Pre-Operative
What types of medications would likely be held prior to surgery?
Blood Thinners/Anticoagulants
NSAIDS
Multivitamins (Vitamin D & E)
Fish oils
Herbal Supplements
Certain Diabetic Medications (Especially Metformin)
What are the types of anesthesia?
Regional
Local
Moderate
and General
What should be included in a patient's discharge instructions?
Potential anesthesia side effects and considerations
When to contact the surgeon (complications)
Activity restrictions
Diet restrictions
How to manage incisions or any medical devices (ex. foley catheter, drains)
What type of anesthesia is delivered topically or by injection and only numbs the area that it's applied?
Local Anesthesia
Which type of surgical procedure uses multiple smaller incisions and requires the abdomen to be filled with gas?
Laparoscopic
What type of testing is commonly done prior to a surgical procedure?
Pregnancy Tests
PT/INR/PTT (coagulation studies)
ECG
Complete Blood Counts (WBC, RBC, Hemoglobin, Hematocrit, etc.)
Basic Metabolic Panel
What drug is used to treat malignant hyperthermia?
Dantrolene sodium
What should be done if evisceration occurs?
If evisceration is found, the nurse should manage by immediately notifying the provider, having the client remain calm, and covering the wound with a nonadherent dressing pre-moistened with sterile normal saline.
This type of anesthesia blocks multiple peripheral nerves and reduces sensation in a specific body region.
Regional Anesthesia
Which type of surgical procedure requires one large incision and has a higher infection rate?
Open
What must a patient be told for an Informed Consent?
Informed Consent-Refers to the process in which the patient has been informed of the following:
•Nature of and reason for surgery
•Who will be performing the surgery and if others will be present during the procedure (ex: students, vendors)
•All options and the benefits and risks of each option
•Risks associated with the surgical procedure and potential outcomes
•The risks associated with anesthesia
•The risks, benefits, and alternatives to the use of blood or blood products during the procedure
What are the signs and symptoms of malignant hyperthermia?
Elevated Temperature, muscle rigidity, tachycardia, tachypnea
•Abnormal heart rhythms, nausea, and vomiting may occur.
When can a patient discharge after inpatient surgery?
Goals that must be met:
Patient has achieved tolerance of oral intake
Recovery of lower gastrointestinal function
Adequate pain control with oral analgesia
Ability to mobilize and self-care
No evidence of untreated medical problems
This type of anesthesia is used for minor surgical procedures such endoscopy, cardiac catherization, cardioversion, and minor surgical procedures.
Moderate Sedation
What two things are done before surgery to decrease infection?
Antibiotic is given and a chlorhexidine gluconate (CHG) bath
What must be included on the informed consent document?
-Patient’s Full Name
-Surgeon’s Name
-Specific Procedure (s) to be performed
-Signature of the Patient, next of kin, or legal guardian
-Witness (Usually the Nurse)
-Date
What are the most common intraoperative complications?
Overdose
Anaphylaxis
Respiratory Depression
Complications fron Intubation
Aspiration
Hypo/Hyperthermia
Increase intracranial pressure
Fluid & Electrolyte Imbalances
Hypovolemic Shock (bleeding)
Malignant Hyperthermia
Who is allowed to be the first person to remove the dressing and check a surgical wound?
This type of anesthesia can be given through inhalation, intravenously or both and the deepest sedation offered.
General Anesthesia
A final count of all equipment used
Why is it important for a patient to remain NPO at least 8 hours prior to surgery?
There is a risk of aspiration due to anesthesia having nausea side effects.
What must be included in a Safety Time Out?
1.Confirm Patient ID, DOB and Procedure
2.Review Patient’s Position
3.Review Patient’s Allergies
4.Verify Surgery & Anesthesia Consent
5.Verify History and Physical Update
6.Confirm Site is marked by surgeon
7.Ensure Necessary Equipment Available
8.Verify Antibiotic Given & Time
9.Review DVT Prophylaxis Given
10.Query Expected Blood loss
11.Review Patient Temperature and Glucose
12.Review Fire Risk Assessment
What are the most common postoperative complications?
DVT & Pulmoinary Embolism
Pneumonia & Atelectasis
Paralytic Ileus, Gastric Dilation & Constipation
Infection
Hypovolemic Shock & Hemorrhage
Urinary Retention
Dehiscence and Evisceration
Malignant Hyperthermia is most likely to occur with what type of anesthesia?
General Anesthesia
A minimum of how many sets of vitals must be obtained in the PACU, and how often?
At least 4 sets of vitals, 5 minutes apart from each other.