Care of Patient in Anesthesia

Subject: Medical and Surgical Nursing II (Theory)

Overview

Anesthesia is a condition of partial or complete loss of feeling with or without loss of consciousness that is medically induced. In the course of surgery or another medical operation, anesthesia manages discomfort. When necessary, it can also assist in controlling respiration, blood pressure, heart rate, and rhythm. General anesthesia, regional anesthesia, and local anesthesia are the different types of anesthesia. There are four stages of anesthesia. Cardiac arrest/arrhythmias, decreased circulation, respiratory depression, aspiration vomiting, hypotension, postoperative headache, and hallucinations are among anesthesia-related complications.

Care of Patient in Anesthesia

Anesthesia is a condition of partial or complete loss of feeling with or without loss of consciousness that is medically induced. In the course of surgery or another medical operation, anesthesia manages discomfort. When necessary, it can also assist in controlling respiration, blood pressure, heart rate, and rhythm.

Types of anesthesia:

  • General anesthesia: The patient is sedated, using either intravenous medication or gaseous substances, and muscle paralyzed, requiring control of breathing by mechanical ventilation.
  • Regional anesthesia: This can be described as central where anesthetic drugs are a cord, blocking the nerves of the spinal cord. The Main of this method in that ventilation is not needed. It can also be peripheral such as:
    • Plexus blocks: e.g. brachial plexus
    • Nerve block: e.g. femoral
    • Intravenous block: e.g. Bier’s block
  • Local anesthesia: The anesthetic is applied to one site, usually topically or subcutaneously. Drugs used for local anesthesia are:
    • Procaine 1-2%solution: used for injection
    • Lignocaine 0.5-2%: injection and topical application
    • Benzocaine 5%: used as an ointment on painful wounds, skin ulcers, mucous membrane.

Stages of anesthesia

  • Stages 1 anesthesia:The time between the first dose of the induction agents and consciousness losses is sometimes referred to as the induction period. The patient moves from analgesia without amnesia to analgesia with amnesia at this stage. A patient may now engage in conversation.
  • Stage 2 anesthesias: The interval following a loss of consciousness, characterized by exuberant and delirious activity, is also referred to as the "excitement stage." Respiration and heart rate may be erratic at this point. Additionally, uncontrollable movements, vomiting, breath holding, and uneven respiration may endanger the airway. Rapidly acting medicines are utilized to reduce the amount of time in this stage and advance as quickly as possible to stage 3.
  • Stage 3 anesthesia: it is surgical anesthesia. During this stage, the skeletal muscles relax and the patients breathing become regular. Eye movement will be slow, then stop and surgery can begin. It has been divided into 4 planes:
    • Rolling eyeballs, ending with fixed eyeballs.
    • Loss of corneal and laryngeal reflexes
    • Pupils dilates and loss of light reflex
    • Intercostals paralysis, shallow abdominal respiration, dilated pupils
  • Stage 4 anesthesia: It is also known as overdose where too much medicine has been given relative to the amount of surgical stimulation and the patient has severe brain stem or medullary depression. This results in cessations of respiration and potential cardiovascular collapse. This stage is lethal without cardiovascular and respiratory support.
    • Complications of anesthesia
      • Cardiac arrest/ arrhythmias
      • Diminished circulation
      • Respiratory depression
      • Vomiting aspiration
      • Hypotension
      • Postoperative headache
      • Hallucination
      • Loss of response to pain

Nursing cares for the anesthetic patient

  • Keep track of the patient's heart rate, ECG, and SPO2 to continuously measure the blood's oxygen content.
  • Regularly check and properly record vital indicators, such as blood pressure, heart rate, and respiration rate.
  • While keeping an eye on the patient's state of awareness, administer oxygen therapy.
  • Maintain airway by, for example, positioning the patient and, if necessary, suctioning. To avoid aspiration following general anesthesia, keep to the side.
  • patients' bodies are kept warm and at a constant temperature. Take your temperature frequently to check for fever or hypothermia.
  • Examine the patient for allergies and other conditions that might develop after the anesthetic medication has taken effect.
  • maintains oxygen emergency resuscitation equipment in good working order and availability.
  • During induction anesthesia, keep the area quiet and peaceful.
  • During this time, the client should be protected from mechanical and thermal harm because their sensory awareness is impaired.
  • To prevent a severe headache following spinal anesthetic, keep the client flat for a set amount of time—typically 12 hours—avoid using pillows, and keep an eye on their blood pressure.
  • Use safety precautions, maintain bed rest until lower extremity motor and sensory function returns following spinal anesthesia, and closely follow input and output chart maintenance.
  • After 12 hours of general anesthesia and when the capacity to swallow has returned, oral intake is typically administered.
  • Keep the side rails up to prevent falls and never leave the patient alone.
  • Keep a record and report the anesthetic kind used.
  • Keep an eye out for the anesthetic agent's adverse effects and problems.
  • After surgery, the patient should be transferred safely.

 

Things to remember
  • Anesthesia is an artificially induced state of partial or total loss of sensation with or without loss of consciousness.
  • Anesthesia controls pain during surgery or other medical procedure.
  • It can also help control breathing, blood pressure, heart rate and rhythm when needed.
  • The types of anesthesia are general anesthesia, regional anesthesia, and local anesthesia.
  • Stages of anesthesia are of 4 stages.
  • Complications of anesthesia are cardiac arrest/ arrhythmias, diminished circulation, respiratory depression, vomiting aspiration, hypotension, postoperative headache, and hallucination.
Questions and Answers

Anesthesia is a state of partial or total loss of sensation, with or without loss of consciousness, that is artificially induced. During surgery or other medical procedures, anesthesia is used to control pain. When necessary, it can also help control breathing, blood pressure, heart rate, and rhythm.

General anesthesia: The patient is sedated, using either intravenous medication or gaseous substances, and muscle paralyzed, requiring control of breathing by mechanical ventilation.

Regional anesthesia: This can be described as central where anesthetic drugs are a cord, blocking the nerves of the spinal cord. The Main of this method in that ventilation is not needed. It can also be peripheral such as:

  • Plexus blocks, e.g. brachial plexus
  • Nerve block, e.g. femoral
  • Intravenous block, e.g. Bier’s block

Local anesthesia: The anesthetic is applied to one site, usually topically or subcutaneously. Drugs used for local anesthesia are:

  • Procaine 1-2%solution, used for injection
  • Lignocaine 0.5-2% injection and topical application
  • Benzocaine 5% used as an ointment on painful wounds, skin ulcers, mucous membrane.

Stages 1anesthesia:

It is also known as the induction is the period between the initial administration of the induction agents and losses of consciousness. During this stage, the patient progress from analgesia without amnesia to analgesia with amnesia. Patient may carry on a conversation at this time.

Stage 2 anesthesias:

also known as excitement stage is the period following a loss of consciousness and marked by excited and delirious activity. During this stage, respiration and heart rate may be irregular. In addition, there may be uncontrolled movements, vomiting, breath holding, and irregular respiration may lead to airway compromise, rapidly acting drugs are used to minimize time in this stage and reach stage 3 as fast as possible.

Stage 3 anesthesia:

It is surgical anesthesia. During this stage, the skeletal muscles relax and the patients breathing become regular. Eye movement will be slow, then stop and surgery can begin. It has been divided into 4 planes:

  1. Rolling eye balls, ending with fixed eyeballs.
  2. Loss of corneal and laryngeal reflexes
  3. Pupils dilates and loss of light reflex
  4. Intercostals paralysis, shallow abdominal respiration, dilated pupils

Stage 4 anesthesia:

It is also known as over dose where too much medicine has been given relative to the amount of surgical stimulation and the patient has severe brain stem or medullar depression. This results in cessations of respiration and potential cardiovascular collapse. This stage is lethal without cardiovascular and respiratory support.

  • Continuously monitor the patient's ECG, heart rate, and SPO2 to determine the oxygen level in the blood.
  • Regularly monitor and record vital signs such as blood pressure, heart rate, and respiratory rate.
  • Provide oxygen therapy and monitor the patient's level of consciousness.
  • Maintain the airway by positioning the patient and, if necessary, suctioning. Maintain a side lying position after general anesthesia to avoid aspiration.
  • Keeps patients warm by maintaining body temperature. Take your temperature frequently to check for hypothermia or fever.
  • Examine the client for allergies and other medical issues that may arise as a result of the anesthetic agent's response.
  • Is oxygen emergency resuscitation equipment kept in good working order?
  • During induction anesthesia, keep the environment calm and quiet.
  • Due to decreased sensory awareness, protect the client from mechanical/thermal injury during this time.
  • Keep the client flat for a specific period of time after spinal anesthesia, usually 12 hours, to protect the severe headache, avoid pillows, and monitor for hypotension.
  • Use safety precautions and stay in bed until motor and sensory function in the lower extremities returns after spinal anesthesia; strictly follow the input and output chart.
  • Oral intake is typically administered after 12 hours of general anesthesia and after the ability to swallow has been restored.
  • Keep the side rails up to keep the patient from falling, and never leave the patient alone.
  • Keep a record and report the type of anesthesia used.
  • Keep an eye out for anesthetic agent side effects and complications.
  • After an operation, safely transport the patient.

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