H&H module 2
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In the context of intraoperative nursing care, what is the primary reason for meticulously checking electrical and mechanical equipment in the operating room?

  • To comply with hospital regulations and accreditation standards regarding equipment maintenance.
  • To create a sterile environment by eliminating any external sources of contamination from faulty equipment.
  • To prevent potential malfunctions that could compromise patient safety during the surgical procedure. (correct)
  • To ensure the surgical team has all the necessary tools readily available, enhancing procedural efficiency.

During the admission phase of intraoperative care, why is it critical for the nurse to verify the patient's identity using multiple identifiers?

  • To comply with hospital policies and legal requirements for patient identification.
  • To update the patient's medical record with accurate demographic information.
  • To prevent errors in medication administration and surgical procedures by ensuring the correct patient receives the intended intervention. (correct)
  • To streamline the admission process and reduce patient wait times.

What is the most important consideration when transferring a patient from the pre-operative area to the operating room (OR) table?

  • Ensuring the patient is moved quickly to maintain the surgical schedule.
  • Maintaining patient safety by using sufficient staff and proper techniques to prevent injury. (correct)
  • Positioning the patient for the surgeon's convenience.
  • Confirming all pre-operative documentation is complete and accurate.

Why is adherence to aseptic techniques crucial during the placement of surgical instruments within the operating room?

<p>To prevent surgical site infections by minimizing the introduction of microorganisms into the sterile field. (D)</p> Signup and view all the answers

Prior to the start of a surgical procedure, what is the primary reason for the surgical team to delineate the roles and responsibilities of each member?

<p>To enhance team communication and coordination, thereby minimizing the risk of errors and optimizing surgical outcomes. (D)</p> Signup and view all the answers

Why is it essential to use a paediatric fluid chart for a child receiving intravenous fluids?

<p>To monitor the child's intake hourly and detect any deviations from the normal range early. (D)</p> Signup and view all the answers

A newborn requires intravenous fluid administration. Given their body composition is approximately 70% fluids, what IV administration approach is most prudent?

<p>Using a burette set (60 drops/mL) to cautiously administer fluids. (D)</p> Signup and view all the answers

What immediate nursing intervention is most appropriate for a newborn exhibiting excessive salivation?

<p>Suction the infant and position them laterally to ensure a patent airway. (C)</p> Signup and view all the answers

A child with abdominal distension and breathlessness is admitted. What initial nursing intervention is most appropriate?

<p>Preparing for nasogastric intubation and oxygen administration. (D)</p> Signup and view all the answers

A 10-year-old child receiving IV fluids with potassium chloride (KCl) exhibits a rapid increase in heart rate. What is the most appropriate immediate action?

<p>Immediately discontinue the potassium chloride infusion. (D)</p> Signup and view all the answers

What is the rationale behind weighing a child upon admission to a healthcare facility?

<p>To accurately calculate and administer drugs and intravenous fluids. (D)</p> Signup and view all the answers

Why is accurate and mandatory recording of a child's intake and output important during intravenous therapy?

<p>To monitor renal function and guide subsequent fluid replacement. (D)</p> Signup and view all the answers

A child is prescribed intravenous fluids with added potassium chloride (KCl). Which nursing intervention is most important to prevent potential complications?

<p>Maintaining the drip rate within the prescribed limits to avoid cardiac effects. (B)</p> Signup and view all the answers

Why is it crucial to inquire about the duration of a child's illness during assessment?

<p>To identify potential diagnoses and assess the severity of the condition. (A)</p> Signup and view all the answers

If a neonate exhibits a failure to pass meconium, which condition should the nurse suspect?

<p>Intestinal obstruction, potentially Hirschsprung’s disease or Anorectal malformation. (A)</p> Signup and view all the answers

A child presents with a febrile illness and abdominal distension. Which condition should the nurse consider as a potential cause?

<p>Typhoid intestinal perforation, requiring urgent surgical intervention. (A)</p> Signup and view all the answers

What is the recommended strategy for managing a child's febrile illness, according to the guidelines?

<p>Alternating between tepid sponging, exposure to fresh air, and antipyretic medication. (D)</p> Signup and view all the answers

Why is it essential to accurately calculate intravenous fluid administration for pediatric patients?

<p>To avoid the risks of underhydration or overhydration, which can have severe consequences. (A)</p> Signup and view all the answers

A 5-kg child requires intravenous fluids. What would be the estimated daily fluid requirement?

<p>500 ml/24 hours (D)</p> Signup and view all the answers

A 3-year-old child post-surgery exhibits increased fretfulness and restlessness. What is the MOST appropriate initial nursing intervention?

<p>Assessing the child for signs of pain and utilizing appropriate pain management techniques. (C)</p> Signup and view all the answers

A nurse is caring for a neonate in an incubator. What is a crucial nursing intervention to address their immature temperature regulation?

<p>Monitoring the neonate for cyanosis and ensuring the incubator alarm is functional. (C)</p> Signup and view all the answers

During the care of a child with a febrile illness, a nurse observes significant derangement in vital signs. What is the most appropriate nursing intervention?

<p>Immediately notifying the managing clinician for prompt medical intervention. (B)</p> Signup and view all the answers

Which action should the nurse prioritize to minimize risks associated with intravenous therapy in children?

<p>Using the smallest gauge catheter appropriate for the prescribed infusion. (B)</p> Signup and view all the answers

A nurse is educating parents of a child recovering from surgery about medication compliance. Which strategy demonstrates the BEST approach to improve compliance?

<p>Persuading the parents by explaining the medication's importance for sustained improvement and addressing potential barriers, such as cost. (D)</p> Signup and view all the answers

Which nursing intervention is LEAST effective in preventing nosocomial infections in paediatric surgical patients?

<p>Administering prophylactic antibiotics without assessing patient's white blood cell count. (C)</p> Signup and view all the answers

When assessing vital signs in a paediatric patient, what is the BEST approach for a nurse to ensure accurate interpretation?

<p>Knowing age-specific normal ranges and documenting accurately to facilitate prompt intervention. (C)</p> Signup and view all the answers

A febrile neonate's temperature remains elevated despite initial interventions. What is the MOST appropriate next step for the nurse?

<p>Consulting the healthcare provider for further orders and possible underlying causes. (C)</p> Signup and view all the answers

Which observation by the nurse indicates a need for intervention in a post-operative newborn?

<p>Evidence of cyanosis around the lips. (C)</p> Signup and view all the answers

What nursing assessment BEST indicates effective pain management in a nonverbal toddler post-surgery?

<p>Calm demeanor, decreased restlessness, and ability to engage in age-appropriate activities. (D)</p> Signup and view all the answers

A patient reports incisional pain of 7/10 on a numeric pain scale postoperatively. Besides administering the prescribed opioid, what additional nursing intervention would best support multimodal analgesia?

<p>Applying a cold pack to the incision site for 20 minutes. (A)</p> Signup and view all the answers

A patient receiving PCA reports breakthrough pain despite frequent bolus doses. What is the MOST appropriate initial nursing intervention?

<p>Assess the patient's pain level, vital signs, and PCA settings, then notify the healthcare provider. (C)</p> Signup and view all the answers

A patient has undergone abdominal surgery and is prescribed opioid analgesics for pain management. What nursing intervention is MOST important to prevent a common side effect of opioid use?

<p>Administering a stool softener and encouraging increased fluid intake. (B)</p> Signup and view all the answers

When assessing a surgical wound, which finding indicates a potential wound infection that requires immediate intervention?

<p>Redness, warmth, and purulent drainage from the incision site. (B)</p> Signup and view all the answers

When performing a dressing change on a postoperative wound, which action BEST demonstrates adherence to aseptic technique?

<p>Washing hands thoroughly before and after the procedure, and using sterile gloves for the entire procedure. (A)</p> Signup and view all the answers

A patient is being discharged with instructions for postoperative wound care. What statement by the patient indicates a need for further education?

<p>&quot;I should change the dressing every day, even if it's dry and clean.&quot; (C)</p> Signup and view all the answers

A patient reports that their pain medication is not effectively controlling their postoperative pain. After assessing the patient, what is the most appropriate next step?

<p>Contacting the healthcare provider to discuss alternative pain management strategies. (B)</p> Signup and view all the answers

A patient’s surgical wound exhibits signs of dehiscence. What is the priority nursing intervention?

<p>Covering the wound with a sterile, moist dressing and notifying the surgeon. (D)</p> Signup and view all the answers

A patient 5 days post-op reports increased pain, redness, and swelling at the incision site. What is the priority nursing intervention?

<p>Notifying the healthcare provider about potential signs of infection. (C)</p> Signup and view all the answers

What is the primary reason for administering prophylactic antibiotics prior to surgery?

<p>To reduce the risk of surgical site infections (SSIs). (B)</p> Signup and view all the answers

During a dressing change, what is the MOST important principle of aseptic technique a nurse should follow?

<p>Maintaining sterility of instruments and materials that will come into contact with the wound. (D)</p> Signup and view all the answers

A patient is being discharged after surgery. Which instruction about wound care at home is MOST important to emphasize?

<p>Wash your hands thoroughly before and after touching the wound. (B)</p> Signup and view all the answers

A post-operative patient has a history of sleep apnea. What vital sign monitoring is MOST critical for this patient?

<p>Continuous oxygen saturation monitoring (D)</p> Signup and view all the answers

A patient reports a pain level of 7 out of 10 on a pain scale, but exhibits no obvious signs of discomfort. What is the MOST appropriate nursing intervention?

<p>Believing the patient's report and administering prescribed pain medication. (C)</p> Signup and view all the answers

What is the significance of monitoring urine output in the post-operative period?

<p>To assess kidney function and fluid balance. (A)</p> Signup and view all the answers

A patient is scheduled for suture removal 10 days post-op, but the incision site is still slightly inflamed. What should the nurse do?

<p>Delay suture removal and notify the healthcare provider about the inflammation. (C)</p> Signup and view all the answers

What is the MOST important information to include when educating a patient about activity restrictions after surgery?

<p>Exact duration of the activity restriction, and guidance on a gradual resumption of normal activities. (B)</p> Signup and view all the answers

Which dietary recommendation is most appropriate for promoting wound healing in a post-operative patient?

<p>A balanced diet with adequate protein, vitamins, and fluids. (D)</p> Signup and view all the answers

Following abdominal surgery, a patient reports increased pain, abdominal distension, and inability to pass flatus. What complication should the nurse suspect?

<p>Paralytic ileus (C)</p> Signup and view all the answers

A nurse notices a significant increase in serosanguineous drainage from a post-operative wound. What is the MOST appropriate action?

<p>Apply a pressure dressing and notify the healthcare provider immediately. (C)</p> Signup and view all the answers

What is the primary purpose of early ambulation in post-operative care?

<p>To prevent pneumonia and deep vein thrombosis (DVT). (A)</p> Signup and view all the answers

Which of the following is the MOST reliable indicator of neurological status post-operatively?

<p>Level of consciousness (C)</p> Signup and view all the answers

A post-operative patient has a hemoglobin level of 7.5 g/dL. What nursing intervention is MOST appropriate?

<p>Notify the healthcare provider about the low hemoglobin level. (C)</p> Signup and view all the answers

A patient with a known latex allergy is scheduled for surgery. What is the MOST critical nursing intervention to ensure patient safety during pre-operative care?

<p>Informing all members of the surgical team about the allergy and ensuring a latex-free environment. (D)</p> Signup and view all the answers

A patient scheduled for a major abdominal surgery expresses extreme anxiety and fear. Besides administering prescribed anxiolytics, what additional pre-operative nursing intervention would be MOST beneficial?

<p>Providing a detailed explanation of the surgical procedure, including potential risks and benefits, and allowing ample time for questions. (B)</p> Signup and view all the answers

While preparing a patient for surgery, the nurse discovers that the patient has not adhered to the pre-operative fasting guidelines. What is the MOST appropriate initial action?

<p>Notifying the anesthesiologist and surgeon about the patient's non-compliance with fasting guidelines. (C)</p> Signup and view all the answers

Which assessment finding would be MOST concerning when evaluating a patient's readiness for anesthesia?

<p>Elevated white blood cell count with signs of localized skin infection. (C)</p> Signup and view all the answers

A patient is scheduled to receive monitored anesthesia care (MAC) for a minor surgical procedure. What is the MOST important nursing consideration during the procedure?

<p>Continuously monitoring the patient's respiratory status and level of sedation. (B)</p> Signup and view all the answers

During the administration of general anesthesia, a patient experiences a sudden increase in heart rate, blood pressure, and body temperature. What immediate action should the nurse prioritize?

<p>Immediately notifying the anesthesiologist and preparing for interventions to manage potential malignant hyperthermia. (A)</p> Signup and view all the answers

A patient receiving regional anesthesia begins to complain of difficulty breathing and numbness around the mouth. What is the MOST appropriate initial nursing intervention?

<p>Administering oxygen and preparing for potential respiratory support while continuously monitoring vital signs. (D)</p> Signup and view all the answers

A patient is receiving an intravenous anesthetic agent. Which of the following assessment findings requires the MOST immediate intervention?

<p>The development of hives and wheezing. (D)</p> Signup and view all the answers

During intraoperative care, what is the primary rationale for meticulous patient positioning on the operating table?

<p>To prevent nerve damage, skin breakdown, and other positional injuries. (C)</p> Signup and view all the answers

What is the MOST critical initial step a nurse should take to prevent Surgical Site Infections (SSIs) during the intraoperative phase?

<p>Maintaining strict sterile technique during draping and instrument handling. (B)</p> Signup and view all the answers

In the Post-Anesthesia Care Unit (PACU), which assessment finding necessitates the MOST immediate intervention by the nurse?

<p>A patient exhibiting signs of respiratory depression (shallow breathing, decreased oxygen saturation). (D)</p> Signup and view all the answers

A patient in the PACU is exhibiting decreased level of consciousness and a drop in oxygen saturation. After ensuring a patent airway and administering oxygen, what is the next MOST important nursing intervention?

<p>Assessing for potential causes of respiratory depression, such as residual anesthetic effects or opioid overdose. (C)</p> Signup and view all the answers

What is the PRIMARY reason for utilizing standardized surgical protocols in the operating room?

<p>To ensure consistent and safe practices, minimizing the risk of errors and complications. (C)</p> Signup and view all the answers

During post-operative care, a patient develops a fever, and the surgical wound exhibits increased redness and purulent drainage. What is the priority nursing intervention?

<p>Obtaining a wound culture and notifying the surgeon of the signs of infection. (B)</p> Signup and view all the answers

A patient is being prepared for surgery. What action is MOST important for the nurse to take to ensure correct site preparation?

<p>Following the hospital's protocol for skin antisepsis and marking the correct surgical site with the patient and surgeon. (A)</p> Signup and view all the answers

In implementing infection control measures, which action is MOST effective in preventing the transmission of pathogens in the operating room?

<p>Performing meticulous hand hygiene before and after patient contact, and after removing gloves. (D)</p> Signup and view all the answers

Flashcards

Pre-operative Chart Review

Review of patient's medical history and consent forms before surgery.

Admitting the Patient

Ensuring correct patient identity and administering prescribed pre-operative medications.

Surgery Checklist

Verifying the patient's belongings are secured and last food intake is noted.

OR Room Preparation

Proper attire, equipment checks, and strict adherence to sterile procedures.

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Patient Transfer

Team roles defined, patient safety during transfer, and equipment secured.

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Monitoring Vital Signs

Close monitoring and documentation of a child's vital signs.

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Achieving Drug Compliance

Ensuring patients take medications as prescribed to avoid complications and increased healthcare costs.

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Pain Control

Recognizing and managing pain in children who may not be able to verbalize it.

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Preventing Infections

Preventing infections through proper techniques and nutrition, especially nosocomial infections.

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High Observation Skill

Using keen observation skills to detect changes, especially in newborns who cannot communicate verbally.

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Neonate Temperature Control

Functional immaturity of thermoregulation in neonates makes them susceptible to temperature extremes.

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Pyrexia

Pyrexia refers to a raised body temperature or fever.

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Hyperpyrexia

Hyperpyrexia refers to a very high fever.

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Duration of Illness

Understanding the length of the illness to aid in diagnosis and assess severity.

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Signs and Symptoms

Using detailed history taking to identify key indicators. Non-passage of meconium is a pointer to intestinal obstruction.

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Fever Management

Maintaining normal body temperature through sponging, air exposure, and antipyretics.

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Fluid Administration

Following guidelines for fluid administration, approximately 100 ml/kg/day.

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Fluid Balance

Ensuring correct calculations to avoid dehydration or overhydration.

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Deranged Vital Signs

Requires prompt notification of the managing clinician.

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Abdominal Pain & Distension with Fever

Suggests typhoid intestinal perforation and its duration.

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Non-passage of meconium in a neonate

It is a pointer to intestinal obstruction like Hirschsprung’s disease or Anorectal malformation

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Patient's General Condition

Used for initial assessment of patient's overall health status to plan appropriate care.

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Weighing the Child

Essential for accurate drug and fluid administration in children.

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Child’s Nutritional Status

Assessing this of a child undergoing surgery contributes to the child's ability to recover.

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Drip Set (IV)

Delivers 20 drops per milliliter, slower administration.

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Solucet (IV)

Delivers 60 drops per milliliter, faster administration, be careful of the newborn body during use.

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Intake/Output Recording

Monitors fluid balance, especially with KCl administration and avoid cardiac events.

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KCl Administration

Monitor rate to avoid cardiac complications.

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Pediatric Fluid Chart

Chart that helps track hourly fluid intake to identify deviations from normal early.

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Postoperative Care

Care given to patients after a surgical procedure to help them recover.

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Postoperative Pain Management

Methods used to reduce pain after surgery, including medications and other techniques.

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Opioid Analgesics

Strong pain relievers that can cause side effects like nausea and slowed breathing.

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Non-Opioid Analgesics

Milder pain relievers like acetaminophen and ibuprofen.

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Multimodal Analgesia

Using different types of pain medicine together to target pain in multiple ways.

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Non-Pharmacological Interventions

Methods like ice packs, heat packs, and relaxation exercises to reduce pain and improve comfort.

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Patient-Controlled Analgesia (PCA)

Allowing patients to give themselves pain medicine within set limits.

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Postoperative Wound Care

Regularly checking a surgical wound for signs of infection and proper healing.

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Wound Healing Monitoring

Monitoring wound edges, granulation tissue, and signs of complications.

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Suture/Staple Removal

Typically removed within 1-2 weeks post-surgery, per doctor's orders.

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Post-op Wound Care Education

Instructions on wound care, infection signs, and when to seek help.

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Infection Prevention Aim

Reduces surgical site infections (SSIs) and other related infections.

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Hand Hygiene

Cornerstone of infection prevention, done before and after patient contact.

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Aseptic Technique

Using sterile techniques during dressing changes and IV line insertions.

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Prophylactic Antibiotics

Given before surgery to lower SSI risk, especially in high-risk procedures.

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Environmental Cleaning

Cleaning surfaces to lower pathogen transmission risk.

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Ambulation & Pulmonary Hygiene

Early activity and lung exercises to prevent pneumonia.

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Signs of Infection

Fever, high WBC count, local signs at the surgical site.

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Infection Prevention Education

Hand hygiene, wound care, recognizing signs of infection.

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Medication Management Education

Clear directions on medication use, side effects, and contact info.

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Wound Care Instructions

Cleaning, dressing, and watching for infection signs.

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Activity Restrictions Guidance

Limits on lifting, bending, with guidance on returning to activity.

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Post-op Diet & Nutrition

A balanced diet with adequate protein, vitamins, and fluids.

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Pre-operative Care

Preparing the patient physically and mentally for surgery.

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Pre-operative Assessment

Gathering a complete medical history to identify pre-exisiting conditions, allergies and medications.

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Patient Education

Explaining the procedure, anesthesia, and post-operative expectations to the patient.

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Informed consent

Ensuring the patient understands and agrees to the surgical procedure.

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Anesthesia Management

Techniques to eliminate pain, awareness, and movement during surgery.

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General Anesthesia

Complete loss of consciousness, sensation, and reflexes through medication.

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Regional Anesthesia

Numbing a specific body region, such as an arm or leg, to block pain.

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Local Anesthesia

Numbing a small area of the body, such as the skin for a minor procedure.

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Intra-operative Care

Maintaining patient safety and hemodynamic stability during surgery.

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Surgical Protocols

Standardized procedures that ensure consistency and safety in the operating room.

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Surgical Site Prep

Cleaning and disinfecting the surgical site to reduce the risk of infection.

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Patient Positioning

Critical to prevent nerve damage, pressure ulcers, and other complications during surgery.

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PACU

A specialized unit where patients recover from anesthesia.

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PACU Discharge

Patients must meet specific criteria showing stability before leaving PACU.

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Standard Precautions

Hand hygiene, PPE use, and safe injection practices to prevent infection spread.

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Description

Overview of nursing management during the intraoperative phase. Includes chart review and patient preparation, including proper identification, medication, and surgical checklists. Also covers room preparation, aseptic techniques, and patient transfer protocols to ensure safety and prevent injury.

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