Nursinglectures.blogspot.com offers Anesthesia lecture for nurses and students. This nursing lecture covers an in depth approach in studying Operating room Nursing especially Anesthesia.
Nursinglectures.blogspot.com offers Anesthesia lecture for nurses and students. This nursing lecture covers an in depth approach in studying Operating room Nursing especially Anesthesia.
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• class 1 - able to visualize soft palate, fauces, uvula, ant and post tonsillar pillars
• class 2 - able to visualize all of the above, except anterior andposterior tonsillar
pillars are hidden by the tongue
• class 3 - only the soft palate and base of the uvula are visible
• class 4 - only the soft palate can be seen (uvula not visualized)
nursinglectures.blogspot.com
Common classification of physical status
at the time of surgery
ASA 1 : healthy fit patient
ASA 2 : with mild systemic disease
ASA 3 : with severe systemic disease that limits activity
ASA 4 : with incapacitating disease that is a constant threat to life
ASA 5 : a moribund patient not expected to survive 24 hours with/without surgery
nursinglectures.blogspot.com
nursinglectures.blogspot.com Levels Findings Minimal Sedation Patient responds normally to VERBAL commands, Cognitive & Coordination Fxn may be impaired, but Ventilatory & Cardiovascular Fxns Unaffected Moderate Sedation Midazolam(Versed)/Diazepam(Valium) used often. Depressed LOC that does not impair patient’s ability to maintain a patent airway Deep Sedation Patient cannot be easily aroused but can respond purposefully after repeated stimulation. IV or Inhalation. NO2 most commonly used GAS Anesthetic ANESTHESIA State of Narcosis (severe central nervous system depression produced by pharmacologic agents), analgesia, relaxation, and reflex loss. Not arousable.
nursinglectures.blogspot.com Stages of ANESTHESIA Findings Beginnning Anesthesia / Induction Patient feels DIZZY,WARMTH and DETACHED . May have ringing, roaring, or buzzing in the ears. AVOID NOISE Excitement PR is rapid. Respirations maybe IRREGULAR. SAFETY of the patient is the PRIMARY CONCERN. Surgical Anesthesia Unconscious patient. RR is regular . PR and BP is normal . SKIN is PINK and slightly Flushed. Continuous administration of Anesthetic agent. Medullary Depression Too much Anesthesia. Pulse is weak and thready. Pupil become WIDELY DILATED .Respiratory and Cardio Support. DEATH rapidly follows.
Inhalation – administered with mixing the vapors with OXYGEN. Via ET TUBE or MASK
Injection – no buzzing, roaring, or dizziness. THIOPENTAL, agent of choice. Useful in EYE surgery(low Nausea and Vomiting)
Rectal – obsolete but sometimes used in Pediatric patients.
nursinglectures.blogspot.com
nursinglectures.blogspot.com
Tranquilizers and Sedative – Hypnotics
a. Benzodiazepines
1. Midazolam ( Versed ) – Monitor Respiratory Status
Life-threatening, characterized by thrombus formation and depletion of select coagulation proteins, Idiopathic
Predisposing factors:
Emergency surgery
Massive trauma
Head Injury
Massive transfusion
Liver/kidney involvement
Embolic events or shock
nursinglectures.blogspot.com
AVOID Derogatory comments
Patient is treated as a person
Respecting cultural and spiritua l values
Providing physical privacy
Maintaining Confidentiality
nursinglectures.blogspot.com
1. A patient in the holding area awaiting surgery indicates that he had not received instructions not to take his usual medications ( antihypertensive agent, diuretic, digoxin, potassium chloride, and insulin injection ); as a result, he took them a few hours ago . What implications does this have for the patient’s care and well-being while awaiting surgery, during surgery, and in the immediate postoperative period?
nursinglectures.blogspot.com
2. What are the differences in responsibility of the operating room nurse for care of patients who receive general anesthesia, conscious sedation, spinal anesthesia, and regional anesthesia ?
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3. While she is being transferred from the stretcher to the operating table, a female patient says she is very anxious about her surgery because of previous negative experiences . What assessment and interventions are indicated at this time?
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