Drugs
Perioperative
Anesthesia
Pain Management
Nurse's Role Grab Bag
100
Avoid these drugs before surgery.
What are insulin, oral hypoglycemics, some NSAIDS (like ASA) and anticoagulants (like heparin and warfarin). NSAIDS may be avoided for 10 days to 2 weeks, coumadin 7 -10 days before and heparin within a few hours before surgery.
100
What ages of patient is less adaptive to fluid loss and more likely to suffer from dehydration post op?
What is an infant or an elderly patient.
100
Pain relief without producing anesthesia (or absence of normal sensation).
What is analgesia.
100
Sudden onset, relatively short duration, mild to severe intensity with a steady decrease in intensity over a period of days to weeks. Once noxious stimulus is resolved, pain usually disappears.
What is acute pain.
100
Give these with just enough water to swallow them, even if surgery is scheduled for early that morning. This is especially important for a client with DM, heart disease or HTN.
What are daily oral medications.
200
Sometimes given by anesthesiologist prior to surgery to decrease oral secretions and prevent aspiration.
What is atropine.
200
What two allergies do we imperatively assess for preop?
What are iodine and latex. If an allergy to either is confirmed, it must be documented and surgeon must be informed.
200
Prevents any sensation of pain and temporarily eliminates or diminishes the client's ability to control many essential physiologic functions such as respiration, heart rate and temperature regulation.
What is anesthesia.
200
Elevated BP, elevated RR, elevated PR, dilated pupils, perspiration, pallor.
What are physiological responses to pain. Cannot be sustained for long. Body will show adaptation within minutes or hours EVEN WITH CONTINUING PAIN OF THE SAME INTENSITY.
200
The nurse knows that, as a regional block wears off, these 3 types of functioning return in this order.
What are motor function, sensation and sympathetic nervous function (as observed as ability to maintain normal blood pressure when getting up -- no fainting).
300
This type of drug may ease the transition into general anesthesia.
What is a sedative. A sedative reduces stress, excitement or irritability and involves some level of CNS depression.
300
What is the purpose of the surgical hand scrub?
Removes soil and transient microorganisms from skin surface. Skin can never be "sterile."
300
Different sedatives given in combination -- having a greater effect on the client than any one of the sedatives given alone.
What is synergism, or "synergistic effect."
300
First theory recognizing that psychological aspects of pain are as important as physiologic. Cognitive, sensory and emotional components, in addition to the physiologic aspects can act on a gate control system to block the individual's perception of pain.
What is the Gate Control Theory.
300
The nurse notices shivering for these two reasons postoperatively and applies a warming blanket to her patient in the PACU.
What is hypothermia and anesthesia emergence.
400
Two common benzodiazepines used as sedatives to ease the induction of general anesthesia.
What are diazepam (Valium) and midazolam hydrochloride (Versed). (Opiods like morphine and Fentanyl are more effective if the clients pre-op anxiety is related to pain sensation. By reducing the pain, anxiety is reduced as well.)
400
The other name for the Postanesthetic Recovery Score -- which is used to objectively assess the physical status of client recovering from anesthesia and serves as a basis for discharge from the PACU.
What is the Aldrete Score.
400
Risks of general anesthesia.
What are airway obstruction, respiratory arrest and aspiration of gastric contents.
400
Relaxation techniques and reframing are examples of what type of pain intervention?
What is noninvasive.
400
For someone with this condition, the nurse would ensure adequate hydration, provide analgesics and ensure bed rest in a supine position. Ensuring consent for a epidural blood patch may also be necessary.
What is postdural puncture headache (PDPH).
500
Drug used to reverse the effects of CNS depressant.
What is Narcan (naloxone hydrochloride).
500
Postoperative complication where the wound separates completely and the viscera protrude from the wound.
What is evisceration.
500
Headache caused by loss of CSF from around the brain.
Postdural puncture headache (PDPH). When CSF leaks out through a hole made in the dural membrane during performancfe of a subarachnoid block or an accidental dural puncture during the attempted performance of an epidural block.
500
Age, previous experience with pain and cultural norms.
What are factors that influence pain perception.
500
The nurse has the responsibility of assessing for this common complication of spinal or epidural block, especially if the block was higher in the spinal column. The nurse will be careful when getting client up for the first time.
What is orthostatic hypotension.
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