Wk 3 Intraoperative Care Flashcards

(32 cards)

1
Q

When does the intraoperative phase end?

A

When they are transferred to PACU

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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

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3
Q

What does the scrub nurse do in the OR?

A

Follows designated scrub procedure
Gowned, gloved
Remains in sterile field

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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

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5
Q

What will be used as the surgical site marking?

A

The surgeons initials

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6
Q

Where should the initials be?

A

As close to the actual incision site as possible

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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

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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
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9
Q

4 potential complications of improper patient positioning during surgery

A

Muscle strain
Joint damage
Pressure ulcers
Nerve damage

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10
Q

What is also important during patient positioning?

A

Secure extremities

Add packing/support

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11
Q

What is general anesthesia?

A

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

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12
Q

What are the 4 phases of general anesthesia?

A

Pre induction
Induction
Maintenance
Emergence

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13
Q

What is regional anesthesia?

A

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

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14
Q

What are 4 examples of region anesthesia?

A

Nerve block
Bier black
Spinal
Epidural

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15
Q

What is local anesthesia?

A

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

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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
You might see breakdown of the masseter muscle which is called...
rhabdomyolysis
26
What else will you see with malignant hyperthermia?
Anaerobic metabolism and metabolic acidosis
27
What is the most common initial sign of malignant hyperthermia?
Unexpected increase in end-tidal CO2
28
What are the early presentations of malignant hyperthermia?
Hypercarbia Sinus tachycardia Masseter or generalized muscle rigidity
29
What is not a presenting sign of malignant hyperthermia?
Hyperthermia
30
What is unique about patients who do experience malignant hyperthermia?
90% of them do not have a family history of malignant hyperthermia
31
About 50% of patients who experience malignant hyperthermia under anesthesia had had....
uneventful general anesthesia in the past
32
What is the antidote for malignant hyperthermia?
dantrolene IV