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PRE/POST OP Surgical
Hot & Cold Therapy Ch 20/ Handouts
| Question | Answer |
|---|---|
| VASODILATION | Blood flow is increase- HEAT THERAPY- increasing blood supply to the affected area.Lumen of blood vessel widens |
| VASOCONSTRICTION | COLD THERAPY- Lumen of blood vessel narrows causing ISCHEMIA- |
| ISCHEMIA | Decreased blood supply to a body part or organ may be accompanied by pain and dysfunction |
| DEHISCENCE | premature "bursting" open of a wound along surgical suture. It is a surgical complication that results from poor wound healing |
| SHOCK | decreased tissue perfusion and oxygen delivery as a result of infection and sepsis |
| EDEMATOUS | Marked by edema. |
| TCDB | Turn Cough Deep Breath |
| 1. Atelectasis | (Lung collapse)Deep breathing and coughing exercise |
| 2. Thrombophlebitis | Pain in calf of leg/, swollen & temp elevation; Leg exercises, ambulation, hydrated, Antiembolic stockings |
| 3. Urinary retention | Distended bladder, inability to void; Encourage voiding, palpate bladder |
| 4. Wound infection | Redness, swelling, pain, warmth, fever-post-op 72 hrs; Aseptic technique for wound care |
| SURGICAL ASEPSIS | Moisture transmits microorganisms/Objects above waist/ sterile pack must opened distal flap first.lateral.proximal/ Bottle cap upon surface/ bottle label in palm of hand/ “lipping” solution/ 1 inch outer edge. |
| Pre-risk factors that put pt at risk for post surgery complications | Smoking – effect on healing, difficult to maintin patent airway Alcohol:Decreased respirations Age:@ risk:decreased circulation & sensory perception |
| INFORMED CONSENT | MUST BE OBTAINED BEFORE SEURGERY, The nurse can be the witnessed when the SURGEON states and clarify the pt about the proc. Protect dr for any claims or liability. TELEPHONE consent MAY BE used |
| 6. HEMORRHAGE & SHOCK = | Copious bleeding, decreased BP, Elevated pulse, clammy skin, decreased urinary output; Blood /volume expander,stop bleeding, meds to raise BP, O2 & take VS |
| 7. WOUND DEHISCENCE | ruptured wound inside)/EVISCERATIONS (intestine out) = Serosanguineous drainage; Splint for coughing, supine position, cover wound w/ saline water or towel |
| 8. Paralytic Illeus = | no peristalsis 24-36 hrs after surgery; Deep breathing,coughing,ambulation, incentive sphincter |
| 9. PULMONARY EMBOLUS | Shortness of breath,anxiety,chest pain, ^ P& R, cyanosis& bloody sputum; ANTIEMBLOSIM STOCKINGS, fluid intake, ambulation |
| Emergency Surgery | necessary in trauma, intestinal obstruction, C-section, saving a limb or organ. |
| -Urgent or Imperative Surgery | Requires attention within 24 to 48 hrs after the need for sx is determined. |
| -Elective Surgery | Voluntary sx. Failure to have sx is NOT life threatening (nose job). |
| -Palliative Surgery | Relieves symptoms or complications of illness But doesn’t cure disease. |
| -Diagnostic Surgery | involves the removal and study of tissue to make an accurate diagnosis. Ex: tissue biopsy |
| -Reconstructive Surgery | create new or different body part. Ex: breast, cleft palate. |
| -Curative Surgery | cures a problem or restores malfunctioning tissue by removing damaged area. Ex: gallbladder removal |
| General ANESTHESIA | Deep sleep/ loss of sensory perception; By IV meds or inhalant gas |
| -Regional Anesthesia | Nerve block. spinal, epidural, caudal, peripheral nerve area. Coffee for headaches, lay flat, darken room. Pt will feel tingle |
| -Conscious Sedation – | awareness surroundings. (Endoscopy procedure) |
| -Local Anesthesia | minor procedures such as superficial tissue biopsies. |
| STAGE I GENERAL ANESTHESIA | ANALGESIA: Administration of anesthesia, pt unconscious & hearing is amplified @ end of stage |
| STAGE II -G.A. | EXCITEMENT phase: tense muscles, Environment should BE QUIET-it may cause pt to become excited. Vomiting/swallowing reflexes present |
| STAGE IV G.A. | RESPIRATORY DEPRESSION: Respiratory absent,pt maintained by machines for O2 |
| SURGICAL Procedures | Preoperative, Intraoperative, Postoperative (not sure of Postanesthesia; comes before Postoperative; |
| 1-PRE-OP Procedures | Lab, Informed consent, NPO, Deep breathing, coughing & splinting- prevent telecasts, Enemas & laxatives , empty bladder before pre-op meds, Skin prep |
| SKIN PREP FOR PRE-OP | Antibacterial solutions to remove microorganisms from skin, can be given to pt or nurse will & shaving of surgical area |
| VENOUS RETURN | Leg exercises, TEDs- Antiembolism stockings, venous return from extremities to heart,Infaltion & deflation device prevents DVT-deep vein thrombosis |
| EMBOLI Vs Thrombus | Emboli- blood clots travel blocking areas. Thrombus- Stationary blood clots |
| SCD | Sequential Compression Device: Inflation & deflation that counteracts blood stasis, increases blood flow towards heart |
| PRE- OP CHECKLIST | 1-order 2- ID, allergies 3- Removal of gown,jewelry, hair pins, dentures-labeled, nail polish, make up, prosthesis 4- Void before preop meds 5- hearing aids/glasses |
| 2- INTRAOPERATIVE Procedure | PACU / OR Holding area to Recovery Room |
| 3- POST-OP | VOIDS,NPO or gAG REFLUX and bowel soundscheck, Capillary reflex, Neuro/Cardiovascular/ |
| HOMMAN’S SIGNS | sign of deep vein thrombosis (DVT). A positive sign is present when there is pain in the calf or popliteal region with examiner's abrupt dorsiflexion of the patient's foot at the ankle while the knee is flexed to 90 degrees |
| EARLY SIGSN OF HYPOXIA | Restlessness, confusion, anxiety … book |
| LATE SIGNS OF HYPOXIA | Cyanosis, Clubbing, Dyspnea |
| Anaphylactic Shock | systemic vasodilation which results in low blood pressure; dizziness, loss of consciousness, labored breathing, |
| Dehiscence | the separation of or re-opening of a wound (pt says something gave way) |
| TCDB exercises? | (Turning, Coughing, Deep, Breathing To prevent Atelectasis and Hypostatic Pneumonia |
| ** CHECK IV SITE for what ( cardinal System) ? | Redness, Swelling, warmth, pain phlebitis |
| INTAKE AFTER SURGERY | check GAG REFLEX then can Start w/ ice chips then clear liquid |
| INTAKE AFTER SURGERY | check GAG REFLEX then can Start w/ ice chips then clear liquid |
| * | |
| PREVENTING INJURY FROM HEAT & COLD APPLICATIONS | Peripheral Vascular diseases (diabetes) /Disorientation or Incons. Spinal Cord Injuries/Edemas or scar formation-LESS SENSITIVE TO TEMP Open Wounds, skin impairment-tissues ARE SENSITIVE but they might not contain temp receptors |
| SAFETY WHEN APPLYING HEAT / COLD THERAPY | *Pg 538 Dr's orders tratment for 20-30 mins @ a time Measure temp of liquids Observe skin before, during & after |
| AQUATHERMIA PAD | PG 540 PG 540 tREATS MUSCLE SPRAINS. Waterproof plastic pad connected by two hoses to electrical control unit that has heat. Distilled water circulates where can be hot or cooled. Fill 2/3 |
| Young & older pts for Hot/Cold Apps | 536 |
| DRY APPLICATIONS | Cold packs ice gloves, freeze bag K-pad or Aquathermia pad Hot water bottles & heating pads |
| MOIST Applications | Alcohol rubs Hot/Cold compresses Warm soaks- whirlpool Sitz bath- |
| HEAT THERAPY | *Improve blood flow by increasing it,reduces swelling,^ metabolism, ^ Oxygenation, reduce stiffness & relieves pain. DO NOT apply it to bleeding are-increase it. |
| SYSTEMATIC CHANGES IN HEAT THERAPY | *fainting, faster pulse, Dyspnea Localized= Erythema, tenderness & pain |
| COLD THERAPY | retards circulation-it can cause hypoxemia>Ischemia>Necrosis- is contraindicated to edematous & shivering- it intensifies it and increase body temp. It decreases swelling, controls bleeding & anesthetize body part |
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