Care of a surgical patient
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Care of a surgical patient - Marcador
Care of a surgical patient - Detalles
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| 🇬🇧 | 🇬🇧 |
| Define surgery | The area of medicine that addresses diseases, conditions, and traumatic injuries that are difficult or impossible to treat only with medicine |
| Ablative | Excision or removal of diseased body parts (e.g., amputation, removal of appendix, cholecystectomy) |
| Define palliative | Surgery for relief or reduction of intensity of disease symptoms; will not produce cure (e.g., colostomy, debridement of necrotic tissue) |
| Define perioperative | Period encompasses the preoperative phase |
| Preoperative | Before surgery |
| Define intraoperative | Phase during surgery |
| Postoperative | Phase after surgery |
| Informed consent | Permission to perform a specific test or procedure before any procedure has begun |
| Atelectasis | An abnormal condition characterized by the collapse of lung tissue |
| Thrombus | An accumulation of platelets, fibrin, and cellular elements of the blood attached to the interior wall of a vessel, sometimes occluding the lumen |
| Embolus | A traveling or mobilized clot |
| Infarct | Localized area of necrosis |
| Incisions | Cuts produced surgically by a sharp instrument to create an opening into an organ or body space |
| Anasthesia | Absence of all sensation, including pain ( "an" meaning without "esthesia" meaning awareness of feelings) |
| Define conscious sedation more recently referred to as moderate sedation | Pt is given drugs in that depress the central nervous system or provide analgesia to relieve anxiety or provide amnesia during surgical diagnostic procedures |
| Define prosthesis | An artificial replacement for missing parts of the body |
| Surgical asepsis | Using sterile technique to protect against infection before, during, or after surgery |
| Define drainage or exudate | Fluids from body cavity, wound, or other source of discharge that slowly sees from cells, tissue, or blood vessels through small pores or breaks in cell membrane |
| Define extubate | Patient remove endotracheal tube from airway |
| Define dehiscence | The separation of surgical incisions or rapture of a wound closure |
| Define cachexia | Ill health, malnutrition, and wasting as a result of chronic disease |
| Define evisceration | Protrusion of an internal organ through a wound or surgical incision, especially in the abdominal wall |
| Define paralytic ileus | A significant decrease in or absence of intestinal peristalsis that may occur after abdominal surgery, peritoneal trauma, severe metabolic disease, and other conditions |
| Define elective surgery | Performed on bases of the pt choice such as bunionectomy, plastic surgery |
| Define urgent surgery | Necessary for pt survival health such as excision of cancerous tumor, removal of gallbladder for stones, vascular repair for obstructed artery |
| Define emergency surgery or emergent surgery | Must be done immediately to save for preserve function of the body part such as removal of perforated appendix, repair of traumatic amputation, control of internal hemorrhaging |
| Define anastomosis | Surgical joining of two ducts or blood vessels to allow flow from one another; to bypass an area (example: billroth, joins stomach and duodenum) |
| Surgical terminology define -ectomy | Surgical removal of ( example: cholecystectomy, removal of the gallbladder) |
| Surgical terminology define lysis | Destruction or dissolution of (exmaple: lysis of adhesions removal of adhesions) |
| Surgical terminology define -orraphy | Surgical repair ( herniorrhaphy, repair of a hernia) |
| Surgical terminology define -oscopy | Direct visualization with a scope (example: cystoscopy, direct visualization of the bladder and urethra by means of a cystoscope) |
| Surgical terminology define -ostomy | Opening made to allow passage of drainage (example: ileostomy, formation of an opening of the ileum onto the surface of the abdomen for passage of feces) |
| Surgical terminology define -pexy | Fixation of (example: cecopexy, fixation or suspension of of the cecum to correct its excessive mobility) |
| Surgical terminology define -plasty | Plastic surgery (example: mammoplasty, reshaping of the breast to reduce, lift, reconstruct) |
| Define inpatient surgical setting | Pt hospitalization for surgery |
| Define one-day(some day surgery) surgical setting | Pt is admitted that day surgery is scheduled and discharged the same day |
| Define outpatient surgical setting | Pt (not hospitalized) is admitted to either short stay unit or directly to the surgical site |
| Define short stay surgical center surgical setting | Independently owned agency; surgery is performed when overnight hospitalization is nit required ( also called ambulatory surgical center or 1 day surgery center) |
| Define short stay unit surgical setting | Department or floor where a pt stay does not exceed 24 hours (sometimes referred to as an outpatient/observation unit) |
| Define mobile surgery unit surgical setting | A unit that moves from place to place; it moves to the pt instead of the pt traveling to the unit |
| What is the preoperative consideration using garlic | Potential for increasing bleeding |
| What is the preoperative consideration using gingko biloba | Potential increase for bleeding |
| What is the preoperative consideration using st johns wort | Should not be used with other psychoactive drugs, monoamine oxidase inhibitors, or serotonin reuptake inhibitors; discontinue before surgery because possible drug interaction |
| Define surgical effects on the body systems if a pt has seizures | Ensure anti-seizure medication are at therapeutic levels to prevent postoperative seizures |
| Define surgical effects on the body systems if a pt has respiratory disorders | Lung capacity is decreased and gas exchanged slowly; anesthetic agents reduce respiratory function, increased risk is sever hypoventilation |
| Define surgical effects on the body systems if a pt has cardiovascular diseases | Hypotension & cardiac dysthymia's disease most common complication; early recognition & management before these complications become serious enough to diminish cardiac output depend on frequent assessment of pt vitals |
| Define why a surgery for which coughing would be contradicted or modified for intracranial | Cough increases pressure (ICP), leading to cerebrospinal fluid leakage |
| Define why a surgery for which coughing would be contradicted or modified for eye | Coughing increases ICO, which then increases intraocular pressure, causing pressure on suture line |
| Define why a surgery for which coughing would be contradicted or modified for ear | If pt must cough, mouth must be kept open to prevent pressure backup through Eustachian tube to middle ear, causing pressure on suture line |
| Define why a surgery for which coughing would be contradicted or modified for nose | If pt must cough, mouth must be kept open to prevent dislodgment of a clot with subsequent bleeding |
| Define why a surgery for which coughing would be contradicted or modified for throat | Vigorous coughing may dislodge a clot subsequent bleeding |
| Define why a surgery for which coughing would be contradicted or modified for spinal | Coughing increases spinal canal pressure |
| Nursing implications for diazepam( valium) for the preoperative period | Monitor for respiratory depression, hypotension, drowsiness, and lack of coordination puts patient at fall risk |
| Nursing implications for H2 receptor antagonist such as famotidine (Pepcid) or ranitidine (Zantac) for the preoperative period | Monitor for confusion and dizziness which put pt at fall risk |
| Nursing implications for antiemetics such as metoclopramide (reglan) or droperidol (inapsine) or zofran for the preoperative period | Monitor for sedation & extrapyramidal reaction ( involuntary muscle movement, muscle tone change, abnormal posture); instruct pt to report any difficulty breathing |
| Anticoagulants special implications for the surgical patient | Warfarin and aspirin are stopped several days before surgery; they prolong clotting times, which may lead to hemorrhage |
| Antihypertensives special implications for the surgical patient | May cause hypotension when combined with anesthetic agents & narcotics used for pain control |
| Anti seizure drugs special implications for the surgical patient | Longtime use of certain seizure drugs such as dilantin, phenobarbital can interact with anesthetic drugs |
| Corticosteroids special implications for the surgical patient | If used for a long time may prolong bleeding & hamper the body's ability to heal; also may decrease the bodies ability to deal with the stress of surgery as a result of suppression of the adrenal glands |
| Diuretics special implications for the surgical patient | Because of fluid loss during surgery, they can cause hypotension after surgery and decreased serum potassium levels |
| Herbal therapies special implications for the surgical patient | Several therapies can affect clotting time ginseng may increase hypoglycemia with insulin therapy; therapies boxes for potential complication that may occur when herbal therapies are combined with traditional medications |
| NSAIDS special implications for the surgical patient | Inhibit platelet function and may prolong bleeding, leading to possible hemorrhage |
| What does a circulating nurse do | Count sponges, needles, and instruments with scrub nurse before surgery |
| What does a scrub nurse do | Count sponges, needles, insruments with circulating nurse; observe progress of surgical procedure |