Term
|
Definition
| Pain, discomfort, the unknown, mutilation, death, anesthesia, disruption of life pattern |
|
|
Term
| Pre-op interview components |
|
Definition
pt and family history
meds
nutrition/herbs
allergies |
|
|
Term
|
Definition
head to toe assessment
know the patient's baseline
ordered lab work
ordered diagnostics |
|
|
Term
| new info that you need to share with Dr/anesthesia |
|
Definition
new dx
new med
new herb
pregnancy
|
|
|
Term
| what if pre-op pt has URI |
|
Definition
procedure should probably be cancelled
increased risk of larygnospasm, bronchospasm, decrease saO2 |
|
|
Term
| what if pre-op pt has hx of dyspnea, coughing, hemoptysis |
|
Definition
| bring to the attention of operative team |
|
|
Term
| what if pre-op pt has COPD |
|
Definition
| emphasize importance of deep breathing, increased risk of atelectasis and hypoxemia |
|
|
Term
| what if pre-op pt is a smoker |
|
Definition
| try to get them to quit 6 wks before surgery, will decrease complications |
|
|
Term
| what if pre-op pt has hx of urinary/renal problems |
|
Definition
tell op team
f & e imbalances
coagulopathies
infection risk
impaired healing
renal function tests
I&O |
|
|
Term
| what if pre-op pt has arthritis |
|
Definition
| ambulate later in the day |
|
|
Term
|
Definition
what to expect
demonstrations (spirometry)
pain management
|
|
|
Term
| after administering pre op meds.... |
|
Definition
| don't let the pt get out of bed |
|
|
Term
|
Definition
sedatives/amnesiacs
anticholinergics
opioids
antiemetics
antibiotics
meds for preexisting conditions |
|
|
Term
|
Definition
versed, valium, ativan
↓anxiety, induce sedation, amnesia |
|
|
Term
|
Definition
atropine,scopolamine
↓resp & oral secretions, prevent bradycardia
prevent n & v |
|
|
Term
|
Definition
morphine, fentanyl
↓anesthesia requirement, pain |
|
|
Term
|
Definition
| prevent post-op infection |
|
|
Term
| what abnormal sign is normal post-op |
|
Definition
increase RR
d/t atelectasis |
|
|
Term
decreased LOC post-op:
normal or abnormal? |
|
Definition
| normal, the goal is "arousable" |
|
|
Term
| post-op positioning of pt |
|
Definition
|
|
Term
|
Definition
patient awake or arousable
vs stable
no excess bleeding/drainage
no resp depression
O2 sat above 90
report given |
|
|
Term
| Ambulatory surgery discharge criteria |
|
Definition
PACU criteria and:
no IV narcotics in the last 30 min
minimal n&V
voided
able to ambulate
RESPONSIBLE ADULT to accompany pt
discharge instructions given and understood |
|
|
Term
| when pt arrives from surgery... |
|
Definition
take VS
LOC
hook up monitors
observe dressings,drainage
get report
|
|
|
Term
| do not accept a PACU pt unless... |
|
Definition
| they have a gag reflex, are stable, until you have assessed them yourself |
|
|
Term
| what should anesthesia/RN report to you when giving you a PACU pt |
|
Definition
| name, procedure, anesthesia used, reversal agents used, fluid loss/replacement, VS, problems, complications, preop condition, comorbidities, vent settings, pain management |
|
|
Term
|
Definition
| airway maintained, protective reflexes, normal spontaneous resp, ABGs normal, no aspiration, HR & BP stable and returning to preop value, body temp WNL, good urine output, normal blood volume, easily arousable, moves purposefully with normal strength |
|
|
Term
| progression of re-establishment of oral intake |
|
Definition
| NPO-ice chips-jello-clear liquid-broth |
|
|
Term
| when can oral intake be re-established |
|
Definition
| protective reflexes return |
|
|
Term
| when can enteral intake be re-established |
|
Definition
|
|
Term
| when can parenteral intake be re-established |
|
Definition
|
|
Term
|
Definition
| pain, nausea, risk for infection, ineffective airway clearance, anxiety, constipation |
|
|
Term
|
Definition
hemorrhage
thromboembolism
urinary retention
paralytic ileus
hypoxemia
hypoventilation
hypotension
htn
dysrhythmias
hypothermia
malignant hyperthermia |
|
|
Term
|
Definition
↑sns, metabolism, O2 demand, stress
↓healing, sleep, cough and deep breathing ability |
|
|
Term
| children may exhibit pain.... |
|
Definition
| withdrawal, may be irritable |
|
|
Term
|
Definition
pain level,type, ability to be active(determines effectiveness)
resp depression, n&v, LOC, allergy
|
|
|
Term
| always verify at beginning of shift (pca pump) |
|
Definition
med
basal rate
dose
lockout |
|
|
Term
|
Definition
respiratory depression
n & v
sedation
allergic reaction |
|
|
Term
|
Definition
level of anesthesia
catheter
dressing
|
|
|
Term
|
Definition
how to report pain
HOB up
don't get up without help
assistance to turn |
|
|
Term
| local anesthetic adverse effects |
|
Definition
hypotension (vasodilation)
urine retention
toxicity (absorbed into blood) |
|
|
Term
| pt has resp depression what do you do |
|
Definition
|
|
Term
|
Definition
decreased bp
have pt lie with legs up (trendelenburg)
|
|
|
Term
| geriatric considerations with surgery |
|
Definition
length of surgery (over 2 hrs)
decreased senses (communication)
decreased compliance, alveoli
more energy to breathe
atherosclerosis, decreased heart function, compensatory mechanisms decreased, less blood volume
liver and kidney function lower, meds stick around longer, fluid electrolyte acid base imbalances,
postop delerium normal
fragile skin |
|
|
Term
|
Definition
| protein-liver-kidney-diet |
|
|
Term
|
Definition
decrease kidney=decreased concentration, ability to conserve water,
more loss through skin
decreased intake
|
|
|
Term
|
Definition
increased:BUN,creatinine,
protein,h&h,glucose,
serum osmolality
specific gravity
urine osmolality
|
|
|
Term
| isotonic solution given for |
|
Definition
|
|
Term
|
Definition
fluid restriction diuretics
na restriction |
|
|
Term
|
Definition
| thirst lethargy agitation seizure coma |
|
|
Term
|
Definition
| confusion n&v seizure coma |
|
|
Term
|
Definition
severe hyponatremia
(pt having seizures) |
|
|
Term
|
Definition
nerve impulses cardiac rhythm skel muscle contraction acid-base
|
|
|
Term
|
Definition
| K+ sparing diuretics renal failure increased intake tissue destruction acidosis |
|
|
Term
|
Definition
muscles weak
vfib
impaired cardiac depolarization
quick repolarization
abdom cramping, diarrhea-early indication |
|
|
Term
|
Definition
no oral/parenteral intake
diuretic/kayexalate
IV insulin
|
|
|
Term
|
Definition
aldosterone
loop diuretics
diarrhea
Mg deficiency
movement into cells |
|
|
Term
|
Definition
lethal v dysrhythmia-inverted t wave, decreased pr interval-ventricles filling
increased dig toxicity
muscle weakness
muscle cell breakdown-myoglobin in urine
decreased gi motility
hyperglycemia |
|
|
Term
|
Definition
replacement-never iv push
never give if kidneys arent working
|
|
|
Term
|
Definition
|
|
Term
|
Definition
lethargy weakness depressed reflexes confusion n&v
bone pain fractures (phosphate)
dehydration
coma |
|
|
Term
|
Definition
aggressive hydration with isotonic
low ca diet
weight bearing exercise |
|
|
Term
|
Definition
decreased intake
chronic renal failure
hypoparathyroid
vit d deficiency
acute pancreatitis
alcoholism
diarrhea |
|
|
Term
|
Definition
fatigue
depression confusion anxiety
numbness tingling
hyperreflexes
chvostek
trousseau
tetany seizure |
|
|
Term
|
Definition
iv replacement
increased dietary intake |
|
|
Term
|
Definition
renal insufficiency
uncontrolled dm
addisons
hypothyroid
too many antacids
|
|
|
Term
|
Definition
loss of dtr
lethargy drowsiness
n&v
cardiac arrest |
|
|
Term
|
Definition
prolonged fasting/starvation
chronic alcoholism
uncontrolled diabetes
chronic renal disease |
|
|
Term
|
Definition
cardiac irritability
confusion
hyperactive dtr
tremor
seizure |
|
|
Term
|
Definition
hypotonic
prevents ketosis
causes edema
|
|
|
Term
|
Definition
isotonic
expands iv volume
risk for fluid overload
compatible with all meds |
|
|
Term
|
Definition
isotonic
most like plasma
don't give to pt with liver problems |
|
|
Term
|
Definition
hypertonic
prevents ketosis |
|
|
Term
|
Definition
hypertonic
given to neonates, hypoglycemic, DKA
eats through veins,preferably given through central line |
|
|
