Perioperative Nursing Flashcards

Question

Surgical Risks: Pre-existing conditions

Answer 1

- bleeding disorders - DM - heart disease - fever - URI *already on ventilator during OR, harder to intubate them - chronic respiratory disease - liver disease (metabolize anesthetics) - immune disorders - renal insufficiency (excreting anesthesia) - chronic steroid use

Answer 2

American operating room nurse association: Operating Room Care Standards

Answer 3

American Society of Perianesthesia Nurses: Perianesthesia Nursing Standards

Answer 4

World Health Organization: Guidelines for Safe Surgery -10 essential objectives

Answer 5

SCIP Surgical Care Improvement Project

Answer 6

1. operate on correct pt on correct site 2. use methods known to prevent harm from administration of anesthetics while protecting pt from pain 3. recognize and effectively prepare for life-threatening loss of airway or respiratory function 4. recognize and effectively prepare for risk of high blood loss 5. avoid inducing an allergic or adverse drug reaction 6. use methods known to minimize risk for surgical site infections 7. prevent inadvertent retention of instruments and sponges 8. secure and identify all surgical specimens 9. effectively communicate and exchange critical information 10. establish routine surveillance of surgical results

Answer 7

1 - Preop antibiotic given within 1 hr before incision 2 - Must receive SCIP recommended prophylactic antibiotic 3 - Discontinue antibiotics within 24 hrs of anesthesia end time (cardiac op exception) 4 - Controlled 6 am postoperative serum glucose (cardiac only) 6 - Appropriate hair removal Card-2 - Peri-operative beta-blocker therapy for pre B blocker Rx VTE-2 - VTE prophylaxis within 24 hrs prior to or after anesthesia end 9 - Remove urinary catheter by potop day 2 10 - Temperature >96.8 F 15 minutes after anesthesia end time

Answer 8

1. Given on time: 1 hour before incision, 2 hours Vancomycin and Levaquin, Ceflosporin 2. Appropriate selection of antibiotic 3. Discontinued within 24hrs after anesthesia end time except 48 hours for cardiovascular surgery

Answer 9

- provider must document reason to extend if applicable (ie infection, suspected infection) - why? antibiotic must be present at time of fibrin formation (at surgical incision) for effectiveness

Answer 10

- broad spectrum of activity against both gram-positive and gram-negative - wide range of therapeutic to toxic dose - inexpensive and easy to administer - allergic rxns are rare - after an incision is closed, antibiotics have no appreciable effect of preventing infections

Answer 11

Blood glucose

Answer 12

Hair Removal Surgical Site Preparation: - considered time sensitive - usually an anti-infective shower the night before and the morning of surgery - clippers in OR only- no other option - why? shaving with a razor causes microscopic skin abrasions which may lead to infections

Answer 13

Foley D/C - discontinued by postop day 2 OR - physician, PA, APN documented reason to continue beyond day 2 (ie: pts with urologic, gyne, perineal op) - why? risk of UTI with increase use of urinary catheter

Answer 14

****Beta Blocker - continue if patient on home beta blocker therapy - beta blocker may be given 24 hours prior to op or day of procedure - beta blockers in the morning - HR must be >= 50 - SBP must be >= 100

Answer 15

physician, PA, APN reason must be documented why: perioperative myocardial ischemia has been identified as the #1 risk factor for mortality after non-cardiac surgery - attributed to the exaggerated sympathetic response leading to persistently elevated HR - Has the potential to significantly reduce cardiac deaths for up to 2 years postoperatively

Answer 16

Timing of VTE Prophylaxis VTE (Venous Thromboembolism) Prophylaxis - Mechanical and/or pharmacological prophylaxis is ordered according to VTE risk assessment tool and type of surgery - Prophylaxis is given 24hrs prior to surgery or within 24 hours after anesthesia end time (guidelines on back of checklist)

Answer 17

provider documentation required if contraindicated (ie open wound, bleeding risk) -reduces the risk of development of PE and DVT

Answer 18

Normothermia - temperature management - At least >= 96.8 F/36 C within 15 minutes of anesthesia end time or warmer used in OR

Answer 19

Provider documentation of intentional hypothermia - 3 times greater incidence of surgical site infections with hypothermia - Delayed wound closure which results in prolonged hospitalization

Answer 20

- Anxiety/Fear - Knowledge Deficit - Risk for Infection - Risk of Injury

Answer 21

- Look for cues of anxiety (physiological and behavioral) - Nurse can allay anxiety: * Therapeutic communication * Determine source of anxiety * Knowledge of the surgery, anesthesia, and their role * Educate and clear up misconceptions

Answer 22

many causes for fear - unknown: may be first surgery - pain and pain management - concern with body image/change in image - death - anesthesia - disruption of life: having to be dependent on others

Answer 23

1. Surgical Permit 2. Pre-op Screenings and examinations 3. foley catheter 4. Pre-op diet and fluid restrictions 5. Pre-op medications 6. skin prep 7. family support

Answer 24

included in knowledge deficit - completed by the physician and anesthesia - risks, benefits, complications - also what may occur without the procedure

Answer 25

- verify that the HC provider has discussed these and has obtained the persons signature - formulate pre-operative nursing diagnoses - usually witnessed by the RN

Answer 26

- Cough and Deep Breathing (incentive spirometer, air flow, anesthesia, prevent pneumonia, mucus build up, alveoli, opening them up for gas exchange) - Leg exercises (circulation, prevent DVT) - ROM - Patient movement (splinting incision with cough, early ambulation, compression devices) - Prevention of constipation (straining, anesthesia/narcotics causes) - Surgical incision care (keep dry, no creams/lotions, mederma)

Answer 27

- ensuring pt completed a chlorohexidine bath - use of clippers only to shave hair from surgical immediately prior to surgery, not day before (EBP), and only if absolutely necessary - insertion and dressing of IV using aseptic technique - bowel prep if indicated

Answer 28

- Client teaching completed - Consent form signed - NPO - in gown - Allergy and ID bands on - No jewelry-banded taped - voiding prior to transfer - pre-op meds - side rails up after pre-op - contact lens out - dentures/bridges out - nail polish removed - vitals within 4 hours of surgery or 30 minutes after pre-op - pre op labwork on chart - abnormal lab values - skin prep - hx of ASA, antidepressant, steroid, NSAIDs

Answer 29

- Labs: electrolyte, H/H, BUN/Cr, Type and cross coagulation, blood sugar, ABG's, total protein - CXR or other XR - EKG - Pulmonary studies - Pregnancy tests

Answer 30

Purpose: - facilitate effective anesthetics - minimize respiratory tract secretions - induce relaxation - reduce anxiety

Answer 31

Instructions on what to do with routine, prescribed medications

Answer 32

Narcotic Analgesic Use: Administered to control moderate to severe pain during intraoperative and postoperative phase and can also be used for patient sedation Nursing considerations: -monitor for decreased LOC, which will eventually lead to respiratory depression - monitor for decreased BP (tissue perfusion) - opiate OD can be treated with Narcan/Naloxone

Answer 33

Use: decrease N/V when given during preoperative phase and decrease N/V from anesthesia when given during postop phase Nursing considerations: - monitor fluid and electrolytes - monitor for diarrhea which is an adverse effect - monitor for tachycardia and angina

Answer 34

inhibits gastric secretion by inhibiting the action of histamine in the gastric parietal cells - prevent peptic ulcers - NPO, not eating and stomach still produces hydrochloric acid - decreases risk of stress ulcers - can be given IVP over at least 5 minutes, so usually given as an IVPB - monitor renal function

Answer 35

Use: used to decrease mild or moderate pain. Lowers the patients pain level in the post op phase. Given in both the pre-op and post-op phase Nursing Considerations: -Watch pt for S/S of hepatotoxicity -Monitor labs for liver function abnormalities

Answer 36

Uses: sedatives to relax the patient (does not relieve pain) Benzos depress the CNS leading to sedation, skeletal muscle relaxation and anticonvulsant activity Nursing considerations: - Watch for adverse CNS effects like sedation - Antidote for sedatives is Flumazenil (Romazicon) - Watch baseline and regular liver function tests - Give during the pre-op and intra-op phase

Answer 37

decreases oral and respiratory secretions by inhibiting action of acetylcholine in smooth muscle and the CNS - dry up secretions (facial, lung, oral, colon surgeries) - causes pupil dilation, use cautiously in pts with glaucoma - increases HR, use cautiously in pts with cardiac issues

Answer 38

Use: fight bacterial infections and lower the risk for surgical site infections Nursing considerations: - watch for anaphylaxis - monitor renal, hepatic, and VS - give during pre-op, intra-op and post-op phases

Answer 39

Opiate/Narcotic Analgesic

Answer 40

Opiate/Narcotic Analgesic * *Strongest narcotic * 100x stronger than morphine

Answer 41

Dilaudid Opiate/Narcotic Analgesic **10x stronger than morphine

Answer 42

Zofran Antiemetic **going to work within first 2 times you give it. Don't give it more than twice if it doesnt work - preferred over phenergan due to LOC and loopy - expensive

Answer 43

Phenergan - IV and needs to be diluted, push very slowly - can cause necrosis in veins - Mid forearm up - comes in suppository Antiemetic

Answer 44

Tagamet H2 Receptor Antagonist

Answer 45

Pepcid H2 Receptor antagonist

Answer 46

Zantac H2 Receptor Antagonist

Answer 47

Tylenol Non-narcotic Analgesics

Answer 48

Versed **Amnesic effect and no hangover feeling -chosen more often over valium Anti-Anxiety

Answer 49

Valium Anti-Anxiety

Answer 50

Atropine **drug of choice for bradycardia Anticholinergics

Answer 51

Scopolamine *comes in a patch behind ear Anticholinergics

Answer 52

Robinul Anticholinergics

Answer 53

Ancef Antibiotic

Answer 54

mefoxin Antibiotic

Answer 55

Unasyn Antibiotic

Answer 56

Antibiotic

Answer 57

- if medicated, don't let client walk or get out of bed - raise be to stretcher height - assist client to locked stretcher - Secure safety strap or raise side rails - transport chart with client

Answer 58

- vomiting with anesthesia | - can't protect airway, no gag reflex

Answer 59

- Call the surgeon - Call anesthesia - Call OR - Reschedule & place back on NPO - signs everywhere - talk with family - wait to hear back from surgical team

Answer 60

- from holding room into surgery and admission to the recovery room - very high risk area for the patient. High potential for errors, life threatening situations and complications are greatly increased. - There is constant monitoring of the patient and environment

Answer 61

- Anesthesiologist - Nurse Anesthetist - Anesthesia tech - Circulating RN - Surgical tech - Surgeons - Radiology tech - OR tech - Orthopedic tech

Answer 62

sets up anesthesia equipment and restocks supplies

Answer 63

cleans room, assists with getting equipment

Answer 64

assists with traction set up, pt positioning, and casting

Answer 65

- plans and coordinates care in OR - Assists in setting up OR room (gathers supplies and equipment) - Opens instruments and supplies - Brings the patient to and from the pre-op area - Collects and verifies patient information - Verifies consent - Supports the patient and acts as the patient advocate - Anticipates and meets the needs of the surgeon, anesthesia, and scrub nurse - Monitors and controls the OR environment - Monitors blood loss with anesthesia - Documents nursing care and all equipment counts

Answer 66

- may be RN, Surg tech, or LPN - Assist in gathering supplies, equipment, and setting up the OR room - Set up and maintain the sterile field, hands supplies, and instruments to surgeons - Keeps count of sponges, sharps, supplies, and instruments - Monitors sterile technique

Answer 67

- Risk for injury - Risk for infection - Altered protection - Risk for impaired skin integrity - Altered body temp

Answer 68

- Ineffective breathing pattern - Ineffective airway clearance - altered tissue perfusion - Risk for aspiration - Risk for fluid volume imbalance

Answer 69

- in pre-op holding, pt confirms identity, site of surgery, procedure, and consent to Anesthesia and circulator - site marked when applicable with a surgical skin pen - Pre-op checklist is verified as complete - In OR, surgical team confirms pt identity, site of surgery, procedure and consent WITH SURGEON - X-rays are viewed when applicable for further confirmation

Answer 70

- all sponges and needles are counted at beginning of case, and again twice when closing of incision begins - instruments in trays are counted in procedures where large body cavities are open, such as with thoracic or abdominal surgical procedures

Answer 71

- 1920's Drs. Cushing and Bovie - electrical current to cut and coagulate fat, fascia, muscle, internal organs, and small blood vessels - decreases the amount of diffuse bleeding - have to "ground the patient" Bovie pad - electrical burns through the patient's skin is the greatest hazard of elctrosurgery

Answer 72

- done to provide optimum exposure and access to the operative site - should sustain body alignment, circulatory and respiratory function - must provide access to the IV and airway - should not compromise neuromuscular structures and skin integrity

Answer 73

can wear street clothes

Answer 74

scrubs and hats required for all staff and patients

Answer 75

- area where surgical procedures are performed | - scrubs, hats and masks requried

Answer 76

- Handwashing - Laminar air flow to reduce air currents - HEPA filters in air ducts - Sterile field is created and maintained throughout surgical procedure

Answer 77

- Purpose (make the operative site as free from microorganisms and dirt as possible) - Hair removal should be done in pre-op area (use of clippers only) - Start at area where incision will be made and move outwards in a circular motion - Move from clean to dirty - A scrubbing/soapy solution may be used followed by a paint solution (Betadine) - Prep should last 5 minutes - CV and Ortho preps should last 10 minutes - After reaching the prep area edges, a new sponge dipped in an antiseptic should be used beginning at the proposed incision site out to the edges again - Repeated 3 times

Answer 78

1. Local 2. Regional 3. General

Answer 79

- numbs a small area on the body - patient is awake and conscious - surgical site is injected with an anesthetic, such as lidocaine, into the SQ tissue in order to depress the superficial peripheral nerves

Answer 80

- blocks the feeling to a large part of the body - includes epidural and nerve blocks - reversible loss of sensation and/or movement when a local anesthetic is injected to block or anesthetize nerve fibers (Spinals, Epidurals, Caudals, or Major peripheral blocks such as aa brachial nerve block)

Answer 81

- reversible, unconscious state characterized by: - amnesia, - analgesia, - depression/loss of reflexes, - muscle relaxation, - homeostasis or manipulation of physiological functions

Answer 82

state of reduced consciousness which allows performance of unpleasant procedures while preserving protective airway reflexes and the ability to respond to verbal commands - amnesic, analgesic, and sedative agents are given - morphine and Midazolam (versed) - used for small procedures that also local block or scope procedures

Answer 83

- Inhales general anesthetics (nitrous oxide, Cyclopropane) - Inhaled liquids (Halothane, Enflurane, Isoflurane) - Intravenous Anesthetics (Pentothal/thiopental)

Answer 84

1. Induction 2. Maintenance 3. Emergence

Answer 85

begins with administration of anesthetic agents and positioning of the patient

Answer 86

lasts from positioning until the surgical incision is closed

Answer 87

begins from the time when the patient begins to "wake up" until being transferred to the PACU

Answer 88

- current techniques used to administer anesthesia - use of combining IV anesthetics, analgesics, amnesiacs, and inhalation drugs to achieve unconsciousness, skeletal muscle relaxation, pain relief and physiological homeostasis

Answer 89

- Anaphylactic rxn - Malignant hyperthermia - Hypotension - Fluid imbalance - Electrolyte imbalance - Hypthermia - Hypoventilation - Airway obstruction - Loss of sensation and/or movement from regional - Hematoma, infection, tissue trauma from regional/local - Inability to void from regional - drug toxicity - N/V

Answer 90

- initial assessment - focus on: - respiratory status - CV status - pain level - type of anesthesia given - temp - control of N/V - operative site assessment

Answer 91

- Pain - Ineffective breathing pattern - Ineffective airway clearance - Altered tissue perfusion - Risk for aspiration - Nausea - Risk for fluid volume imbalance - Risk for altered body temp - Alteration in sensory perception - Fear - Anxiety

Answer 92

- snoring - nasal flaring - accessory muscle use - intercostal retractions

Answer 93

-tongue occlusion

Answer 94

- chin lift/jaw thrust - stimulate the patient - insert oral airway - intubation

Answer 95

- CO2 >45mmHg - Extreme sedation - Decreased RR - Shallow respirations - HR & BP increase or decrease

Answer 96

- residual effects of anesthesia - pain - obesity - supine positioning

Answer 97

- stimulate the patient to take deep breaths - supplemental O2 - Elevate HOB - Place in lateral position (side, full lung expansion, left lateral is best) - Provide pain relief **Assess for hypovolemia and replace with appropriate fluids

Answer 98

- hypoventilation/mechanical ventilation - mucus plugs - decreased surfactant production - constant recumbent position - ineffective coughing - hx of smoking

Answer 99

development of pneumonia

Answer 100

- HOB elevated 30 degrees - O2 therapy as ordered - coughing and deep breathing q1hr - incentive spirometer q1hr - incisional splinting - changing position q1-2hr - early ambulation - adequate hydration

Answer 101

- BP >160/90 - causes: pain, anxiety, full bladder, pulmonary emboli, hypervolemia, hypothermia, hypoxemia - treatment: treat the cause and give quick acting antihypertensives

Answer 102

- due to increased platelet production - fluid volume deficit - high risk for venous thromboembolism (VTE) Common in: - elderly - obese - immobilized patients

Answer 103

- Accurate I and O - Monitoring of electrolyte levels - close monitoring of IV therapy replacement - promote early, progressive ambulation - prophylaxis for VTE (Heparin or LMWH, intermittent compression devices (ICD's))

Answer 104

- alteration in tissue perfusion and impaired gas exchange - occlusion of a portion of the pulmonary bed by an embolus - emboli may be: thrombus (blood clot), tissue fragment, lipids, air bubbles - most common DVT in thigh - may originate in the pelvis particularly during pregnancy

Answer 105

Developmental: - childbirth - pregnancy - birth control pills - older adults with hx of A-fib or heart valve disease - trauma/surgery - cancer Sociocultural: - sedentary lifestyle - overweight - smoking - drug abuse - dehydration - hypertension

Answer 106

- most common pulmonary complication in the hospitalized patient - identify those at risk - give heparin or LMWH - teach prevention measures

Answer 107

- sudden onset of dyspnea - increase in HR and RR - chest pain - hemoptysis - crackles - fever - accentuation of pulmonic heart sounds - sudden change in mental status

Answer 108

- pulse ox - ABGs - Blood Coagulation studies - EKG - CT Scan (spiral) - Pulmonary angiogram - V/Q scan

Answer 109

- two part test. Ventilation and arterial perfusion - approx time of scan 45 min - 1.5 hours - ventilation may use radioactive gas or aerosol - perfusion: injection of radioactive material, pulmonary circulation system scanned yielding a map

Answer 110

- made by comparison of ventilation to perfusion - 3 possibilities: 1. low probability (normal) 2. indeterminate or intermediate (non-diagnostic) 3. high probability (definite PE) -a current CXR is required with V/Q (w/in 24 hrs or less)

Answer 111

- stay with patient - thorough assessment - call doctor - provide pain relief measures - prepare patient for diagnostic tests as ordered - bedrest

Answer 112

- monitor ABGs - monitor continuous pulse ox - O2 and be prepared for ventilator use - place in semi-fowlers position - may give bronchodilator - TCDB to prevent or treat atelectasis - bedrest

Answer 113

- mild analgesics such as ASA or Codeine - If crushing pain may order morphine sulfate - may need an anti-anxiety if patient very fearful - elevate affected leg

Answer 114

- assess for S/S right sided heart failure (Cor Pulmonale) - Digoxin - Diuretics - Vasopressors if in shock

Answer 115

- will be started on Heparin drip immediately then transitioned to Coumadin for 3-6 months - dosage of Heparin is adjusted according to PTT levels

Answer 116

prevents the conversion of fibrinogen to fibrin, potentiates the action of anti-thrombin III, and inhibits the activation of factor IX and neutralized activated factor X

Answer 117

-given continuous IV infusion after initial bolus dose, given for up to 7 days until Coumadin PO has been given for a few days and the PT is 1.5 to 2 times the control

Answer 118

inhibits hepatic synthesis of Vitamin K (Factors II, VII, IX, and X depend on Vitamin K)

Answer 119

- given PO depending on PT levels - given same time each day - tablets may be crushed - dietary concerns: green leafy veggies - antagonist is Vitamin K (AquaMephyton)

Answer 120

- intracaval devices - embolectomy - thrombolytic agents

Answer 121

- rehab care, home care, or long term care - focus is limiting progression and supporting patient with followup care - assess for new problems and medication and dietary compliance - teaching should focus on lifestyle changes, prevention of thrombophelitis, medication administration and followup care

Answer 122

- reason and length of therapy - need to take med at same time every day - close followup for frequent lab work - side effects requiring medical attention - use medical alert bracelet - notify dentist of medication use - NO ASA, NSAIDs or alcohol - avoid trauma, no contact sports - use electric razor - consult doctor when taking new meds - consult pharmacy when choosing OTC medications - watch amount of green leafy vegetables

Answer 123

- must know what anethetics and analgesics were given in OR - need to adjust pain med dose and assess RR - get pt temp to normothermic - touch and repositioning may help

Answer 124

- Sublimaze/Fentanyl - Hydromorphone/Dilaudid - Must have Naloxone/Narcan ready!

Answer 125

major CNS depression, used as supplement to general anesthesia

Answer 126

CNS depression, used for moderate to severe pain

Answer 127

- IV opioids provide most rapid pain relief - Sustained relief (ESI, PCA pumps, Regional anesthesia blockade) - First 48 hours: opioids - Thereafter: non-opioids (NSAIDs) - Times prior to activity

Answer 128

-body temp

Answer 129

bradycardia and shallow respirations

Answer 130

increase O2 demand

Answer 131

hypotension, metabolic acidosis, and cardiac dysrhythmias

Answer 132

- check for bowel sounds q 4hours - replace fluids & electrolytes as indicated to improve GI circulation - begin offering ice chips after assessing for return of gag reflex - advance diet slowly, ice chips, clear liquids, full liquids, then regular diet - may need to give soft diet for a day or two if throat sore from ETT of if pt had neck surgery - if NGT present, check patency and output q 4 hours, will be NPO, HOB >30 degrees

Answer 133

- may have fluid volume excess or deficit - monitor BP, HR q 5 minutes x4, then q 15 mins x4, then q 390 minutes while in PACU - On unit, VS q 15 mins x4, q 30 mins x2, and then q 4 hours for at least first 24 hrs post op - replace electrolytes as indicated - monitor K+, Na+, Mg++, and H & H levels - if NGT present, strict I & O required, asked physician and 1 to 1 NGT IVF replacement

Answer 134

less than 93%

Answer 135

less than 10

Answer 136

more than 120 BPM

Answer 137

hyper or hypotension

Answer 138

absence of peripheral pulses

Answer 139

less than 30mL

Answer 140

more than expected amount of bleeding at the incision site

Answer 141

prolonged unresponsiveness

Answer 142

- pt/family education and psychosocial support is throughout the process - return MD visit - dressing care and comfort - optimum circulatory and respiratory function, diet, meds (antibiotics and analgesics) - adequate hydration and body temperature - adequate renal function - safety in ADL

Answer 143

-anticoagulants (ASA, Warfarin/Coumadin, Heparin) -CNS depressants/Narcs/Opioids (anesthesia, BP drops, accumulative effect) - Oral Hypoglycemics - Antihypertensives - Beta Blockers

Answer 144

fluid volume deficit -dehydration

Answer 145

**How much alcohol do you consume everyday? - psychology, more comfortable - laying it out there like its normal - real honest answer

Answer 146

kidney function -how well they are working

Answer 147

how well kidneys are hydrated

Answer 148

- BP was too low for too long - kidneys don't like it - abnormal BUN and Creatine

Answer 149

- heart - BS - affects healing - affects kidneys

Answer 150

adrenal storm -patient will get really hypertensive

Answer 151

- pain - sepsis - "normal" all in your "head" - goes on for months to a year

Answer 152

- feel vulnerable - no control over their body - strapped to table

Answer 153

secretions

Answer 154

- tell them pre-op - must be 14 days post op - need to be completely healed - 3 months of using everday

Answer 155

peritendinitis after surgery

Answer 156

oxygenation - O2 carrying capacity - less than 10, don't want to operate want to fix it first

Answer 157

- NPO - Not going to eat - hold insulin - NPH, hold - stop, hold meds, and call anesthesia - routine sliding scale diabetes has to be on hold pre-op, up to anesthesia

Answer 158

residual 150-200mL

Answer 159

at least have sensation

Answer 160

bradycardia

Answer 161

ineffective airway clearance

Answer 162

high pitched wheezing upper airway - retractions - audible without stethoscope - medical emergency

Answer 163

local epi effect in trachea - open up airway - if not, trach tray - S/E: HR increases - if working but not enough, IV steroids - same as anaphylaxis

Answer 164

when put on O2, O2 sat doesn't move

Answer 165

- lowers HR | - heart failure patients: decrease workload of heart and decreases oxygen demand

Answer 166

Under did it: less than 35 Did it right: 50-80 Over did it: over 120 Less than 35: Increase drip by 4u, give 80 bolus 35-49: increase drip by 2u, give 40 blous 50-80 no change 81-100: decrease infusion by 2u 100-120: decrease infusion by 3 u over 120: stop infusion, call doctor immediately *After any change in drip, repeat PTT in 6 hours

Answer 167

Protamine sulfate

Answer 168

paralytic illeus intestines do not wake up from anesthesia - food will sit in stomach - feel bad - bloated - more you feed, more bloated until throw up

Answer 169

blood transfusion not enough O2 carrying capacity -poor wound healing

Perioperative Nursing Flashcards

(197 cards)