Nursing Safety Priority: Critical Rescue
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Questions and Answers

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?

  • 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?

  • 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?

    <p>Pulse rate</p> Signup and view all the answers

    What should be avoided by a patient taking anticoagulant medication?

    <p>Foods high in vitamin K</p> Signup and view all the answers

    What laboratory tests are used to monitor a patient on anticoagulant therapy?

    <p>INR, PT, aPTT</p> Signup and view all the answers

    What is used to apply temporary transcutaneous pacing?

    <p>Two large external electrodes</p> Signup and view all the answers

    Why is it important for a patient with a pacemaker to report a pulse rate lower than that set on the pacemaker?

    <p>To monitor for potential pacemaker malfunction</p> Signup and view all the answers

    What is the primary goal of defibrillation in cardiac arrest?

    <p>To disrupt the chaotic rhythm and allow the SA node signals to restart</p> Signup and view all the answers

    Why should you not defibrillate ventricular asystole?

    <p>Because there are no electrical impulses to disrupt</p> Signup and view all the answers

    What medication is commonly administered to prevent infections, usually before surgery?

    <p>Cefazolin</p> Signup and view all the answers

    What is the primary purpose of administering atropine in bradycardia interventions?

    <p>To increase heart rate by reducing parasympathetic stimuli</p> Signup and view all the answers

    How is ventricular rate quickly determined on a 6-second strip?

    <p>By measuring the distance between the 'R' waves</p> Signup and view all the answers

    What is the primary goal of preoperative teaching?

    <p>To teach the patient about coughing, turning, deep breathing, and incentive spirometer</p> Signup and view all the answers

    What is assessed during a psychosocial assessment for the preoperative patient?

    <p>The patient's level of anxiety</p> Signup and view all the answers

    What is the primary purpose of administering medications and performing interventions during the 2-minute intervals of high-quality CPR?

    <p>To restore an organized cardiac rhythm</p> Signup and view all the answers

    What is the first action to take if a patient experiences evisceration?

    <p>Notify the surgeon immediately</p> Signup and view all the answers

    What is a common cause of dehiscence and evisceration?

    <p>Forceful coughing or vomiting</p> Signup and view all the answers

    What is a patient risk factor for dehiscence?

    <p>Obesity</p> Signup and view all the answers

    What is the typical time frame for dehiscence to occur after surgery?

    <p>Between the fifth and tenth days after surgery</p> Signup and view all the answers

    What is the first action to take if a patient experiences respiratory depression?

    <p>Notify the anesthesia provider</p> Signup and view all the answers

    What is the primary concern when managing a patient with a postdural puncture headache?

    <p>Providing pain management</p> Signup and view all the answers

    What is a potential consequence of untreated hypotension?

    <p>Decreased level of consciousness</p> Signup and view all the answers

    What is the primary goal when managing a wound dehiscence?

    <p>Preventing further wound complications</p> Signup and view all the answers

    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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    Description

    This quiz focuses on the importance of early defibrillation in resolving pulseless ventricular tachycardia and ventricular fibrillation, and the proper procedure for defibrillation in critical rescue situations.

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