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Stage 1 (analgesia and sedation, relaxation)
begins with induction and ends with loss of consciousness
close operating room doors, dim the lights, and control traffic in the o.r.
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Stage 1 (analgesia and sedation, relaxation)
patient feels drowsy and dizzy, has a reduced sensation to pain, and is amnesic.
position pt securely with safety belts
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Stage 1 (analgesia and sedation, relaxation)
Hearing is exaggerated
keep discussions about the pt to a minimum
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Stage 2 (Excitement, delirium)
Begins with loss of consciousness and ends with relaxtion, regular breathing, and loss of the eyelid reflex
avoid auditory and physical stimuli
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Stage 2 (Excitement, delirium)
PT may have irregular breathing, increased muscle tone, and involuntary mvmt of the extremities during this stage.
protect the extremeties
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Stage 2 (Excitement, delirium)
Laryngospasm or vomitting may occur
assist the anesthesiologist or CRNA with suction as needed.
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Stage 2 (Excitement, delirium)
Pt is susceptible to external stimuli
stay with pt
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Stage 3 (operative anesthesia, surgical anesthesia)
Begins with generlized m. relaxation and ends with loss of reflexes and ends with loss of relexs and depression of vital functions
assist the anesthesiologist or CRNA with intubation
place pt into operative position
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Stage 3 (operative anesthesia, surgical anesthesia)
The jaw is relaxed, and breathing is quiet and regular.
prep (scrub) the pt's skin over the operative site as directed.
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Stage 4 (danger)
Begins with depression of vital functions and ends with respiratory failure, cardiac arrest, and possible death.
prepare for and assist in treatment of cardiac and/or pulmonary arrest.
Document occurrence in the pt's chart.
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Stage 4 (danger)
respiratory m. are paralyzed; apnea occurs
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Stage 4 (danger)
pupils are fixed and dilated
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Normal Ranges:
K+
3.5-5 mEq/L
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Normal Ranges:
Na+
136-145 mEq/L
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Normal Ranges:
Cl-
98-106 mEq/L
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Normal Ranges:
CO2
23-30 mEq/L
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Normal Ranges:
Glucose
70-110 mg/dL
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Normal Ranges:
Creatnine
Females: .5-1.1 mg/dL
Males: .6-1.2 mg/dL
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Normal Ranges:
Blood urine nitrogen (BUN)
10-20 mg/dL
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Normal Ranges:
Prothrombin time (PT)
11-12.5 sec 85-100%
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Normal Ranges:
International normalized ratio (INR)
.7-1.8
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Normal Ranges:
Partial thromboplastin time (aPTT)
30-40 sec
-
Normal Ranges:
WBC
Total: 5,000-10,000/mm3
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Normal Ranges:
Hemoglobin
Females: 12-16 g/dL
Males: 14-18g/dL
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Normal Ranges:
Hematocrit
Females: 35-45%
Males: 42-52%
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Roles and responsibilities during care:
Holding Nurse
- Greet
- Review med record
- preop checklist
- verifying consent forms signed
- documenting risk assesment
- asses physical and emotional state
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Roles and responsibilities during care:
Circulating Nurse:
- coordinate activities within particular OR
- set up OR
- ensure supplies are available, gathered and inspected
- make up operating bed with pads, safety straps and arm boards
- assumes responsibility of holding nurse if one is not present
- moniters traffic in room
- assesses blood and urine loss
- reports finding to surgeon and anesth
- ensures sterility of room
- anticipates needs of surg team and pt
- communicate pt status to family members
- document
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Roles and responsibilities during care:
Scrub nurse
- set up sterile field
- drape pt
- hand sterile supplies to surgeon
- anticipates the needs of the surgeon
- throughout procedure maintains accurate count of sponges, sharps, instruments, and amts of irrigation fluid and drums used
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Roles and responsibilities during care:
Speciality Nurse
- may perform scrub work
- in charge of certain specialty surgery
- assesses, maintains, and recommends instruments and supplies used in specialty
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Performed to determine the origin and cause of a disorder or the cell type for cancer
diagnostic
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Performed to resolve a health problem by repairing or removing the cause
curative
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Performed to relieve symptoms of a disease process, but does not cure
palliative
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performed primarily to alter or enhance personal appearance
cosmetic
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planned for correction of a nonacute problem
elective
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requires prompt intervention; may be life threatening if treatment is delayed more than 24-48 hours
urgent
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requires immediate intervention because of life threatening consequences
emergent
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