Blood Product Administration
The RN must remain with the patient for the first ___ mins of the transfusion to observe for transfusion reaction symptoms.
5 minutes
What is crepitus?
Crackling under skin, indicator of subq emphysema
During the administration of a nerve block, aspiration is performed to?
Ensure that the block needle is not inside a vein or artery.
The patients will be instructed to drink how many ounces of Gatorade the evening before surgery?
20 oz
Topical anesthesia only-due to systemic toxicity and addictive potential. This substance could have been found in Coca-Cola in the 1800s.
Cocaine
Transfusion must be initiated within how many minutes of the time it is released from the blood bank?
30 minutes, unless it in stored in a blood bank cooler. BB coolers must be returned with 8 hours of the time it is issued.
TRUE or FALSE: An RN must accompany the patient during transport and stay with the patient until another RN is ready to assume care.
True
"LAST" stands for Local Anesthetic Systematic Toxicity. Name 2 signs/symptoms of LAST.
Tinnitus, circumoral numbness, altered mental status, seizures, cardiac arrhythmias, metal taste in mouth, confusion, dizziness, drowsinesss,
Information on weight limit capacity for equipment can be found where?
PAH Intranet-Bariatric website and Safe Patient Handling
This opioid antagonist can treat respiratory depression from a narcotic overdose.
Narcan
What is the purpose of using a blood filter administration set?
To retain blood clots and particles potentially harmful to the patient. Fill the drip chamber just enough to cover the filter.
In case of accidental removal of the chest tube, the RN will cover the insertion site with what?
Sterile 4x4 gauze, tape securely on 3 sides.
The Patient must meet the following criteria prior to initiation of epidural infusion (3 answers).
Stable VS, Patent IV access, bilat dorsi-plantar flexion
Name three PRIMARY post-op complications that the RN will assess for in the post-op bariatric patients?
Anastomotic leak, PE/DVT, stricture or bowel obstruction, wound infection, post-op bleed, perforation, hypovolemia
This anesthetic can induce a dissociative state, causing an "emergence phenomena" with hallucinations, vivid dreams, and delirium.
Ketamine
What is the frequency of vital sign documentation? (4 answers)
Prior to the start of transfusion, 15 min after the start of transfusion, 45 min after the start of the transfusion, and at the completion of the transfusion
In the water seal chamber, what is the RN assessing for?
Fluctuation with respiration "tidaling". No fluctuation indicates expansion of lung or clot formation in the system.
The Patient must remain in the PACU for a minimum of ___ min after initiation Epidural Infusion.
30 minutes
It is best to have the appropriate size of equipment for the Bariatric population. Name 4 pieces of equipment that can be considered for bariatric use.
Blood pressure cuffs, scale, gowns, beds, wheelchairs, chairs, commode, walkers
Name two Muscle Relaxants.
Rocuronium, Succinylcholine, Vecuronium
Patients receiving blood and blood products can be transported away from the patient care unit after blood products have been infusing for at least ___ minutes and the patient does not exhibit signs of a transfusion reaction.
30 minutes
During patient transport, the RN will bring what supplies with them?
Hemostat, occlusive dressing, and 4x4 gauze
Treatment for LAST includes? (Name at least 3 interventions)
Stopping the local anesthetic, administration of Intralipid, 100% O2
An Anastomotic leak is a leak at the staple line for Gastric Sleeves or at the connection of the G/J (gastrojejunal) anastomosis. What are signs and symptoms of an Anastomotic Leak?
Worsened abdominal pain/abdominal distention, fevers, tachycardia, hypotension, tachypnea, decreased urine output
This depolarizing muscle relaxant can cause Malignant Hyperthermia.
Succinylcholine