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Med Surge 4th exam > Intra-op > Flashcards

Flashcards in Intra-op Deck (51)
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1

The surgical suite (designed to control the spread of infection) is divided into three areas: unrestricted area, semirestricted area, and restricted area. What is allowed in each area

  • Unrestricted area: street clothes allowed in holding area, lockers, nsg station
  • Semirestricted area: only authorized staff are allowed in the corridors near OR and must wear surgical attire covering all head and facial hair
  • Restricted area: Masks are required to be worn, includes scrubsink and clean core and ORs

2

What is the holding area:

Waitng area outside of OR to identify and assess the pt pre/post-op

3

WHat is the OR;

A controlled geographically evironment from pathogens and limits the amount of staff. Utilizes filters/ventilations/and controlled airflow. No shelving and tables are admitted d/t collecting dust

4

This type of surgical team nurse  is concerned w/sterile activites: remains in sterile field, scrubs, gowns, gloves self and other members of team, sterile drapes, counts sponges and instraments, assists w/the surgery

Scrub nurse

5

This type of surgical team nurse is non-sterile, assists preparing the room continually assess pt through out procedure, transfer pt, aseptic practice, also counts sponges and equipment

Circulating nurse

6

The joint commision has provided what is called the universal protocol prior to a start of a surgical procedure that prevents wrong site, wrong procedure and wrong pt. What are the three universal protocols:

  1. Pre-procedure verification: R. pt, R. procedure, R. site
  2. Mark the operative site
  3. Time out: averybody stops to verify pt identification, surgical procedure, and durgical site

7

What are some notes about aseptic technique with scrubbing, gloving, and what's considered sterile:

Wash fingers and hands first moving on to forearms and elbows; hands should be held away from me and above elbows; once packages have been opened=edges are contaminated, gowns are sterile from above the table to chest level and sleeves two inches above elbow is considred sterile. Double gloves are worn.

8

6 Steps on Postioning an intra-op pt:

  1. correct musculoskeletal alignments
  2. prevent undue pressure on nerves/skin over bony prominences
  3. provide for adequate thoracic excrusion
  4. prevent occlusions of arteries/veins
  5. provide modesty in exposure
  6. recognize/respect/considerate in pt's needs to baseline pain, deformities, aches

9

What are the supine, prone, and lithotomy positions used for:

  1. supine: most preferred for abs, heart, breast
  2. prone: back surgery
  3. lithotomy: pelvic surgery, hysterectomy

10

The prepping the surgical site is to reduce the number of microorganisms available to migrate to the surgical site. How is the site prepped:

Skin is scrubbed w/an antimicrobial agent in a circular motion, hair is removed with electric razor so as to not feel any burning sesation from antimicrobial agent; clean area is the incision part, distal area from the incision is the dirty part; skin is draped with only the surgical site to be exposed

11

What are the trhee types of anesthesia used:

  1. General
  2. regional/local
  3. conscious sedation/MAC monitores anesthesia care

12

This type of anethesia: loss of all sensation and consciousness; POSSIBLE IMPAIRED VENTILATORY/CARDIOVASCULAR FUNCTION; protective reflexes of gag/cough reflexes are lost; BLOCKS AWARENESS CENTER IN BRAIN FOR AMNESIA/ANALGESIA/HYPNOSIS/RELAATION occurs

General anesthesia

13

Which of the phases in general anesthesia includes the period starting w/pre-op medication, initiation of IV/arterial access/application of monitors:

preinduction phase of general anesthesia

14

Completing pre-op assessment, checking/confirming consents/permits; completing TIMEOUT; administering aspiration prophylactics are the roles of the pro-op nurse in what phase of general anesthesia:

preinduction phase of general anesthesia

15

Which of the phases in general anesthesia is the initiation of sequence of medications that render the pt unconscious and to secure the airway:

induction phase of general anesthesia

16

Assisting w/application of monitors (noninvasive/invasive); assist w/airway management are the roles periop-nurse during what phase of general anesthesia:

induction phase

17

Which of the phases of general anesthesia is the time period the surgical procedure is performed, pt remains in unconscious state  with measures taken to ensure safety of airway:

Maintenance phase

18

Adjusting pt's position as necessary and monitoring pt safety are the roles of the periop-nurse during what phase of general anesthesia:

maintenance phase

19

Which of the phases of general anesthesia is where the surgical procedure is completed, pt is prepared to return to conscious state and removal of airway assistive advices:

Emergence phase of general anesthesia

20

Assiting placement of dressing, preparing pt for movement to postanesthesic care unit (PACU) are roles of the periop-nurse during what phase of general anesthesia:

Emergence phase of general anesthesia

21

What are the general anesthesia routes:

  1. Intravenous agents: single dose last minutes for intubation to be inserted
  2. inhalation agents: includes volatile liquids or gases that enters the body via alveoli delieverd by an intubation tube (LMA)

22

What is the adjunct to general anesthesia that is used to sedate/analgesia, induces/maintains anesthesia/analgesia; and is used as pain management post-op:

opioid: fentanyl

23

what is the reversal agent used for fentanyl:

narcan

24

What is the adjunct to general anesthesia that has an amnesic effect; induces.maintains anesthesia; and is used for anxiety/agitation post-op:

Benzodiazepines: Versed

25

What is the reversal agent for Versed:

Benzodiazepine reversal agent is flumazenil 

26

What is the adjunct to general anesthesia that facilitates endotracheal intubation; paralysis/relaxes skeletal muscles:

Nerve blosk: succinylcholine (watch BP if it falls to 40/20=RR distress

27

What is the reversal agent for succinylcholine:

Reversal agent for nerve block: Neostigmine

28

What is the common adjunct antiemetic that counteracts emetic effects of inhalation/opioid anesthesia agents; considered a prophylactic prevention of N/V:

Inaspine

29

This type of anesthesia causes the loss of sensation to a region of the body w/o loos of consciusnesswhen a group of nerves are blocked:

Regional anesthesia is always injected (nerve block)

30

This type of anesthesia causes the loss of sensation w/o loss of consciousness and w/o blocking the nerves in an immediate area:

Local anesthesia (lidocaine)