Wk 3 Intraoperative Care Flashcards Preview

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Flashcards in Wk 3 Intraoperative Care Deck (32)
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1
Q

When does the intraoperative phase end?

A

When they are transferred to PACU

2
Q

What does the circulating nurse in the OR do?

A

Not scrubbed, gowned, or gloved
Remains in unsterile field
Records all nursing care

3
Q

What does the scrub nurse do in the OR?

A

Follows designated scrub procedure
Gowned, gloved
Remains in sterile field

4
Q

When is site identification especially important?

A

Extremities
Laterality (right versus left)
Multiple structures
Levels of the body need surgical site markings by the surgeon

5
Q

What will be used as the surgical site marking?

A

The surgeons initials

6
Q

Where should the initials be?

A

As close to the actual incision site as possible

7
Q

What is a time out?

A

The entire surgical team will stop, verify and agree to a list of things before an incision is made

8
Q

What is verified during the time out?

A
Patient identity 
Surgical site
Level, laterality, or structure
Correct procedure
Patient position 
Availability of correct implants, special equipment of other requirements
9
Q

4 potential complications of improper patient positioning during surgery

A

Muscle strain
Joint damage
Pressure ulcers
Nerve damage

10
Q

What is also important during patient positioning?

A

Secure extremities

Add packing/support

11
Q

What is general anesthesia?

A

Inhalation or injection of anesthetic drugs that results in loss of all sensation and consciousness

12
Q

What are the 4 phases of general anesthesia?

A

Pre induction
Induction
Maintenance
Emergence

13
Q

What is regional anesthesia?

A

Medication instilled into or around a nerve to block transmission of nerve impulses in a specific region

14
Q

What are 4 examples of region anesthesia?

A

Nerve block
Bier black
Spinal
Epidural

15
Q

What is local anesthesia?

A

temporary loss of feeling as result of inhibition of nerve endings in part of body

16
Q

What is monitored anesthesia care?

A

Similar to general anesthesia, but it doesn’t involve inhaled agents. So they are conscious but sedated

17
Q

What is another term that is commonly used instead of monitored anesthesia care?

A

Conscious sedation

18
Q

4 intraoperative nursing considerations

A

Risk for infection
Risk for perioperative positioning injury
Risk for injury
Risk for imbalanced body temperature (hypothermia)

19
Q

What is malignant hyperthermia?

A

Inherited muscle disorder that is triggered by certain types of anesthesia that may cause a fast acting life-threatening crisis

20
Q

What is the incidence of malignant hyperthermia?

A

Incidence is low but if it goes untreated mortality is high

21
Q

What do you not see initially with malignant hyperthermia?

A

You don’t initially see a high fever

22
Q

The trigger for malignant hyperthermia results in what?

A

unregulated calcium accumulation

23
Q

What is the first thing you will see in a patient experiencing malignant hyperthermia?

A

Sustained muscle contraction in the masseter muscle

24
Q

Where is the masseter muscle?

A

Lateral sides of the mandible

25
Q

You might see breakdown of the masseter muscle which is called…

A

rhabdomyolysis

26
Q

What else will you see with malignant hyperthermia?

A

Anaerobic metabolism and metabolic acidosis

27
Q

What is the most common initial sign of malignant hyperthermia?

A

Unexpected increase in end-tidal CO2

28
Q

What are the early presentations of malignant hyperthermia?

A

Hypercarbia
Sinus tachycardia
Masseter or generalized muscle rigidity

29
Q

What is not a presenting sign of malignant hyperthermia?

A

Hyperthermia

30
Q

What is unique about patients who do experience malignant hyperthermia?

A

90% of them do not have a family history of malignant hyperthermia

31
Q

About 50% of patients who experience malignant hyperthermia under anesthesia had had….

A

uneventful general anesthesia in the past

32
Q

What is the antidote for malignant hyperthermia?

A

dantrolene IV