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WVC Mo periop sol
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Question | Answer |
---|---|
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. |