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Questions and Answers

Which of the following is a contraindication for the use of alfentanil?

  • Mild headache
  • Respiratory depression (correct)
  • Severe dehydration
  • Recent surgery
  • What must a healthcare provider monitor throughout the administration of alfentanil?

  • Emotional state
  • Patient's blood glucose levels
  • Skin temperature
  • Respiratory rate (correct)
  • Which of the following is an expected side effect of alfentanil?

  • Insomnia
  • Increased heart rate
  • Frequent urination
  • Nausea (correct)
  • What should be readily available in case of an alfentanil overdose?

    <p>Resuscitation equipment (C)</p> Signup and view all the answers

    What is a potential adverse effect of alfentanil related to the cardiovascular system?

    <p>Hypotension (D)</p> Signup and view all the answers

    Which nursing responsibility is important to prevent muscle rigidity when administering alfentanil?

    <p>Administer slowly (B)</p> Signup and view all the answers

    Why is it important to assess a patient's pain level before and after administering alfentanil?

    <p>To evaluate effectiveness and adjust dosage if needed (A)</p> Signup and view all the answers

    What should be checked in a patient's history before administering alfentanil?

    <p>History of opioid use or abuse (C)</p> Signup and view all the answers

    What nursing intervention is essential during the Induction stage of anesthesia?

    <p>Monitor vital signs and provide emotional support (A)</p> Signup and view all the answers

    Which symptom is characteristic of Stage II (Delirium/Excitement) anesthesia?

    <p>Irregular breathing and increased muscle tone (B)</p> Signup and view all the answers

    In which stage does the patient lose the gag and cough reflexes?

    <p>Surgical Anesthesia (C)</p> Signup and view all the answers

    What immediate action is required during Stage IV (Danger/Medullary Depression) anesthesia?

    <p>Initiate support of vital functions (A)</p> Signup and view all the answers

    Which nursing intervention is specific to managing risks during the Stage of Delirium/Excitement?

    <p>Prepare to assist anesthetist as needed (C)</p> Signup and view all the answers

    What is a key sign of Stage I anesthesia?

    <p>Loss of pain sensation (A)</p> Signup and view all the answers

    What symptom should be monitored closely in patients in Stage IV anesthesia?

    <p>Weak and irregular pulse (B)</p> Signup and view all the answers

    What is a responsibility of nursing staff during the Surgical Anesthesia stage?

    <p>Maintain sterility and ensure surgical site access (B)</p> Signup and view all the answers

    What is a critical aspect of ensuring informed consent prior to surgery?

    <p>The surgeon must provide comprehensive information about the procedure. (D)</p> Signup and view all the answers

    How do antihypertensive drugs potentially increase surgical complications?

    <p>They may lead to hypotension during the perioperative period. (B)</p> Signup and view all the answers

    What is a primary reason to assess coagulation status prior to surgery?

    <p>To minimize the risk of excessive bleeding during procedures. (D)</p> Signup and view all the answers

    In which situation would a patient with diabetes require special monitoring during surgery?

    <p>If they are hyperglycemic or hypoglycemic. (C)</p> Signup and view all the answers

    What effect does decreased immunity have on surgical patients?

    <p>It can lead to a longer recovery time and increased infection risks. (D)</p> Signup and view all the answers

    Why is it important to identify cultural and ethnic factors in the surgical setting?

    <p>They may affect the patient’s perceptions and expectations of care. (A)</p> Signup and view all the answers

    How does malnutrition, including obesity, impact surgical outcomes?

    <p>It can impair wound healing and increase the risk of complications. (C)</p> Signup and view all the answers

    What role do bleeding disorders have in the surgical setting?

    <p>They increase the likelihood of excessive bleeding during and after surgery. (B)</p> Signup and view all the answers

    Flashcards

    Alfentanil Contraindications

    Hypersensitivity to alfentanil or other opioids, respiratory depression, or severe asthma, paralytic ileus.

    Alfentanil Side Effects

    Common side effects include nausea, vomiting, dizziness, and respiratory depression.

    Alfentanil Adverse Effects (CNS)

    Central Nervous System effects include sedation and confusion.

    Alfentanil Adverse Effects (CV)

    Cardiovascular effects include hypotension and bradycardia.

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    Alfentanil Adverse Effects (Respiratory)

    Respiratory depression and apnea are possible adverse effects.

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    Nursing Responsibility: Monitoring

    Monitor respiratory rate, blood pressure and O2 sat during alfentanil administration.

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    Nursing Responsibility: Resuscitation

    Keep resuscitation equipment available to address possible overdose or severe respiratory issues.

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    Nursing Responsibility: Patient Education

    Educate patients about potential side effects and monitoring needs.

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    Stage I of Anesthesia

    The patient progresses from awake to drowsy, losing pain sensation, with slowed responses to stimuli. Mild respiratory depression occurs.

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    Stage II Anesthesia

    Characterized by irregular breathing, involuntary movements, increased muscle tone, active reflexes, potential vomiting or struggling, and increased risk of laryngospasm.

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    Stage III Anesthesia

    Regular breathing resumes, muscle relaxation occurs, eye movements cease; patient is ready for surgery, with adequate anesthesia depth. Gag and cough reflexes are lost.

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    Stage IV Anesthesia

    Severe respiratory and cardiovascular depression; pupils dilate, pulse weakens and is irregular. This is a life-threatening stage.

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    Surgical Anesthesia

    The stage of anesthesia where the patient is completely ready for surgery.

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    Induction, Anesthesia

    Transition from awake to drowsy, loss of sensation and slowing responses.

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    Nursing Interventions (Stage I)

    Monitor vital signs, assist with induction, reassure the patient, provide emotional support, ensure equipment is functioning.

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    Nursing Interventions (Stage II)

    Protect patient from self-injury, maintain a calm environment, secure airway, suction secretions if needed, assist anesthetist if needed.

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    Preoperative Lab Tests

    Tests performed before surgery to assess the patient's health and identify potential risks.

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    Informed Consent

    A patient's agreement to surgery after receiving sufficient information about the procedure, risks, and alternatives, signed and witnessed.

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    Surgical Complications

    Problems that may arise during or after a surgical procedure, influenced by various patient factors.

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    Hemoglobin/Hematocrit

    Blood tests measuring the amount of red blood cells and their ability to carry oxygen; low levels indicate anemia.

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    Electrolyte Imbalance

    An abnormal level of electrolytes, like sodium, potassium or chloride, which can cause dehydration, renal or cardiovascular issues.

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    Coagulation Status

    Blood's ability to clot; assessed to prevent excessive bleeding during and after surgery.

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    Blood Type

    Categorization of blood based on antigens; necessary for blood transfusions if needed during or after surgery.

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    Preoperative Assessment (Diabetes)

    Monitoring blood glucose levels to identify and manage potential complications in diabetic patients before surgery.

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    Study Notes

    Peri-Operative Nursing

    • This module covers nursing care for clients during the peri-operative period.
    • The learners are third-year nursing students who have successfully completed NCM 109.
    • The module is divided into five concepts:
      • Care of Clients with Problems in Oxygenation
      • Care of Clients with Problems in Fluids and Electrolytes Imbalances
      • Care of Clients with Problems in Infectious, Inflammatory, and Immunologic Responses
      • Cellular Aberration (Oncology Nursing)
      • Care of Clients during the Peri-Operative Period (Peri-Operative Nursing)
    • Program outcomes include applying knowledge of sciences to nursing practice, providing safe care, and applying evidence-based practices.
    • The module includes knowledge, judgment, and skills based on nursing science, concentrating on safety, advocacy, and patient education.
    • The module covers preoperative, intraoperative, and postoperative phases of surgical experience.

    Instruction to Learners

    • The module tackles nursing care during the peri-operative period.
    • This module will focus on specific surgical topics.
    • A 4-hour session will be held Monday and Wednesday.
    • Unit 1: Introduction to Peri-Operative Nursing (1 hour)
    • Unit 2: Pre-Operative Phase (2 hours; includes assessment, preparation, and ethico-legal aspects)
    • Unit 3: Intra-Operative Phase (3 hours; includes environment, team, positioning, incision, aseptic techniques, and anesthesia)
    • Unit 4: Post-Operative Phase (2 hours; includes PACU and nursing management in surgical unit)

    Objectives

    • Included objectives are based on content of each unit.

    Introduction to Peri-Operative Nursing

    • Definition of perioperative nursing
    • Three phases of perioperative nursing
    • Major pathologic processes requiring surgery
    • Relationship of the nursing process to perioperative nursing
    • Types of surgical classifications

    Pre-Operative Assessment

    • Goals of preoperative assessment include determining the patient's psychological status and identifying potential risks related to the surgical procedure.
    • Identifying risk factors for surgical complications
    • Describe routine pre-operative screening tests.

    Pre-Operative Assessment and Preparation

    • Documentation of results for pre-operative tests
    • Identifying patient's level of anxiety, coping ability, and support systems.
    • Definition of informed consent
    • Legal implications of informed consent
    • Identifying circumstances that require informed consent

    Intraoperative Phase: Surgical Environment and Team

    • Description of surgical environments.
    • Responsibilities of surgical team members.
    • Principles of aseptic techniques in the OR.

    Intraoperative Phase: Surgical Positioning, Incisions, and Aseptic Techniques

    • Positioning techniques for surgery.
    • Types of surgical incisions.
    • Aseptic techniques.

    Intraoperative Phase: Anesthesia

    • Effects of anesthesia
    • Stages of anesthesia
    • Types of anesthetic drugs

    Postoperative Phase (PACU)

    • Responsibilities of a PACU nurse in preventing complications.
    • Common postoperative problems.
    • Outline wound healing process.
    • Assessment and discharge criteria

    Post Operative Phase: Nursing Management in Surgical Unit

    • Postoperative nursing interventions in the general surgical unit.
    • Common Post-operative problems and management.
    • Wound healing process

    Post-Operative Complications

    • Potential complications (wound infection, impaired wound healing, dehiscence, evisceration, pneumonia, atelectasis, thrombophlebitis, urinary incontinence, intestinal obstruction, constipation and paralytic ileus, postoperative depression).

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