Term
What type of birth is a epidural block used for? |
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Definition
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Term
| What are the advantages of an epidural block? |
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Definition
| substantial relief of pain from contractions and birth canal distention w/o sedation |
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Term
| What are some adverse effects of the epidural block? |
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Definition
Hypotension Bladder Distension Prolonged Second Stage Catheter migration |
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Term
| What are some contraindications for an epidural block? |
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Definition
Patient refusal Maternal coagulation problems Hypovolemic shock Infection in the area of insertion |
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Term
| What is a pudendal block? |
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Definition
anestheization of lower vagin and part of the perineum, provides anesthesia for a episitomy does not block pain from contractions |
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Term
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Definition
| loss of both motor and sensory function below the level of the subarachnoid block |
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Term
| What are some advantages of the spinal block |
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Definition
| may be done for a quick cesarean birth if epidural catheter is not in place |
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Term
| What are some adverse effects of the spinal block? |
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Definition
hypotension spinal headache bladder distension |
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Term
| What is conscious sedation? |
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Definition
| drug induced depression of consciousness that retains patient's ability to maintain their own airway and respond appropriately to verbal commands |
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Term
| What are some drugs administered for conscious sedation? |
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Definition
Valium Versed Demerol Sublimaze Alfenta Morphine |
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Term
| For what procedures might conscious sedation be used for? |
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Definition
endoscopy cardiac cath closed fx reduction carioversion PTA other short procedures |
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Term
| What is general anesthesia? |
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Definition
| Sedation that causes amneisa, muscle relaxation, and unconsciousness |
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Term
| What items should be a part of an informed consent? |
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Definition
description of procedure expected outcome and all risks involved name and qualifications of persson performing procedure |
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Term
| At what point can informed consent be withdrawn? |
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Definition
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Term
| Who is responsible for securing informed consent? |
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Definition
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Term
| What is the nurses role in obtaining informed consent? |
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Definition
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Term
| Is consent legal if patient is sedated or confused? Will it always stand up in court? |
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Definition
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Term
| What are some helpful nursing activites to prepare an infant for hospitlization and surgical procedures? |
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Definition
use sheets/blankets to swaddle expect regressive behavior limit number of caregivers to whom infant must adjust encourage parents to be present during procedures request that parents bring infant security object |
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Term
| What are some helpful nursing activities to help a toddler who is going to be hospitilized or having a surgical procedure? |
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Definition
expect regression, and inform parents about it involve parents in care of toddler allow opportunities for mobility when it can be done safely anticipate temper tantrums encourage independance provid support when toddler needs it approach with a positive attitude |
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Term
| What are some helpful nursing activites to prepare an preschooler for hospitlization and surgical procedures? |
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Definition
provide safe ways to act out agression explain all procedures honestly allow choices whenever possible expect egocentric behavior be consistent tell child that he or she did not cause illness place child with other children of same age accept regression if it occurs, explain it to parents |
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Term
| What are some helpful nursing activites to prepare an school age child for hospitlization and surgical procedures? |
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Definition
involve child in planning and implementing care encourage independence assist child in contacting friends encrouage parents to bring in school work, and schedule study times |
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Term
| What are some helpful nursing activites to prepare an adolescent for hospitlization and surgical procedures? |
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Definition
provide privacy encourage them to wear normal clothing and perform normal grooming use scientific and medical terminology to prepare adolescent for procedure encourage peers to call and visit if adolescent's condition can tolerate this action allow favorite foods to be brought in if adolescent does not need a special diet provide for education needs, as for a school age child |
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Term
| What are some important things to remember about patient anxiety prior to surgery? |
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Definition
Anxiety is a normal reaction to surgery Extreme anxiety can diminish coping skills Patient fear of death or disfigurement are very common Extreme fear of death is cause to notify physician, extreme stress can negatively affect surgical outcomes |
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Term
| What should be taugh to patients preoperatively? |
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Definition
As little as much as they want concerning surgical events Pain management: teach patients to ask for pain medication if they need it Physical activities: patient should be taught preop what they will be able to do post op Patient should be aware of sensations, activity level etc. |
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Term
| What are some nursing actions that should be preformed peroperatively for a patient concerning health beliefs and practices? |
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Definition
gather information about patient healthy history and belief inquire about medical history, medications, perceptions and knowledge of surgery, nutrition, use of alchohol, use of illicit drugs or nicotine, coping patterns and support |
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Term
| What should preoperative nursing instructinon be individualized for? |
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Definition
Language food preferences family interactions personal space health beliefs and practices |
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Term
| What should patients be taught preoperatively about pain management? |
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Definition
Be made aware of options for pain relief, and be taught to ask for pain relief when they feel they need it |
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Term
| What should patients be taught preoperatively about physical activity? |
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Definition
| patient should be encourage in coughing and using the incentive spirometer after surgery to prevent pnemonia |
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Term
| What should patient be taught following surgery regarding leg exercises? |
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Definition
| Patient should be taught leg excercise and other physical activity to prevent development of DVT |
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Term
| What are possible causes of airway obstruction in the post operative patient? |
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Definition
tongue falling back retained think secretions laryngospasm laryngeal edema |
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Term
| What are possible causes of hypoxemia in the postoperative patient? |
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Definition
Atelactasis Pulmonary Edema Pulmonary emboslism Aspirtation Bronchospasm |
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Term
| What are posible causes of hypoventilation in the postoperative patient? |
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Definition
depression of central respiratory system poor respiratory muscle tone mechanical restriction pain |
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Term
| What is the best recovery position for the postoperative patient who is unconscious? |
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Definition
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Term
| How often should vital signs be monitored in the post op patient? |
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Definition
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Term
| When should the SCP/surgeon be notified for vitals in a post op patient? |
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Definition
systolic blood pressure < 90, >160 pulse rate < 60 bpm or > 120 bpm pulse pressure narrows blood pressure gradual decreases during several consecutive readings irregulary cardiac rhythm significant variation from pre op readings |
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Term
What is the first step in treatment of hypotension? What is the most common cause of hypotension? |
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Definition
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Term
| What are some ways to reduce the risk of cardiovascular complications in the post op patient? |
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Definition
treat hypotension by providing oxygen therapy to promote oxygenation of hypoperfused organs assess volume status provide IV bolus to normalize blood pressure if hypotensive eliminate any causes of arrythmias keep accurate intake and output records leg exerise should be encourage 10-12 times every 1-2 hours while awake elastic stocking or sequentials heparin to prevent venous thrombosis and pulmonary embolism |
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Term
| What are some ways to reduce the risk of respiratory complications in the post op patient? |
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Definition
proper position of patient -- change position every 1-2 hours to allow full chest expansion encourage deep breathing to facilitate gas exchange and promote return to consciousness encourage coughing techniques splinting an abdominal incision with a pillow or rolled blanket provides support to incision and aids in coughing |
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Term
| What are some ways to reduce the risk of wound complications in the post op patient? |
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Definition
when drainage occurs on the dressing, the type, amount, color, consistency, and odor of drainage should be noted and recorded incisions may be covered with dressing immediately after surgery, and, if no drainage after 24-48 hours, open to air wear clean gloves when removing a dressing and use sterile technique when applying new dressing |
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