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WVC Mo periop sol

WVC blah blah blah more periopp by sol

QuestionAnswer
2 lab test for kidney fxn? 1.Creatinine (60 and younger 0.5 – 1.2) 2.BUN (10-20 mg/dL)
Time length of NPO status prior to surgery? 6-8 hours.
Preoperative medication to reduce anxiety? Versed.
Preoperative medication to promote relaxation (2)? 1.Versed 2.Fentanyl
Preoperative medication to reduce pharyngeal secretions (2) 1.Atropine 2.Glucoparnate
Preoperative medication to inhibit gastric secreation? 1.Reglin 2.Fenegrin
Goal of preop meds? Decrease amount of anesthetic needed for induction and maintenance of anesthesia.
% of surgeries performed in ambulatory centers? 70 – 90%.
When is an antiobiotic given? 1 hr before surgery (JHACO Rule).
Sterile field in a surgery? Elbows down and neck to waist.
4 stages of general anesthesia? 1.Analgesia 2.Excitement (pt can still hear) 3.Operative 4.Danger AEOD
3 types of intravenous general anesthetics? 1.Barbiturates 2.Ketamine 3.Propofol
3 adjuncts to general anes agents? 1.Hypnotics 2.Opioid analgesics 3.Neuromuscular blocking agents.
Balanced anesthesia combo used to provide (5)? 1.Hypnosis 2.Amnesia 3.Analgesia 4.Muscle Relaxation 5.Reduced Reflexes (with minimal disturbance of physiologic fxn).
MH antidote? Dantrolene sodium 2-3mg/kg via IV.
MH and tx for metabolic acidosis? IV NaHCO3 (Bicarbonate).
MH and hyperkalemia tx? 20% dextrose and insulin IV.
Balanced anesthesia example (4)? 1.Thiopental for induction (anesthetic) 2.Nitrous oxide for amnesia (aneshetic) 3.Morphine for analgesia (opioid) 4.Pancuronium for muscle relaxation (neuromuscular blocker)
Medication tx for overdosage of local/regional anesthesia? Fast-acting barbiturate.
7 drugs used for conscious sedation? 1.Versed 2.Diazepam 3.Midazolam 4.Meperidine 5.Fentanyl 6.Alfentanil 7.Morphine
When and what (5) is monitored in conscious sedation? Q 15-30 minutes. Airway, LOC, O2 sat, ECG, VS.
Time out: 5 facets? 1.Right person 2.Right site 3.Right equipment 4.Right procedure 5.Consent is signed.
Primary nursing intervention when using localized lidocaine? BP and Pulse.
What size scapel is used to cut deep, delicate tissue? 7 handle 15 blade aka deep knife.
What size for superficial tissue? 3 handle 10 blade aka inside knife.
What size for skin? 4 handle 20 blade aka skin knife.
Straight Mayo Scissors used for, aka? To cut suture and supplies. Suture scissor.
Hemostat: uses, 3 other names? Used to clamp blood vessels or tag sutures. 1.Crile 2.Snap 3.Stat
Kelly: uses, aka? Used to clamp larger vessels and tissue. Rochester Pean.
Mosquito? Used to clamp small blood vessels. Smaller than a hemostat.
Clamping/occluding instruments from largerst to smallest? Kelly, hemostat, mosquito.
Fancy name for a towel clip? Backhaus towel clip.
3 types of grasping/holding instruments? 1.Pick-ups 2.Thumb forceps 3.Tissue forceps.
What is used to hold needles when suturing? Mayo-hegar needle holders.
Good narcotic=? = pinpoint pupils
How long does decreased peristalsis last for abd surgery pts? At least 24 hours.
Asses nasogastric drained material how often? Every 8 hours.
When can ineffective wound healing most often be seen? Between the 5th and 10th day after surgery.
When do dressings, drains, casts, and plastic bandages need to be assessed? Upon admission to the PACU and then hourly thereafter.
Hydrocolloid dressing? Protects the wound from surface contamination.
Hydrogel? Maintains a moist surface to support healing.
Who sets standards for client and family education? The joint commission.
Coffee grounds in NG tube? Call MD.
Irrigate wounds with? Sterile saline in a 35ml syringe with a 19 gauge needle.
Hypoxia? Reduction of oxygen supply to the tissues.
Hypoventilation? A state in which gas exchange at the alveolar-capillary membrane is inadequate so that little oxygen reaches the blood and carbon dioxide is retained.
Who accompanies the postop patient to the PACU (2)? 1.Anesthesiologist 2.Circulating Nurse
Most important assessment in the PACU? Respiratory.
Salem sump? Most common NG tube; double lune tube with an air vent to keep the tube from grabbing the gastric mucosa.
Sanguinous drainage? Bloody
Serous? Serum-like, yellow.
Serosanguinous? Pinkish.
Serosanguineous drainage beyond the 5th day? Points to dehiscence.
Created by: wvc
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