Perianesthesia Nurses Association of British Columbia Cathy Hanley, RN, BSN November 6, 2010
Management and Monitoring Perianesthesia
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Transcript of Management and Monitoring Perianesthesia
MANAGEMENT AND MONITORING PERIANESTHESIA
By : Stevan Pagar406 138 052Medical Faculty of Tarumanagara UniversityMANAGEMENT AND MONITORING PERIANESTHESIA
Goal?Early detectionPrediction for future emergenciesEvaluation
what to observe??Airway pressure
Blood pressure
Oxygen saturation
EKG
scopeDepth of anesthesia
CV system
Respiration ventilation
Temperature
Urine output
Fluid therapy
Depth of anesthesiaanalgesia : starting from the current administration of an anesthetic agent to loss of consciousnessDelirium/excitation, hiperrefleksi : starting from the loss of consciousness and eyelash reflex untill regular breathing again
Surgery : begins with irregular respiration until spontaneous respiration is lostBreathing regular, spontaneous, chest abdomen balance, pupillary mydriasis, no light reflex, lacrimation increased,muscle tone begin to decrease+ belly-chest,moderate muscle relaxation+ intercostal muscle paralysis, breathing by the stomach, striated muscle relaxation perfectly+ breathing irregular e.c paralysis intercostal muscle and stomach, greatly decreased muscle tone
Depth of anesthesia
Paralysis of the medulla oblongata : begins with the weakening of the abdominal breathing rather than stage III plana 4
Depth of anesthesia
CV systemObserve HR
ECG
BP
Respiration Monitor :Airway pressureHypersecretionBronchospasm 1ml/kg/h hyperglycemiaDetermine :Blood volumeBlood pressureRenal function
Fluid therapyChildren W : first10kg: 4ml/kg/h10-20kg: 2ml/kg/h>20 kg: 1ml/kg/hAdult Fasting replacement: 2cc/kg/hMaintenance: 2cc/kg/hOperative stress mild: 4 ml/kg/hmoderate: 6ml/kg/hsevere: 8ml/kg/h
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