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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher
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18 - Intraoperative Care

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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid

18 - Intraoperative Care
16 Picmonics to Learn | 28 mins
Aseptic Technique
Invasive Procedures
Skin Integrity Broken
Sterility
Hands Up for Scrubbing
Keep Objects in View
Only Sterile Objects in Field
Only Sterile Touches Sterile
Contamination
Edges of Sterile Field
If Sterility Questioned
If Wet or Prolonged Exposure to Air
Considerations
Never Leave Sterile Area
PPE Order
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2 mins
Pressure Ulcers
Risk Factors
Prolonged Immobilization
Neurologic Disease
Decreased Level of Consciousness
Classification
Stage 1: Intact Skin with Non-blanchable Erythema
Stage 2: Partial Thickness Skin Loss
Stage 3: Full-thickness Skin Loss without Fascial Involvement
Stage 4: Full-thickness Skin Loss with Fascial Involvement
Management
Wound Care
Surgery
Considerations
Septicemia
Osteomyelitis
Prevention
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3 mins
Patient Position Overview
Position Techniques
Trochanter Roll
Trapeze Bar
Ankle-Foot Orthotic (AFO) Devices
Positions
Fowlers Position
Supine Position
Trendelenburg
Side-Lying Position
Prone Position
Sims' Position
Nursing Considerations
Reposition q2 Hours/Prevent Skin Breakdown
Confirm Body Alignment
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2 mins
Hypothermia Interventions
Remove From Environment
Remove Wet Clothing
Passive Rewarming
Warm Clothing
Active Rewarming
Heated Blankets
Warm IV Solutions
Heated Oxygen
Warm Gastric Lavage
Considerations
Warm Trunk BEFORE Extremities
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2 mins
Inhaled Anesthetics
Mechanism of Action
Unknown Mechanism
Inhaled Anesthetic Drugs
HEISMN Drug Name Acronym
Side Effects
Respiratory Depression
Myocardial Depression
Lower Metabolic Demand, Increased Cerebral Blood Flow
Hepatotoxicity (Halothane)
Nephrotoxicity (Methoxyflurane)
Seizure (Enflurane)
Malignant Hyperthermia
Expansion of Trapped Gas
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2 mins
Local Anesthetic Overview
Indications
Minor Procedures
Epidurals
Mechanism of Action
Blocks Na+ Channels
State Dependent
Combined with Vasoconstrictors
Infected Tissue Requires Higher Dose
Drugs
Esters
Amides
Side Effects
Arrhythmias
Cardiotoxicity
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1 min
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
Opioid Antidote
Antidote
Naloxone
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29 secs
Benzodiazepine Antidote
Antidote
Flumazenil
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40 secs
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
Nondepolarizing Neuromuscular Blocking Drugs
Names Include "Cur"
Competitive Antagonists
Acetylcholine Competition
Reversal of Blockade
Neostigmine, Edrophonium
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1 min
Succinylcholine
Indications
Inducing Paralysis
Mechanism of Action
Neuromuscular Blocking Drugs
Motor Nicotinic Receptor
ACh Receptor Agonist
Depolarization
Phases of Action
Phase I (Paralysis Non-reversible)
Phase II (Paralysis Reversible)
Neostigmine (Reversal Agent)
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2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Anaphylaxis Intervention
Intervention
Assess Airway and Oxygen Needs
Reassure Patient with Anxiety
Supine Position
Methylprednisolone (Solu-medrol)
Epinephrine
Diphenhydramine (Benadryl)
Medical Alert Bracelet
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2 mins

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