Question

Identify nursing considerations that should be implemented for all patients receiving general or local anesthetics

Answer 1

There are lot of nursing considerations that are implemented for all patients receiving general or local anaesthetic.

Considerations implemented while administration of general anaesthetics are as follows:- observation of unconsciousness with amnesia , analgesia reflex suppression and muscle relaxation . cricoid pressure may need to be applied for that we need to displace cricoid cartilage and close the esophagus while passing an ET tube to decrease tge risk of aspiration asses for bilateral breath sounds after passing it. Keeping the patient warm to prevent hypothermia.we need to look for emergency assessment which include airway patency, return of reflex and muscle strength and ability to follow commands.Post operative assessment observation of loss if consciousness , patency of airways, cardiovascular status , temperature, fluid balance, return of neuro functions,asses nausea and vomiting , post operative analgesia and inspection of operation site. consideratios to be taken for administration of Local anaesthetic:- local anaesthetics act on cellular memberanes interrupting sensory pathways between surgical site and brain. Lidocaine acts for 1 to 3 hrs and bupivacaine for 3 to 10 hrs need to assess for signs and symptoms of toxicity with which Central nervous system is affected first leading to effect on cardiovascular system which in turn leads to drowsiness, numbness of tongue, blurred vision,tinnitus, dizziness,restlessness,slurred speech, muscular twitching followed by convulsions ,also hypotension, bradycardia, heart block and cardiac arrest can occur so need to assess nervous system and immediately halt the administration of Local anaesthetic, need resuscitation with epinephrine , intravenous administration with hydrocortisone , aminophylline and fluids. While giving blocks one should keep an eye on prevention of systemic bolus asses return of normal sensation, colour and cap refill. While giving blockade post operative assessment for return of sensory and motor functions. While give central nervous blockade nursing considerations for use of dermatomal landmarks to asses level of sensory motor blockade , assessment for high spinal blockades by auscultating breath sounds anaesthetic may travel as high as C4 . Postoperative assessment of sensory and motor functions, return of sensation in both extremities and rectum , checking for hypotension, urinary retention and spinal headache.