Nur 513 Weberg Exam 7 2024
Types of Anesthesia - Local- Any technique to induce the absence of sensation in part of the
body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain. (Ex.
Stiches)
Regional-Is anesthesia affecting a large part of the body, such as a limb or the lower half of
the body.
Spinal and Epidural- anesthesia only stop the sensation in part of the body, and generally
patients are awake. Usually stops the feeling from the stomach down. (Ex. include epidural
for cesarean or vaginal birth)
General- The patient is out and paralyzed so they don't wake up during surgery. Patient is
intubated!
*Conscious Sedation-The use of sedation to put you in a state of sleep, but patients don't have
to be intubated because their still arousable. Almost like a twilight! Patient is still awake but
sedated. High doses of sedatives and pain medication such as Fentanyl and Versid. (ex.
include cath lab, Upper GI procedures).
Types of Incontinence - Stress Incontinence- Stress incontinence may happen when there is
an increase in abdominal pressure -- such as when you exercise, laugh, sneeze, or cough.
Urine leaks due to weakened pelvic floor muscles and tissues.
Urge Incontinence- Urge incontinence is often referred to as overactive bladder: You have an
urgent need to go to the bathroom and may not get there in time, leaking urine.
Functional Incontinence- With functional incontinence, physical problems such as arthritis, or
cognitive problems such as dementia, prevent you from getting to the bathroom in time
Over Flow Incontinence- You may have overflow incontinence if you are not able to empty
your bladder appropriately. As a result, you may have leakage once the bladder is already
full. This is more common in men with symptoms of frequent dribbling of urine.
urine output - Minimal urine output in a patient should be 30ml per hour! ** take that foley
out as soon as possible!
ASA Scale physical status classification - pg 554 patients who are staying less than 24 hours!
An evaluation the anesthesiologists uses to determine the risk of patient undergoing surgical
procedure.
1.) healthy patient = can have surgery
2.) mild systemic disease = can have surgery
3.) severe, mobility, limiting systemic = considered for surgery
4.) severe systemic disease involving live threat = can not have surgery
5.) moribund = can not have surgery
6.) brain dead or tissue donor
, Malignant Hyperthermia (MH) - Severe spike in temperature! Malignant hyperthermia is
disease passed down through families that causes a fast rise in body temperature (fever) and
severe muscle contractions when the affected person gets general anesthesia.
How to reverse Malignant Hyperthermia - pg 536 Hyperventilate the patient, High doses of
Dantrolene Sodium, Stop the surgery, begin cooling with ice water in NG tube, ice on neck,
underarms and groin to lower core temperature. Make sure to screen the patient before
surgery. Make sure to screen the patient prior to surgery.
DIC ( Disseminated intravascular coagulation) - (RISK OF ANESTESHIA) The body starts
making micro clots all over the body that aren't needed. because the body is using up those
clotting factors they bleed from areas they shouldn't be bleeding from such as IV insertions
sites, coughing up blood, and blood in their foley.
Treatment for DIC - Can be very complicated! Give the patient Cryoprecipitate or fresh
frozen plasma that contain clotting factors and actually give them anticoagulants at the same
time.
Hypothermia - Most common complication in the intraoperative and early post operative time
in the OR. When the body temperature falls below 96.8. (Your not dead till your warm and
dead). Keep the patient as warm as possible using warm fluids during surgery, use warm
heating blankets. **its important to monitor temperature regularly.
Informed Consent - *Its the doctors responsibility to explain the procedure and answer
questions, the nurse is only the witness to the patients signature.
Wrong Side Surgery - **The surgeon has to mark the site before the patient is transferred to
the OR. Use the time out method to prevent accidents!
Patient Care: IVP - another test to check for kidney stones! Intravenous pyelogram! A
radiopaque contrast agent is injected intravenously. This renders the urine radiopaque as the
contract agent is excreted in the urine. Abnormalities of the lumen, calculi, and masses can be
detected. It is imperative to check for dye allergies and to hydrate the patient for posttest dye
excretion to avoid nephrotoxicity.
*check allergies
*monitor BUN and Creatnine (it will be cleared through the kidneys)
*hydrate after procedure (lots of water)
Self-Determination - The Self-Determination Act of 1991 mandates advance
directives for patients when they are admitted to a health care
facility.The PSDA requires health care institutions who receive
Medicare or Medicaid funds to provide written information to
patients concerning the patients' rights under state law to
make decisions, including the right to refuse treatment and
formulate advance directives.
Beneficence - Beneficence is action that is done for the benefit of others. Beneficent actions
can be taken to help prevent or remove harms or to simply improve the situation of others. To
do good, to provide maximal benefits.
Types of Anesthesia - Local- Any technique to induce the absence of sensation in part of the
body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain. (Ex.
Stiches)
Regional-Is anesthesia affecting a large part of the body, such as a limb or the lower half of
the body.
Spinal and Epidural- anesthesia only stop the sensation in part of the body, and generally
patients are awake. Usually stops the feeling from the stomach down. (Ex. include epidural
for cesarean or vaginal birth)
General- The patient is out and paralyzed so they don't wake up during surgery. Patient is
intubated!
*Conscious Sedation-The use of sedation to put you in a state of sleep, but patients don't have
to be intubated because their still arousable. Almost like a twilight! Patient is still awake but
sedated. High doses of sedatives and pain medication such as Fentanyl and Versid. (ex.
include cath lab, Upper GI procedures).
Types of Incontinence - Stress Incontinence- Stress incontinence may happen when there is
an increase in abdominal pressure -- such as when you exercise, laugh, sneeze, or cough.
Urine leaks due to weakened pelvic floor muscles and tissues.
Urge Incontinence- Urge incontinence is often referred to as overactive bladder: You have an
urgent need to go to the bathroom and may not get there in time, leaking urine.
Functional Incontinence- With functional incontinence, physical problems such as arthritis, or
cognitive problems such as dementia, prevent you from getting to the bathroom in time
Over Flow Incontinence- You may have overflow incontinence if you are not able to empty
your bladder appropriately. As a result, you may have leakage once the bladder is already
full. This is more common in men with symptoms of frequent dribbling of urine.
urine output - Minimal urine output in a patient should be 30ml per hour! ** take that foley
out as soon as possible!
ASA Scale physical status classification - pg 554 patients who are staying less than 24 hours!
An evaluation the anesthesiologists uses to determine the risk of patient undergoing surgical
procedure.
1.) healthy patient = can have surgery
2.) mild systemic disease = can have surgery
3.) severe, mobility, limiting systemic = considered for surgery
4.) severe systemic disease involving live threat = can not have surgery
5.) moribund = can not have surgery
6.) brain dead or tissue donor
, Malignant Hyperthermia (MH) - Severe spike in temperature! Malignant hyperthermia is
disease passed down through families that causes a fast rise in body temperature (fever) and
severe muscle contractions when the affected person gets general anesthesia.
How to reverse Malignant Hyperthermia - pg 536 Hyperventilate the patient, High doses of
Dantrolene Sodium, Stop the surgery, begin cooling with ice water in NG tube, ice on neck,
underarms and groin to lower core temperature. Make sure to screen the patient before
surgery. Make sure to screen the patient prior to surgery.
DIC ( Disseminated intravascular coagulation) - (RISK OF ANESTESHIA) The body starts
making micro clots all over the body that aren't needed. because the body is using up those
clotting factors they bleed from areas they shouldn't be bleeding from such as IV insertions
sites, coughing up blood, and blood in their foley.
Treatment for DIC - Can be very complicated! Give the patient Cryoprecipitate or fresh
frozen plasma that contain clotting factors and actually give them anticoagulants at the same
time.
Hypothermia - Most common complication in the intraoperative and early post operative time
in the OR. When the body temperature falls below 96.8. (Your not dead till your warm and
dead). Keep the patient as warm as possible using warm fluids during surgery, use warm
heating blankets. **its important to monitor temperature regularly.
Informed Consent - *Its the doctors responsibility to explain the procedure and answer
questions, the nurse is only the witness to the patients signature.
Wrong Side Surgery - **The surgeon has to mark the site before the patient is transferred to
the OR. Use the time out method to prevent accidents!
Patient Care: IVP - another test to check for kidney stones! Intravenous pyelogram! A
radiopaque contrast agent is injected intravenously. This renders the urine radiopaque as the
contract agent is excreted in the urine. Abnormalities of the lumen, calculi, and masses can be
detected. It is imperative to check for dye allergies and to hydrate the patient for posttest dye
excretion to avoid nephrotoxicity.
*check allergies
*monitor BUN and Creatnine (it will be cleared through the kidneys)
*hydrate after procedure (lots of water)
Self-Determination - The Self-Determination Act of 1991 mandates advance
directives for patients when they are admitted to a health care
facility.The PSDA requires health care institutions who receive
Medicare or Medicaid funds to provide written information to
patients concerning the patients' rights under state law to
make decisions, including the right to refuse treatment and
formulate advance directives.
Beneficence - Beneficence is action that is done for the benefit of others. Beneficent actions
can be taken to help prevent or remove harms or to simply improve the situation of others. To
do good, to provide maximal benefits.
