Pre-Op
Performed within the surgical suite to prevent wrong patient, wrong site injuries
What is a timeout?
1000ml fluid bolus given in PACU, cough, coarse lung sounds, 2+ edema in lower extremities
What is hypervolemia?
Bonus: Nursing interventions?
This classification of medication is often given pre-operatively for its anti-anxiety and sedative effects
What is a benzodiazepine?
Bonus: what is the reversal agent?
OR clients with VTE prophylaxis, OR clients with beta-blocker therapy, OR clients with appropriate hair removal
What are SCIP measures?
Bonus: Provide examples
Genetic muscle disorder related to surgical complications
What is Malignant hyperthermia?
These are your priority assessments for any patient in post-anesthesia care
What is ABC: Airway, Breathing, Circulation Bonus: How do you assess these?
ABG results:
pH:7.58
CO2: 40
HCO3:33
PaO2: 93
What is metabolic alkalosis?
Bonus: Causes?
N/V/NG suctioning increased antacid use, diuretics
Acid-base imbalance caused by anesthetics, opioids, muscle weakness
Respiratory Acidosis
Bonus: what electrolyte abnormality is commonly seen in acidotic clients?
A patient who is having ANY surgery should always receive teaching on this in the pre-op stage.
What is coughing and deep breathing
What is leg exercises
What is incentive spirometer
In this step, the patient's identification, surgical site marking, signed consent and procedure to be done are all verified
What is a time out?
PACU client: Morphine PCA, difficult to arouse, O2 saturation-87%, RR-9
What is Respiratory depression due to opioids?
Bonus: what is a reversal agent for opioid induced respiratory depression? Other nursing interventions?
Causes for this electrolyte imbalance include NPO, nausea, vomiting, diuretic use
Two possible answers
What is hypokalemia?
What is hyponatremia?
Naloxone
What is reversal of opioid medication?
Factors that increase surgical complications include:
What is older age? What is infection?
What is diabetes, chronic diseases?
What is drug/tobacco/alcohol use?
Client vital signs 10 minutes into surgery: CO2-65, O2 saturation-83%, HR-126, RR-32
What is the nurses first intervention?
Assist with stopping the procedure
Malignant hyperthermia.
Triggered by anesthetic agents. Elevated temp is a late sign. Bonus-treatments?
Chart 15-1 pg. 260
The surgeon usually performs the first of these post-op
What is dressing change?
Bonus: what does the RN do if it becomes soiled/saturated?
Parasthesias, cramping, decreased bone density are manifestations of this electrolyte imbalance
What is hypocalcemia?
Bonus: What is the most serious complication of hypercalcemia?
CV changes, increased BP/HR
Early ambulation helps reduce these three potential problems after surgery
What is atelectasis/pneumonia, deep vein thrombosis, and constipation (paralytic ileus)
This population group are susceptible to anesthetic agents, decreased kidney and liver function, increased number of co-morbidities
What are older adults
Dantrolene Sodium 2 to 3mg/kg
What is treatment for MH?
Post-op complication related to opening of surgical incision and/or protrusion of organs
Dehisicense and eviseration
Bonus: what are nursing interventions?
Alterations in this electrolyte, both high and low, put a patient at risk for cardiac arrhythmias
What is potassium?
Bonus: What is the normal range?
Vital signs 1 hour post op: BP-82/50, HR-123, RR-29, Blood loss in OR est. 1,000ml.
What is hypovolemia/FVD?
Bonus- causes & treatments