1. Anesthesia Care Provider (ACP) - ANS-Administers Anesthesia
2. - "Knows everything"
3. - Monitors breathing, insulin, etc
4. - Maintenance of physiologic homeostasis throughout intraoperative period
5. - Fluid replacement, blood pressure, etc
6. Anxiety & Nursing Assessment - ANS-Anxiety can arise from:
7. - Lack of knowledge (More they know the better, use layman's terms)
8. - Unrealistic expectations (I will have this surgery and be fine)
9. - Information lessens anxiety
10. Atropine - ANS-Oral and respiratory secretions dry up!!!!
11. Basic Information Before Arrival - ANS-- Time and place
12. - Fluids and food restrictions (Do not want to throw up)
13. - Need for shower
14. - Anesthesiologist makes decision about insulin
15. *MOST CAREFUL DOCUMENTATION TAKES PLACE IN THE OR*
16. Cardiovascular System Objective Data - ANS-- Heart rate, blood pressure, skin color,
sounds, capillary refill, edema, history of heart attack or cardiac problems, blood clots in
legs?
17.
18. REPORT: Any cardiac problems so they can be monitored during the intraoperative
period. The use of cardiac drugs, and the presence of a pacemaker/ICD (Implantable
Cardioverter Defibrillator)
19. Consent for Surgery - ANS-Informed Consent Includes:
20. - Adequate disclosure, understanding and comprehension, voluntarily given consent
21. - Surgeon is responsible for obtaining consent
22. - Nurse may obtain and witness the signature
23. - Consent for surgery and anesthesia
24. *Emergency surgery may override need for consent*
25.
26. - Legally appointed representatives of family may consent if the client is: A minor,
unconscious, or mentally incompetent
27. Day-of-Surgery Preparation - ANS-- Final preoperative teaching
28. - Assessment and report of pertinent findings
29. - Verify signed consent
30. - Labs
31. - History and physical examinations
32. - Baseline vitals
33. - Consultation results
34. - Nurse's notes (Documentation)
, 35.
36. - Client should not wear cosmetics
37. - Dentures, contacts, prostheses are removed
38. *- Identification and allergy bands on wrist*
39. - Void before surgery to: Prevent involuntary elimination under anesthesia or during early
postoperative recovery; before medication administration
40. Endocrine System Objective Data: - ANS-- Clients with Diabetes Mellitus are especially
at risk for delayed healing time, changes in blood sugar, higher risk for infections
41. - Clients with thyroid dysfunction have an altered metabolic rate
42. - Clients with adrenal insufficiency (Addison's Disease) also do not heal as well; sterioids
43. Fluid and Electrolyte Balance Objective Data: - ANS-- Assess Electrolytes
44. - Use of diuretics (Evaluate serum electrolyte levels; can alter K+)
45. - NPO Status (Dehydrated)
46. - Critical assessment for older adults because they have a reduced adaptive capacity
47. General Anesthesia - ANS-Combination of:
48. - Hypnosis, analgesia, and amnesia
49. - Loss of sensation with loss of consciousness
50. - IV or Inhalation
51. - Skeletal muscle relaxation
52. - Possible impaired ventilatory and cardiovascular function
53. - Elimination of coughing, gagging, vomiting, and sympathetic nervous system
responsiveness (Could have pneumonia, so you cannot eat before)
54. - IV agents: Beginning of virtually all general anesthesia; TIVA (Total IV Anesthesia)
Monitored Anesthesia Care (MAC)
55. Genitourinary System Objective Data: - ANS-- Kidney problems, frequency of urination,
urgency, blood, period
56. - History of renal diseases
57. - Assess BUN, Creatinine, Specific Gravity
58.
59. Renal Dysfunction contributes to:
60. - Fluid and electrolyte problems
61. - Altered response to drugs
62. - Increased risk of infection
63. Hepatic System Objective Data: - ANS-- Jaundice, Ascites
64. - Liver involved in drug metabolism and clotting
65. - Hepatic dysfunction may increase risk of postoperative complications
66. Holding Area - ANS-Surgical Care Improvement Project (SCIP)
67. measures to implement here
68. - Drug administration
69. - Patient warming
70. - Application of sequential compression devices (SCDs)
71. - Minor procedures
72.
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