Flashcards in Exam 1 Chapter 5 Deck (141)
Patients under general anesthesia
not even to painful stimuli
they lose the ability to maintain ventilatory function.
require assistance in maintaining a patent airway.
impaired cardiovascular function.
patients at greatest risk of anesthesia awareness
Anesthetic agents used in general anesthesia
inhaled or administered by IV
what are the most reliable guides to patient's condition when general anesthesia is administered?
responses of the pupils
Type of anesthesia used to block nerves in the peripheral and CNS?
blocks transmission of pain sensation along nerve fibers.
A form off local anesthesia in which an anesthetic agent is injected around nerves, so that the area supplied by these nerves is anesthetized?
peripheral nerve blocks
patient is awake and aware
anesthetic into subarachnoid space lumbar level (L4 and L5)
anesthesia of the lower extremities, perineum, and lower abdomen.
side in knee to chest position for the lumbar puncture.
Position on back when injection has been made.
EBP shows that healthy patients are allowed clear fluids up to 2 to 3 hours prior to surgery. True or False
Benzodiazepines (versed, valium, Ativan) properties.
no analgesic properties
metabolized by the liver
when combined with opiates, increased the effect of the drug.
increase risk of respiratory depression.
Side effect of benzodiazepines (versed, valium, ativan)
drowsiness and ataxia
fatigue and confusion
weakness and dizziness
what is the reversal agent for benzodiazepines (versed, valium, Ativan)
Properties of Opioids (morphine, Demerol, Fentanyl)
analgesic and sedation
side effects of opioids (morphine, Demerol, Fentanyl)
hypotension, orthostatic hypotension
bronchospasm in asthmatics
metabolized in the liver
excreted in the kidneys
what is the reversal agent for Opioids (morphine, Demerol, Fentanyl)
What are some properties of Histamine (H2) receptor antagonists (Tagamet, Pepcid, Zantac, Prilosec, Prevacid)
inhibit gastric acid secretion
Side effects: skin rash (hypersensitivity)
decreased RBC's, WBC's platelet synthesis
Nursing care: do not administer at same time as antacids
give oral preparation with meals.
Antiemetics (Reglan, Droperidol, Zofran, Phenergan)
Properties: Alleviate nausea and vomiting
Side Effects: drowsiness (CNS depression)
dry mouth (anticholinergic effect)
blurred vision (dilation from anticholinergic)
Anticholinergics (Atropine, Glycopyrolate, scopolamine)
Properties: decrease salivation, prevents bradycardia, inhibit smooth muscle contraction in GI tract.
Side Effects: decreased parasympathetic stimulation
decreased peristalsis, decreased salvation, urinary retention, CNS disturbances.
What will happen if a patient aspirates vomitus?
severe bronchial spasms
what should the RN do if gagging occurs during surgery/
turn pt to the side
lower head of table or bed
provide a basin
might have to suction
what is given to increase gastric fluid PH?
what medications can be given to decrease gastric acid production?
histamine (h2) receptor antagonist- cimetidine (Tagamet)
what is the most common cause of anaphylaxis?
RN must be aware of the type and method of anesthesia used as well as the specific agents.
Intervention for hypoxia and other respiratory complications
vigilant monitoring of O2 status.
pulse oximetry values
Indicated by a core body temperature that is lower than normal (36.6C (98.0F) or less).
what is the goal of intervention if hypothermia occurs?
minimize or reverse the physiologic process.
what are some possible cause of temperature changes 12 hr after surgery?
effects of anesthesia medication
low temp in OR
body heat loss during surgical exposure (open body wounds or cavities)
infusion of cold fluids
inhalation of cold gases
decrease muscle activity
what are some possible causes of temperature first 24-48 hr after surgery?
inflammatory responses to surgical stress
what are some possible cause of temperature elevation above 100 F (37.7) third/later after surgery?
On what post-op day would an RN expect to see an elevated temp related to a wound infection?