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68wm6 p2 intra-op

Intra-operative PT care

What is regional anesthesia? an injection made near a cluster of nerves to numb the area of your body that requires surgery. This may involve numbing of entire limb, such as an arm or leg, or a whole portion of the body such as the entire lower half of the body.
Define analgesia inability to feel pain though conscious
Define autonomic stability relative sympathetic and parasympathetic nervous system homeostasis
In regards to intra-op PT care, what is the inability of the muscles to contract or maintain resting tone? Muscle relaxation
True or False: General anesthesia often results in the PT being unable to recall the surgical procedure. True.
What drug competively reverses the effects of narcotics? Naloxone
What drug reverses the effects of Benzodiazepenes? Romazicor/Flurazenil.
What drug reverses the effects of neuromuscular blocking agents? Anticholinesterases (neostigmine, edropnonium, pyridostigmine).
What are the three stages of anesthesia? Induction phase, Maintenance phase, Emergence phase
True or False: Once a reversing medication has been applied, the drug it reversed in the body is permanently neutralized False. The elimination half life of the reversal drug may be shorter than that of the agent being reversed
What potentially fatal reaction to anesthesia presents itself with rapid rise in body temp, tachycardia, tachypnea and muscle rigidity? Malignant hyperthermia
What are the 4 types of regional anesthesia? Nerve Block, Spinal Anesthesia, Epidural Anesthesia, Intravenous regional anesthesia (Bier Block)
What anesthesia is used for major procedures requiring extensive tissue manipulation? General anesthesia
Why is sedation usually used for patients recieving Regional anesthesia? Sedation is usually used for patient comfort (anxiolysis)
What are the two major categories of regional anesthesia? Central anesthesia, Peripheral anesthesia
What part of the spine are drugs distributed to in spinal anesthesia? Sub-arachnoid space
Why must you encourage the PT to drink plenty of water during the post-op evaluation of spinal anesthesia? To replace leaked CSF.
What is a significant complication of a subarachnoid block (SAB)? Headache.
What part of the spine are drugs distributed to in epidural anesthesia? The epidural space located between the Dura and overlying connective tissue
True or False: Only a little anesthetic is required for epidural anesthesia False. Generally large quantities are required.
What is the brachial plexus? a collection of nerve fibers within a perivascular sheath.
What can cause an unintentional migration of spinal anesthesia block? Improper positioning.
What kind of block is a brachial plexus block? Peripheral nerve block.
What is a bier block? Peripheral IV regional block
How is an IV (bier) block performed? A large volume (50cc) of LA is infused into the veins of an extremity distal to an occlusive tourniquet
What must be done in a bier block prior to application of the LA, but after application of the tournequet? exsanguination of the extremity
How quickly does sensation return after the tournequet is removed from a bier block? within 10 minutes of tourniquet deflation.
What happens if the tournequet fails during a IV (bier) block? Patient receives a potentially toxic dose of local anesthesia very rapidly
How is Local anesthisia applied? Injected or applied topically.
What is commonly used in minor surgery? Local anesthesia.
What state of consciousness occurs with regional anesthesia? The patient is conscious but usually sedated.
What is routinely used for procedures that do not require complete anesthesia Conscious sedation.
What are two examples of procedures that would require conscious sedation? bronchoscopy, pulmonary biopsy
Common agents used for conscious sedation Opioids or Sedatives/Benzodiazepines
Who must monitor a the consciously sedated patient? Continuous monitoring by a RN.
Who: *Dons sterile gown and gloves aseptically *Arranges sterile supplies and instruments Checks instruments for proper functioning *Gowns and gloves surgeons as they enter operating room The scrub nurse
Who: Sends for patient at proper time Visits with patient preoperatively, Performs patient assessment Checks medical record for completeness Explains role, verifies operative permit, identifies patient, and answers any questions Circulating nurse.
Created by: Shanejqb