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Intraop Care

perioperative nurse prepare the OR; patient's advocate;last minute assessment; provide physical and emotional comfort to patient & caregiver
circulating nurse role not scrubbed, gowned, and gloved; remain in the unsterile field; records all nursing care
scrub nurse role following scrub procedure; remain in strile field and don sterile attire
Registered Nurse First Assistant (RNFA) works with the surgeon; sutures; handles tissue; providing exposure to surgical site; assiting w/ hemostasis
Holding area / Unrestricted area where you ID and assess patient before OR transfer; patient prep area; caregiver/family can visit
when transfering a patient to the OR adequate staff should be present to assist in lifting; monitoring devices are added once tha patient is securely strapped down;
OR preparation included placing instruments on the sterile field (aseptic technique); counting all instruments and small medical devices
preventing wrong site, wrong procedure or surgery, and wrong patient (includes surgical timeout) Universal Protocol (launched by the WHO as part of the global patient safety initiative)
positioning of the patient should allow for operative site accessibility; admin & monitoring of anesthetic agents; airway maintenance
improper positioning could lead to muscle strain, joint damage, pressure ulcers, or nerve damage,
supine position most common; used for surgeries invilving the abdomen, heart, and breast
prone position used for back surgery (laminectomy)
lithotomy position used for some types of pelvic organ surgeries (vaginal hysterectomy)
general antesthesia causes blood vessels to _______ and blood to _______. This makes positioning a high priority. dilate, pool
general anesthesia (conscious effects) loss of sensation with loss of consciousness; combination of hypnosis, analgesia, & amnesia
general anesthesia (physiological effects) elimination of coughing, gagging, vomiting, and SNS responsiveness; possible impaired cardiovascular & ventilatory function
regional anesthesia (conscious effects) loss of sensation to a region of the body without loss of consciousness
regional anesthesia (physiological effects) blocks a specific nerve or nerve group w/ admin of a local anesthetic
local anesthesia (conscious effects) loss of sensation without loss of consciousness
local anesthesia (administered) induced topically or via infiltration; intracutaneously; subcutaneously
monitored anesthesia care (MAC);formerly called conscious sedation (conscious effects) relieves anxiety, provides analgesia and amnesia; reamin responsive and breathe without assistance
monitored anesthesia care (MAC);formerly called conscious sedation (physio effects) sedatives and opioids are used at low doses; often used for minor surgeries and diagnostic procedures
dissociative anesthesia blocks sensory pathways while blocking associative brain pathways
dissociative anesthesia (patient response) may appear catatonic, is amnesic and experiences profound analgesia that lasts into postop period
Ketamine (Ketalar) common dissociative anesthetic; IV or IM route; promotes bronchodilation; potent analgesic and amnesic; increase HR & maintain cardia output
OR catastrophic events anaphylaxis and malignant hyperthermia
malignant hyperthermia rare disorder; hyperthermia w/ rigidity of skeletal muscles; primary trigger is succinylcholine; stress, trauma, & heat are other causative factors
Created by: ashanti20