Appropriate Monitoring Report

When there is a complication of the regional anesthesia which might include anaphylaxis, overdose, incorrect delivery technique and systemic absorption, the nurse will monitor for systemic toxic reaction which comprises of monitoring the central nervous system (CNS) stimulation along with CNS and cardiac depression. The nurse will also assess the patient for incoherent speech, restlessness, blurred vision, excitement, headache, nausea, vomiting, metallic taste, seizures, tremors, increase blood pressure, respiration and pulse. The patient may become apnea, hypotensive, unconscious, and have a cardiac arrest which may lead to death if the toxic reaction is not treated. Nursing intervention for the complication of regional anesthesia include establishing an open airway, administering oxygen, and notifying the surgeon. Treatment usually comprise of a fast acting barbiturate with epinephrine being administered for cardiac arrest. Edema and inflammation is an early sign of local complication with abscess formation, tissue necrosis and /or gangrene occurring later (Ignatavicius & Workman, 2013). Since general anesthesia was administer in addition to the regional anesthesia, the nurse and anesthesiologist will have to also monitor for complication of general anesthesia which range from a minor sore throat to death. Certain drugs used for general anesthesia may cause an acute, life threatening complication know as malignant hyperthermia (MH). The exposure of these agent to the skeletal muscle causes an increases in serum calcium and potassium level, metabolic rate leading to increased body temperature, acidosis and cardiac dysrhythmias. MH might occur immediately after the administration of the anesthesia, or several hours into the

2.7 Monitoring physiological measurements it´s important to make sure the individual health status and also necessary after surgery, as patients in intensive care units require continuous monitoring, and sometimes have medications that requires physical measurements taken. These are measurements we take to ensure that they are functioning in the way they are supposed to. When we carry out physiological measurements, such as measuring temperature, pulse and respiration, we are monitoring for signs of abnormality. Then be able to draw conclusions about the health status of the individual and any treatments they may

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

Many factors have contributed to the sentinel event, specifically the current conscious sedation policy. The improvement plan would include revising the conscious sedation policy to ensure the patient is properly monitored post procedure and to intervene when issues arise. The sedated patient should be monitored one on one post procedure by an RN, who is educated on the conscious sedation protocol, for thirty minutes or until the patient reaches his baseline. Also, mandatory monitoring will include EKG, pulse oximetry, blood pressure, heart rate, respirations and level of consciousness. A list of appropriate medications and the dosages should be included in the conscious sedation policy. In addition, reversal agents should be readily

In order to decrease the likelihood that such sentinel event will occur again, a change must be put into place. In this case, the change should involve the process in which conscious sedation is carried out as well as the knowledge of those providing care for those patients. The registered nurse in this case is most likely very good at her job, she probably felt that she had everything under control and has most likely provided conscious sedation many times in the past. As an experienced nurse, however, it is wise to understand that one should never become complacent and it is okay to ask for additional help, especially when a change in patient’s status can occur so quickly. And while this nurse is up to date on her sedation modules

The relationship between the perioperative nurse and the patient has suffered a long process of mutation throughout the last decades. If before all the dynamics experienced within an operating theatre were based upon organizational and logistical aspects, these days the focus lies on the patient and all the comfort and security demanded throughout a process that already reveals itself aggressive for the patient. Being the front-line person in this dynamic, the anaesthetic nurse plays a crucial and intense role on the patient’s experience.

Gathering observations of patients is a vital task that all Nurses must complete on a regular basis, they include Blood pressure, respiration rate, pulse, temperature and oxygen saturation. The information gathered from the observations enable for warnings when a patient is deteriorating

The skilled CRNA is not only proficient in the operating room, but also comfortable dealing directly with patients and their family members. Once in the operating room this is where their wealth of knowledge, experience, and critical thinking really comes into play. Taking into account the patient’s history and current medical issues, the CRNA lays out a plan of care for the patient and makes decisions regarding the type, dose, and rate of medications needed to induce a safe anesthetic effect for the patient during the procedure. While the procedure is underway it is the duty of the CRNA to keep the patient stable and successfully handle any bumps in the road that might occur. This is the role of the nurse anesthetist that I have been most impressed with. The time that I spent in the OR following a CRNA I witnessed him handle difficult situation after difficult situation. As the patient’s respiratory status started to decline, I watched as he manipulated the ventilator; switching between modes and changing settings until a safe respiratory rate and saturation level was achieved. Later the patient went into an adventitious heart rhythm that began to affect their

During one of the most susceptible times in a patient’s life you are caring for the patient and essentially breathing for the patient when they are unable to do so, as well keeping them alive. Furthermore, what inspired me to be a Nurse Anesthetist is the control you have over the patient and their physiologic

sedation have continuous BP, ECG, & Pox monitoring done. Nurse J. who was trained in the

The purpose of this paper is to discuss the methods used by a local health care facility, Southwest General Hospital, to evaluate and monitor healthcare quality data. Quality measurement in health care is the process of using data to evaluate the performance of health care providers against recognized quality standards (FamiliesUSA, 2014). The measuring of quality plays a vital role in the creating, maintaining, and managing of the data that this healthcare facility aims in focusing on quality of health care.

The anesthetist assessed the patient’s vitals by comparing the values to what is normal and what was normal for the patient when it was measured at the beginning of anesthesia. The vitals were taken every 10 minutes with a blood gas analysis performed every 30 minutes to monitor the electrolytes. These parameters would not only help to maintain the patient at a surgical plane of anesthesia but also help the anesthetist maintain the patient at a steady state physiologically and metabolically. In addition, the patient’s potassium levels were specially monitored throughout the anesthesia due to his HYPP status. An arterial catheter would also be placed in the patient’s metatarsal artery for measurement of direct blood pressure and would also be used for blood collection for IRMA blood gas

Learning about the potential complications of epidural reinforced my knowledge in being able to choose the right anaesthetic monitoring equipment. Knowing that Spinal and epidural anaesthesia can cause unpredictable and profound arterial hypotension necessitate the use of adequate monitoring like the; Pulse oximetry, ECG and Blood pressure cuff. This knowledge will help me to be able to select appropriate monitoring devices during epidural catheter insertion. Also it goes without saying that an epidural must be performed in a work area that is equipped for airway management and resuscitation.

Mr. B.’s procedure after sedation (was accomplished) was successful and his sedation level continues. Nurse J then applies an automatic blood pressure machine to measure every 5 minutes and a pulse oximeter, however the nurse does not apply any respiratory monitor or heart monitor which are protocol after a sedation procedure. The nurse then rushes out of the room leaving Mr. B. with his son with no medical personnel at the bedside to monitor the patient. No sedation score or neurological assessment of Mr. B. is noted, which should be performed after any procedure including sedation. This data is either missing, not documented or not performed by Nurse J. Mr. B.’s alarm for low saturation is alarming and the LPN enters the room briefly,

There are many diagnostic devices in the ICU. One diagnostic device is the Electroencephalograph or EEG, which is used to record brain waves in order to show the brain cells electrical activity. The device works by attaching small caps to the patient’s scalps in order to indicate the brain electrical energy. Then, the health caregiver will be able to constantly record the brain waves activity of the patient. Another diagnostic equipment is the Intracranial Pressure Monitor or ICP, which is used to monitor and determine the brain pressure of a patient. The way that ICP works is by attaching a small tube such as catheter to the patient’s skull, and it is connected to a transducer on the other side in order to record the pressure of the patient’s