NUR 105 Exam I
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Created by:
cdabernathy on January 29, 2010
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Chapters 17-20
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156 terms
Terms | Definitions |
|---|---|
 ectomy | excision or removal of |
| lysis | destruction of |
| orrhaphy | repair or suture of |
| oscopy | looking into |
| ostomy | creation of opening into |
| otomy | cutting into or incision of |
| plasty | repair or reconstruction of |
| anxiety, fear, hope | most common psychologic factors associated with surgery |
| P1 | a normal healthy person; rating |
| P2 | a patient w/ mild systemic disease; rating |
| P3 | a patient w/ severe systemic disease; rating |
| P4 | a patient w/ severe systemic disease that is a constant threat to life; rating |
| P5 | a moribund patient who is not expected to survive without surgery; rating |
| P6 | a declared brain-dead patient whose organs are being removed for donor purposes |
| benzodiazepines | reduce anxiety, amnesic effects; induce sedation, amnesia |
| opioids | may be given to reduce intra-op anesthetics requirements and to reduce pain |
| histamine H2 receptor antagonists | reduce HCL acid secretion; increase gastric pH; decrease gastric volume |
| antiemetics | may be given to decrease nausea and vomiting; increase gastric emptying |
| anticholinergics | given to reduce secretions; prevent bradycardia |
| homeostasis | the state of equilibrium in the internal enviroment of the body, naturally maintained by adaptive responses and promote healthy survival |
| ions | electrically charged particles |
| cations | postively charged ions |
| anions | negatively charged ions |
| valence | electrical charge of an ion |
| diffusion | the movement of molecules from an area of high concentration to one of low concentration |
| facilitated diffusion | moves molecules from an area of high concentration to one of low concentration; there is a carrier molecule on most cells that increases the rate |
| active transport | process in which molecule move against the concentration gradient; external energy is required ex. sodium-potassium pump |
| osmosis | the movement of water between 2 compartments seperated by a semipermeable membrane |
| osmotic pressure | amount of pressure required to stop the osmotic flow of water |
| osmolality | measures the osmotic force of solute per unit of weight of solvent; describes fluids inside the body |
| osmolarity | measures the total milliosmoles of solute per unit of total volume of solution; pertains to fluids outside the body |
| isotonic | fluids with the same osmolality as the cell interior |
| hypotonic | solutions in which the solutes are less concentrated than the cells |
| hypertonic | solutions with solutes more concentrated than cells |
| hydrostatic pressure | the force within a fluid compartment |
| oncotic pressure | osmotic pressure exerted by colloids in solution |
| fluid spacing | describes the distribution of body water |
| aldosterone | mineralocorticoid with potent sodium-retaining and potassium-excreting capability |
| thirst mechanism | primary protection against the development of hyperosmolality |
| anti-diuretic hormone (ADH) | acts in the renal distal and collecting tubules causing water reabsorption |
| atrial natriuretic peptide (ANP) | act on the renal distal tubules to promote excretion of sodium and water, resulting in a decrease in blood volume and BP; suppress secretion of aldosterone, renin and ADH |
| hypovolemia | ECF volume deficit |
| hypervolemia | ECF volume excess |
| dehydration | refers to loss of pure water alone without corresponding loss of sodium |
| fluid volume excess | may result from excessive intake of fluids, abnormal retention of fluids or interstitial to plasma fluid shift |
| fluid volume deficit | can occur with abnormal loss of body fluids, inadequate intake or plasma to interstitial fluid shift |
| sodium | main cation in the ECF |
| hypernatremia | elevated serum sodium from water loss or sodium gain |
| hypernatremia | causes shift of water out of cells, leads to cellular dehydration |
| hyponatremia | results from loss of sodium-containing fluids, from water excess or a combo of both |
| hyponatremia | symptoms are r/t cellular swelling and are first manifested in the CNS |
| potassium | major cation in the ICF |
| hyperkalemia | caused by massive intake of potassium, impaired renal excretion, shift of potassium from the ICF to the ECF or combo of all; high serum potassium |
| hyperkalemia | results in increased cellular excitibility cause cramping leg pain |
| hyperkalemia | tall, peaked T wave |
| hypokalemia | flattened T wave; presence of U wave |
| hypokalemia | results from abnormal losses of potassium from a shift of K+ from ECF to ICF |
| hypercalcemia | caused by hyperthyroidism, malignancy (breast cancer, lung cancer, multiple myeloma); Vitamin D overdose |
| hypocalcemia | caused by any condition that decreases the production of PTH; patient who receives multiple blood transfusions; acute pancreatitis |
| tetany | sustained muscle contraction |
| hypophosphatemia | seen in patient who is malnourished or has a malabsorption syndrome |
| hyperphosphatemia | caused by acute of chronic renal failure that results in altered ability of kidneys to excret phosphate; also caused by: chemotherapy, excessive ingestion of milk or phosphate containing laxative |
| hypermagnesemia | usually only occurs with an increase in magnesium intake accompanied by renal insufficency or failure |
| hypomagnesemia | caused from prolonged fasting or starvation also chronic alcoholism |
| alkalosis | process that adds base or eliminates acid from body fluids; blood pH >7.45 |
| acidosis | process that adds acid or eliminates base from body fluids; blood pH <7.35 |
| pH | hydrogen ion concentration |
| buffer | substance that acts with acid or base to prevent a large change in pH |
| respiratory acidosis | CO2 retention from hypoventilation |
| respiratory alkalosis | incresed CO2 excretion from hyperventilation |
| metabolic acidosis | gain of fixed acid, inability to excrete acid or loss of base (loss of bicarb) |
| metabolic alkalosis | loss of strong acid or gain of base (gain of bicarb) |
| respiratory acidosis | pH - decreased; PaCO2 -increased |
| respiratory alkalosis | pH - increased; PaCO2 - decreased |
| metabolic acidosis | pH - decreased; HCO3 - decreased |
| metabolic alkalosis | pH - increased; HCO3 - increased |
| ABGs | values provide information about a patient's acid-base status, underlying cause of imbalance, body's abilty to regulate pH and patient overall oxygen status |
| fluid volume deficit | poor skin turgor |
| Na+ deficit | cold, clammy skin |
| fluid volume excess | pitting edema |
| Na+ excess | flushed, dry skin |
| fluid volume excess | bounding pulse |
| FVD, hyponatremia | rapid, weak, thready pulse |
| hypokalemia | weak, irregular, rapid pulse |
| hyperkalemia | weak, irregular, slow pulse |
| FVD, hyponatremia | hypotension |
| FVE | hypertension |
| dantrolene (Dantrium) | definitive treatment of MH is prompt administration of |
| dysrhythmias | in PACU; are often the result of hypokalemia, hypoxemia, hypercarbia, alterations in acid-base status, circulatory instability, and preexisting heart disease; hypothermia, pain, surgical stress, and man anesthetic agents are also a capable cause |
| hypertension | common finding in PACU; most frequently result of SNS stimulation that may be result of pain, anxiety, bladder distention, or respiratory compromise or hypothermia. |
| hypotension | most common cause in PACU is fluid and blood loss |
| deep vein thrombosis (DVT) | may result in leg veins following surgery as result of inactivity, body position and pressure; common in older adult, obese patient and immobolized patient |
| early ambutation | most significant general nursing measure to prevent post-op complications |
| emergence delirium | waking up wild; can include behaviors such as restlessness, agitation, disorientation, shouting and thrashing. |
| FVE | shortness of breath |
| FVE | moist crackles |
| hypocalcemia | restricted airway |
| hypocalcemia | cramping of excercised muscle |
| hypocalcemia | carpal spasm (Trousseau's sign) |
| hypokalemia | flabby muscle |
| hypocalcemia | positive Chvostek's sign |
| hypokalemia | picking at bedclothes |
| FVD, hyponatremia | indifference |
| FVD, hyperkalemia, hypernatremia | extreme restlessness |
| FVE, hypercalcemia, hypokalemia, hyponatremia | confusion and irritability |
| hyponatremia | decreased level of consciousness |
| hypotonic | solution that provides more water than electrolytes, diluting ECF |
| isotonic | ideal fluid replacement for a patient with an ECF volume deficit; only expands the ECF |
| hypertonic solutions | require freqent monitoring of BP, lung sounds and serum sodium levels and should be used with caution because of risk for intravascular FVE |
| surgical suite | a controlled enviroment designed to minimize the spread of infectious organisms and allow a smooth flow of patients, personnel and instruments & equipment needed to provide safe patient care |
| holding area | special waiting area inside or adjacent to the surgical suite |
| operating room | unique acute care setting removed from other hospital clinical areas; surgical enviroment |
| perioperative nurse | registered nurse who implements patient care during the perioperative period based on nursing process |
| circulating nurse | nurse that is not scrubbed, gloved or gowned and remains in unsterile field |
| scrub nurse or tech | assists surgeon by passing instruments and implementing other technical functions during surgical procedure |
| surgeon | physican who performs surgical procedure |
| anesthesia care provider | one who adminsters anesthesia and can be an anesthesiologist or CRNA |
| nurse anesthetist | RN who has graduated from accredited nurse anesthesia program |
| conscious sedation | drug induced depression of consciousness that reatains the patient's ability to maintain his/her own airway and respond appropiately to verbal commands |
| general anesthesia | loss of sensation with loss of consciousness; skeletal muscle relaxation; possible impaired ventilatory & cardiaovascular function and elimination of the somatic, autonomic and endocrine responses, including coughing, gagging, vomiting and SNS responsiveness |
| local anesthesia | loss of sensation without loss of consciousness; may be induced topically or via IV or subQ |
| regional anesthesia | loss of sensation to a region of the body without loss of consciousness when a specific nerve or group of nerves id blocked with administration of local anesthetic ex. spinal, epidural or peripheral nerve block |
| preinduction | time period starting w/ pre-op medication, initiation of appropiate IV/arterial access, application of monitors |
| induction | initiation of sequence of medications that render the patient unconscious, securing airway |
| maintenance | time period during which the surgical procedure is performed; patients remains in unconscious state with appropiate measures to ensure safety of airway |
| emergence | time period which the surgical procedure is completed; patient is prepared for return to consciousness and removal of airway assist devices |
| spinal anesthesia | injection of a local anesthetic into cerebrospinal fluid found in the subarachnoid space, usually below level of L2 |
| epidural block | injection of local anesthetic into the epidural (extradural) space via thoracic or lumbar approach |
| controlled hypotension | technique used to decrease amount of expected blood loss by lowering BP during anesthesia administration |
| hypothermia | deliberate lowering of body temp to decrease metabolism thus reducing demand for oxygen & anesthetic requirements |
| cryoanesthesia | cooling or freezing localized area to block pain impulses |
| anaphylaxis | most severe form of an allergic reaction |
| malignant hyperthermia | rare metabolic disease characterized by hyperthermia with rigidity of skeletal muscles that can result in death; occurs in affected people exposed to certain anesthetic agents |
| anectine | appears to be primary trigger of MH along with volatile inhalation agents |
| PACU | recovery; immediate postanesthetic period |
| PACU phase 1 | intensive monitoring and care of patient in immediate post op period |
| PACU phase 2 | care for ambulatory post surgery patients |
| PACU phase 3 | extended care/observation unit following surgery |
| fast tracking | admitting ambulatory surgical patients who received general, local, or regional anesthesia to phase 2 care |
| RPP | how patients move throught PACU phases |
| atelectasis | alveolar collapse; most common cause of post-op hypoxemia |
| airway obstruction | most commonly caused blockage of the airway by patient tongue |
| hypoxemia | partial pressure of arterial oxygen of less than 60 mm Hg |
| bronchospasm | result of increase in bronchial smooth muscle tone with resultant closure of small airways |
| hypoventilation | decreased respiratory rate or effort, hypoxemia and increase partial pressure of arterial CO2; common complication in PACU |
| syncope | factor that reflects cardiovascular status; may indicate decreased cardiac output, fluid deficits, or defects in cerebral perfusion |
| delayed emergence | prolonged drug action |
| Patient controlled analgesia (PCA) | provides immediate analgesia and maintains a constant, steady blood flow of analgesic agent; self administrationor predetermined doses of analgesica by patient |
| epidural analgesia | infusion of opioid analgesics through a catheter placed into epidural space surrounding spinal cord |
| hypothermia | core temperature of less than 96.8 degrees F, occurs when heat loss exceeds heat production |
| hiccups | intermittent spasms of diaphragm caused by irritation of phrenic nerve |
| wound dehiscence | separation & disruption of previously joined wound edges |
| Bier Block | this type of nerve block provides not only analgesia but also ability to work in a bloodless field. |
| dissociative anesthesia | interrupts associative brain pathways while blocking sensory pathways; Patient appears catatonic, is amnesic, and experiences profound analgesia that lasts into the post-op period. |
| Ketamine (Ketalar) | commonly administered dissociative anesthestic; used in asthmatic patients under going surgery because it causes bronchodilation and in trauma patients because it increases heart rate and helps maintain cardiac output. |
| hallucinations and nightmares | adverse reaction from ketalar, particularly in older adult |
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