Podcast
Questions and Answers
What is the recommended method for removing hair prior to surgery?
What is the recommended method for removing hair prior to surgery?
- Using an electrical clipper (correct)
- Depilatory creams
- Using a razor
- Waxing
Why is it important to avoid lifting the arm over the head or lifting more than 10 lbs for the next 4 weeks after pacemaker insertion?
Why is it important to avoid lifting the arm over the head or lifting more than 10 lbs for the next 4 weeks after pacemaker insertion?
- To prevent pacemaker wire dislodgement (correct)
- To promote wound healing
- To prevent shoulder stiffness
- To reduce the risk of infection
What is the indication for an implantable cardioverter/defibrillator?
What is the indication for an implantable cardioverter/defibrillator?
- Heart failure
- Ventricular tachycardia or ventricular fibrillation (correct)
- Myocardial infarction
- Atrial fibrillation
What should be monitored closely in a patient taking Digoxin or beta-blockers?
What should be monitored closely in a patient taking Digoxin or beta-blockers?
What should be avoided by a patient taking anticoagulant medication?
What should be avoided by a patient taking anticoagulant medication?
What laboratory tests are used to monitor a patient on anticoagulant therapy?
What laboratory tests are used to monitor a patient on anticoagulant therapy?
What is used to apply temporary transcutaneous pacing?
What is used to apply temporary transcutaneous pacing?
Why is it important for a patient with a pacemaker to report a pulse rate lower than that set on the pacemaker?
Why is it important for a patient with a pacemaker to report a pulse rate lower than that set on the pacemaker?
What is the primary goal of defibrillation in cardiac arrest?
What is the primary goal of defibrillation in cardiac arrest?
Why should you not defibrillate ventricular asystole?
Why should you not defibrillate ventricular asystole?
What medication is commonly administered to prevent infections, usually before surgery?
What medication is commonly administered to prevent infections, usually before surgery?
What is the primary purpose of administering atropine in bradycardia interventions?
What is the primary purpose of administering atropine in bradycardia interventions?
How is ventricular rate quickly determined on a 6-second strip?
How is ventricular rate quickly determined on a 6-second strip?
What is the primary goal of preoperative teaching?
What is the primary goal of preoperative teaching?
What is assessed during a psychosocial assessment for the preoperative patient?
What is assessed during a psychosocial assessment for the preoperative patient?
What is the primary purpose of administering medications and performing interventions during the 2-minute intervals of high-quality CPR?
What is the primary purpose of administering medications and performing interventions during the 2-minute intervals of high-quality CPR?
What is the first action to take if a patient experiences evisceration?
What is the first action to take if a patient experiences evisceration?
What is a common cause of dehiscence and evisceration?
What is a common cause of dehiscence and evisceration?
What is a patient risk factor for dehiscence?
What is a patient risk factor for dehiscence?
What is the typical time frame for dehiscence to occur after surgery?
What is the typical time frame for dehiscence to occur after surgery?
What is the first action to take if a patient experiences respiratory depression?
What is the first action to take if a patient experiences respiratory depression?
What is the primary concern when managing a patient with a postdural puncture headache?
What is the primary concern when managing a patient with a postdural puncture headache?
What is a potential consequence of untreated hypotension?
What is a potential consequence of untreated hypotension?
What is the primary goal when managing a wound dehiscence?
What is the primary goal when managing a wound dehiscence?
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Study Notes
Critical Rescue
- Early defibrillation is critical in resolving pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF)
- Defibrillation should not be delayed for any reason after the equipment and skilled personnel are present
- Do not defibrillate ventricular asystole, as there are no electrical impulses to disrupt
- Before defibrillation, loudly and clearly command all personnel to clear contact with the patient and the bed and check to see they are clear
- Deliver shock and immediately resume CPR for 5 cycles or about 2 minutes
Administration of Prophylactic Antibiotics
- Given to prevent infections, usually before surgery
- Examples include Cefazolin, Vancomycin, and Gentamicin
Bradycardia Interventions
- Atropine increases heart rate by reducing parasympathetic stimuli to the heart
Finding Ventricular Rate Quickly on a 6-Second Strip
- The distance between the "R" waves determines the ventricular rate
Psychosocial Assessment for the Preoperative Patient
- Determined the patient's level of anxiety before surgery, which can impair their learning ability
Preoperative Teaching to Avoid Postoperative Complications
- Teaching about pain control, coughing, turning, deep breathing, and incentive spirometer use
Complications to Report to the Provider Post Op
- Respiratory depression
- Hypotension (if significantly low)
- Epidural hematoma
- Infection (meningitis)
- Postdural puncture headache
- Decreased LOC
Management of Dehiscence and Evisceration
- Wound dehiscence is a partial or complete separation of the outer wound layers
- Evisceration is the total separation of all wound layers and protrusion of internal organs through the open wound
- Evisceration is a surgical emergency
- Management of dehiscence includes applying a sterile nonadherent or saline dressing to the wound and notifying the surgeon
- Management of evisceration involves immediate surgical intervention
Permanent Pacemaker Education and Assessment Findings to Report
- Teach pt to report a pulse rate lower than that set on the pacemaker
- Review the proper care of the pacemaker insertion site and the importance of reporting any fever or redness, swelling, or drainage at the site
Implantable Cardioverter/Defibrillator Education
- Indicated for patients who have experienced one or more episodes of spontaneous sustained ventricular tachycardia or ventricular fibrillation not caused by myocardial infarction
Care for Patient with Atrial Fib and Receiving Anticoagulant Medication
- Carefully assess pulse rate if pt takes Digoxin, other beta-blockers, etc
- Teach pt the importance of avoiding foods high in vit.K and to avoid certain herbs
- Laboratory test monitoring includes INR, PT, and aPTT
Temporary Transcutaneous Pacing Use
- Accomplished through the application of two large external electrodes attached to an external pulse generator
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