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| A physician with specialized education and skills I. The admin of anesthesia and in monitoring the pt surgical procedure. |
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Curative: removes or repairs damaged or diseased body organs or structures and cure the pt.
ex: appendectomy, hysterectomy, fixation of fractures |
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| Certified registered nurse anesthetist |
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| CRNA- nurse with specialized education and skills in the administration of anesthetic agents and in monitoring pts during surgical and other procedures. Also skilled in managing pain and in placing vascular lines |
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Exploratory surgery: confirms the type and extend of the disease
Ex:laparotomy, joint exploration |
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Effectively produces analgesia is, relaxes muscles and result in a sleep like state. Admin eithe IV or inhalant. Inhalant gases are delivered from an anesthesia machine and face mask, endotracheal tube,laryngeal mask airway or endonasal tube.
-gas: nitrous oxide,oxygen,halothane,enflurane, isoflourane.
-IV: barbiturates, opioids, tranquilizer a, phenylcyclines
Muscle relaxants also administered and are especially beneficial in wound closure.
-close monitoring is necessary during induction, maintenance of and emergence from general anesthesia. |
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Obtained before any surgical procedure is an important legal document. Provide pt with all info needed to make decision about procedure, discussed in language or can understand, and obtains the pts signature on the consent form. If they don't speak English get them a translator.-discuss description of proposed surgery, risks and benefits, y it's indicated, probability of success, consequences of non surgical treatment or no treaent and any other info to help pt make informed decision.
Pt can ask any questions and withdraw consent at any time. Also lists names of surgeons and must be designed and dated with a witness.
-do not give any meds that may alter perception like preoperative meds opioids or barbiturates that alter cognitive abilities and invalidate informed consent
- if pt is unsure or indicates lack of understanding notify the surgeon so that more information is provided.
- the nurse is responsible for making sure that the consent form contains all correct and necessary information, is properly signed and witnessed, and is part of the pts medical record before surgical procedure begins |
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Depresses superficial peripheral nerves and blocks conduction of pain impulses from their site of origin
-type of regional anesthesia differentiated by the ppl responsible for administration. And monitoring. The surgeon applies it and the peri operative nurse monitors the physiological and psychological status of pt.
-methods: topical, injection.
-pts eligible are calm, able to cooperate with surgeon and have no systemic medical problems.
Advantages are decreased cost.
-nurse is totally responsible for monitoring pt. bp, loc, trying,O2, pulse rate and rhythm and maintaining patent IV access. |
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Malignant hyperthermia: a hyper metabolic disorder of skeletal muscle that can be induced by some anesthetic agents, including certain inhalant and muscle relaxants. It's an inherited disease manifested by masseter (jaw)rigidity and ventricular dysrhythmias which are associated with tachypnea, cyanosis, skin mottling, and unstable bp. These are followed by an increase in body temperature as a late sign.
Nurse must identify susceptble ppl and monitor muscle rigidity, vital signs, and body temp closely during and after surgery for all pts and have emergency meds and equipment immediately available.
-can result in cardiac arrest and death |
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Involves the use of IV sedation admin during surgical or diagnostic procedures to alter the patients conscious state, thereby allaying fear and anxiety. Combos of IV opioids and sedatives decrease consciousness but pt can still respond to verbal commands and maintain a patent airway.
-Valium, morphine, Demerol,versed.
-nurse is responsible for administering and monitoring pt. receive special training and validation of skills.assess physiological and psychologically, monitoring for reaction to the drugs. A working knowledge of resuscitation a and monitoring equipment and the ability to interpret data obtained is crucial
*have antagonists ready |
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Palliative: alleviates pain or other disease symptoms, slows progression of disease but does not cure
Ex: tumor debulking, nerve blocks, placement of feeding tubes |
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Smarize the patients preoperative prep. Provides preop baseline measurements like LOC,vitals, skin integrity and ensure all info is in pt record before transport. It is a quick way to show that all pt preparations activities have been accomplished and safety measures have been taken. The nurse usually checks off each item as it is compress and the. Signs the form in the appropriate place. Document is the completed according to protocol and pt is ready for transport to preop care unit.
-pt name band
-site n type of surgery
-location of valuables
-allergies
-appropriate dress of pt
-surgical consent of pt
-NPO status
-appropriate records and paperwork
-lab and diagnostic study results entered in chart
-blood availability
-preop med admin
-status of any addition physicians orders |
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| Post anesthesia care unit PACU |
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Definition
| Pacu: immediate post op care is usually given in this designated area of the hospital or ambulatory care facility |
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Reconstructive surgery: repairs physical deformities or improves appearance
Ex: rhinoplasty, mammon lastly, skin grafting |
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Regional anesthetic: produces decreased sensation and pain in selected body parts by way of nerve blocks, intrathecal blocks or epidural blocks.
Topical
Nerve block
Epidural
Spinal
Advantageous. Bc they avoid go and pulmonary complications of general anesthesia. Usually recover more quickly and can be used for post op pain control |
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Definition
Universal protocol for preventing wrong site, wrong procedure, or wrong person surgery. Recommended that once the pt is in the OR, the entire surgical team pause for a time out before starting any procedure to verify correct site, procedure and pt. the goal of surgical verification is to prevent avoidable errors by standardizing procedures for all surgical facilities, focussing on clear, active communication among all members of the perioperative team. Includes:
-correct if of the pt using 2 ids
-preoperative verification process: review of docs,diagnostic studies, lab tests In the pt record to check that they are consistent and agree with or verbalization and understanding of planned procedure
-marking of the surgical site, involving pt whenever possible
-check for implants
-check for the arrival of special instruments or equipment before surgery begins
-final procedural time out involving all meme era if the surgical team where final oral verification occurs, confirming that the correct pt is in the room and is positioned correctly and that the site and procedure is agreed upon before the incision is made |
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Term
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Definition
| final procedural time out involving all meme era if the surgical team where final oral verification occurs, confirming that the correct pt is in the room and is positioned correctly and that the site and procedure is agreed upon before the incision is made |
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| Transplant:replaces diseased or damaged body organs and structures with donated or artificial organs |
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Pre operative:all activities that prep the pt for surgery. It begins when the decision for surgery is made and ends when the pt is transferred to the OR
Intra-operative: includes all those activities that occur from the time the pt is transferred to the OR until he or she is transferred to a recovery facility
Post-operative: involves the period after the pt is discharged from the recovery facility and ends with the resolution of all surgical consequences. Post op phase may be short or long depending on the nature and extent of procedure and pt.s ability to recover from it. Immediate post op care usually is given in a PACU |
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