgeries
Epidural Anesthesia
Metallic taste
Systemic absorption, CNS stimulation
- Reversible loss of consciousness achieved by singular or plural agents
- Analgesia and amnesia
- Retching, emesis & restlessness may occur during emergence – have suction ready
- Shivering, rigidity, and slight cyanosis may occur during recovery – warm blankets, radiate lights and oxygen
General Anesthesia
- Certified RNs admin IV sedatives, hypnotics, and opioids
- Pts can maintain airway and respond commands
- Vitals, LOC, O2 sats, ECG, capnography are taken every 15-30 minutes
- PO intake may resume 30 post sedation
- Pts can be discharged home with a Ramsay Scale score of 2=cooperative, calm, oriented
Conscious/Moderate Sedation
Increase capillary fragility
Long term steroids
Fluoroquinolones
Tendon rupture
Succinylcholine, a depolarizing blocker agent
Document general muscle twitching, it’s normal
RNs who coordinate, oversee, and are involved in the client’s nursing care in the operating room.
Circulating nurses or “circulators”
Manage the client’s care before surgery.
Holding area RNs
Set up the sterile field, drape the client, and hand sterile supplies, sterile equipment, and instruments to the surgeon and the assistant.
Scrub RNs
Sanguineous drainage is okay for how long after surgery?
5 days. Crusting is okay
Post surgical pain is usually worst when?
2nd day post op
Assess what for bandemia or left shift as sign of infection
WBC
Post op clients do IS how often?
Every 1-2 hrs
Secure the airway and IV access before starting antagonist therapy.
• Prepare to administer flumazenil (Romazicon)* in a dose of 0.2 mg to 1 mg IV.
• Repeat drug every 2 to 3 minutes up to 3 mg, as needed, depending on the patient’s response.
Benzodiazapine Overdose
Post op wound care
Transparent dressing stay in place for 3-6 days
Use Montgomery straps when indicatedClean suture lines every shift with normal saline or whatever is prescribed by the MD or policy
Offer pain meds before wound care or pulling drains.
Remove sutures or staples (day5-10 per order)
Clean
Remove every other on first day then the others the next day
Use steri strips when indicated
Dehiscence/Evisceration
Cover with a sterile moist dressing, bend knees, avoid coughing, call surgeon
Post op pain assessment
Give opioids with caution as they may mask anesthetic responses
Document pain response 5-10 min after IV injection
Around the clock pain meds are best
No knee gatch or pillows under knees
Don’t massage calves
Opioid overdose
Prepare to administer naloxone hydrochloride (Narcan)* in a dose of 1 to 2 mg IV.
• Repeat naloxone every 2 to 3 minutes up to 10 mg, as needed, depending on the patient’s response.
Post op diet to promote wound healing
High in protein, Vitamin C, zinc, and calories
