AORN journal
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Practice Guideline
Recommended practices for sponge, sharps, and instrument counts.
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Postoperative nausea and vomiting (PONV) is a frequent complication of surgery. Guidelines recommend using a 5-HT3 receptor antagonist (eg, ondansetron, dolasetron, granisetron) combined with a second agent (eg, dexamethasone) for patients at moderate to high risk for PONV. ⋯ Metabolism of granisetron differs from metabolism of other 5-HT, antagonists, so it is less likely to adversely interact with other medications. This article explains the clinical pharmacology of 5-HT3 antagonists and provides recommendations for nursing management of PONV.
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Malignant hyperthermia (MH) usually is triggered during or after administration of commonly used general anesthetics, and it can result in death if left untreated. The only definitive diagnostic test for MH is the caffeine halothane contracture test. A new molecular genetic diagnostic blood test may offer a less-invasive alternative for some patients. ⋯ Other clinical signs include tachyarrhythmias, tachypnea, and acidosis. Perioperative nurses should perform MH risk assessments during routine preoperative interviews to identify patients at risk for MH crisis. Perioperative nurses must respond rapidly and ensure the cooperation of the OR team when dealing with MH.