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Surg and oxygen
| Term | Definition |
|---|---|
| Classifications of surgery | Urgency Degree of risk Purpose |
| Urgency of surgery | elective urgent- 24 hrs emergent |
| Degree of risk of surgery | minor-biopsy/colonsocopy major |
| Purposes of surgery | Diagnostic, palliative, transplant ablative- remove something Constructive: congenital reconstructive: knee/hip replacement |
| General anesthesia | Inhalation or IV in operating room Risks? benefits? |
| Moderate sedation | IV in procedural room benefits: pt maintains airway, pt can respond to verbal and tactile stimuli risks: oversedation |
| Regional anesthesia | Injection at bedside or procedural/operating room benefits: awake, targeted to area risks: loss of reflexes (dermatomes) |
| Local/topical anesthesia | Cream or injection can be done anywhere benefits: numbs specific area risks: local sensitivity reaction |
| Components of informed consent | 1. disclosure 2. comprehension 3.competence 4. voluntariness |
| Provider job in informed consent | OBTAIN informed consent |
| Patient job in informed consent | GIVE informed consent |
| Nurse job in informed consent | WITNESS informed consent |
| What does an advanced directive do? | 1. instructions for treatment if unable to communicate wishes properly 2. appoints POA for healthcare 3. resuscitation efforts |
| Preoperative phase | From when surgery is deemed necessary TO when the patient is taken to the OR |
| Intraoperative phase | pt arrives at OR TO pt leaves OR |
| Postoperative phase | PT arrives in PACU TO Pt fully recovered from surgery |
| Preoperative assessment | important to determine baseline so PACU nurse knows normals - med/surg history - thorough physical assessment - medications/ nutrition/ alcohol/ drugs - ADLS and education |
| Preoperative implement actions | 1. communication: no false reassurance 2. Teaching 3. physical preparation |
| Intraoperative phase actions | 1. universal protocol: time-out 2. error preventions 3. nursing interventions (bony prominences padded, draping, documentation) |
| What is most important immediately post-op? | 1. respiratory 2. cardiovascular 3. CNS and Fluid status |
| Post-op respiratory problem | pulmonary embolism atelectasis pneumonia |
| PE post-op | MEDICAL EMERGENCY recognize: SOB, trachea, SpO2 sat drop, *impending sense of doom Respond: notify provider, rapid response, monitor VS, administor O2, anticoagulants |
| Atelectasis post-op | Most common post-op respiratory prob recognize: diminished lung sounds, dyspnea, restlessness respond: notify provider, ICOUGH, administer oxygen, pain control |
| ICOUGH | Incentive spirometer, cough and deeply breathe, oral care, understand ICOUGH, get out of bed and walk the hallway, head of bed elevation |
| Pneumonia post-op | recognize: fever, moist cough, dyspnea, crackles respond: notify provider, administer IV, antibiotics, monitor VS, ICOUGH |
| Hemorrhage post-op to do | recognize: hypotension, tachycardia, clammy skin, apprehension respond: notify provider, pressure dressing, monitor VS, transfusion, return to OR |
| Shock post-op | recognize: hypotension, tachycardia, clammy skin, tachypnea, pale respond: rapid response, notify provider, maintain airway, administer oxygen, VS, patient flat |
| thromboembolism post-op | Recognize: redness, swelling, warmth, pain, increased extremity circumference respond: medications, SCDs, early and frequent ambulation |
| Factors affecting Oxygenation | meds: opioids, CNS depressants, meds decreasing HR environment: air pollution, allergens, smoking |
| hypoventilation definition | alveolar ventilation inadequate to meet the body's oxygen demand or to eliminate sufficient carbon dioxide |
| Hyperventilation definition | Ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism |
| Cyanosis definition | Blue discoloration of the skin and mucous membranes |
| Oxygenation health history assessment | - exercise habits - Hx of heart or lung disease - Air quality - use of substances that cause respirator problems - ADLS - immunizations, medications, and home oxygen - career |
| Oxygenation physical assessment | inspect: pallor, clubbing, kyphosis palpate: edema, pulsations, cap refill Auscultation: lung sounds, cough, wheezing, stridor |
| Eupnea | Normal, unlabored and regular breathing pattern |
| Tachypnea | Increased respiratory rate |
| Bradypnea | Decreased respiratory rate |
| Apnea | No breathing |
| Cheyne-Stokes | Cycles of deep breathing followed by shallow breathing |
| Biots | Regular deep breathing mixed with periods of apnea |
| Kussmauls | Rapid, deep breathing at a consistent pace |
| Respiratory diagnostics | PFT's Spirometry Peak expiratory flow rate Pulse Ox Capnography |
| Actions to help respiration | hydration oral care ambulation diet frequent rest periods reduced anxiety |
| STUDY OXYGEN THERAPY SLIDES | |
| Neyland Stadium Vol Nation | low-flow Nasal cannula high-flow Nasal cannula Simple face mask Venturi face mask Non-rebreather |
Created by:
mdedobbe