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68WM6 Phase II Ch42

Care of the Surgical Patient

QuestionAnswer
when was anesthesia dicovered? 1840's
3 classifications of surgery elective, urgent, emergent
surgery not necessary to preserve life and may be preformed when the patient chooses elective surgery
surgery required to keep additional health problems from occuring urgent surgery
surgery performed immediateley to save the individual's life or preserve the function of a body part emergency surgery
what are the two ways that surgeries are also labled? minor or major
an amputation or excision of any part of the body or removal of a growth or harmful substance alation
therapy designed to relieve or reduce intensity or uncomfortable symptoms without cure palliative
reasons that surgeries are preformed? diagnostic studies, ablation, palliative, reconstructive, transplant, constructive
role of the nurse during preoperative, intraoperative, and postoperative care perioperative
before surgery properative
during surgery intraoperative
following surgery postoperative
what is a nurse's major responsibility in surgical care? consistent effective nursign intervention during each phase of surgery
what patient factors influence a surgical procedure? age, physical condition, nutritional factors, psychosocial needs, socioeconomic/cultural needs, medications, education and experience
concurrent use of multiple medications polypharmacy
how many medications do patients age 65 and older generally take? 2-6 prescribed, 1-3 OTC
what does using multiple medications put a patient at risk for? adverse drug reactions and interactions
what non prescription should we always ask about? use of herbals and supplements
act like medications and may interact or potentiate other medications or interfere with surgical procedures herbs
herbal commonly used for migrane prevention, but has anicoagulant factors, and should be d/c before surgery? Feverfew
herbal taken for motion sickness, cough, menstrual cramps, intestinal gas, causes risk of prolonged clotting times, and should be d/c before surgery Ginger
herbal that has antidepressant, antiviral, antiinflammatory action and should not be used with psych meds St John's wart
herb that has sedative or tranquilizer effects, sleep aid, should not be used with sedatives or anxiolytics, may increase effects of CNS depressants Valerian root
what types of allergies do we enquire about presurgery? food, chemicals, pollen, antiseptics, latex, rubber
what has been shown to influence levels of anesthesia, pain meds and speed of recovery? properative anxiety levels
what does smoking do to put surgical pt's at risk? alveoli may be impaired and the pts lung capacity reduced. muccus and anesthesia by products may be trapped in the lung causing atelectasis and pneumonia
preoperative questions? allergies, past surgeries, infection, disease hx, prescription drugs, otc drugs, record baseline vitals, height and weight
when is preoperative teaching preformed? 1-2 days before surgery
how often will vital signs, tubes, and dressing be assessed post op? every 15-30 min until the pt is awake and stable
what does preoperative preparation consist of? age, physical, nutritional status, type of surgery, and preference of the surgeon
what labratory test are preformed prior to surgery? depends on institution and physicians preference: urinalysis, CBC, blood chem,
what systems are evaluated pre op? endocrine, hepatic, renal, cardiovascular, adn serum electrolytes
what essential electrolyte is monitored closley perioperativley? potassium
why is potassium monitored? if not avalailable in adequate amount, dysrhythmias can occur during anesthesia
what is used to identify disease process or prevent cardiac damage pre op? chest roentgenogram, electrocardiogram
what tests verify hepatic functioning? LDH, gamma GT, alkaline phosphate, total bilirubin, urine bilirubin
permission obtained from the patient to preform a specific test or procedure informed consent
procedure in which a device is used at the bedside in regular intervals to encourage the patient to breathe deeply insentive spirometer
resting tidal capacity 500ml
tidal capacity 4300ml
an accumulation of platlets, fibrin, clotting factors, and cellular elements of the blood attatched to the anterior wall of a vessel, sometiem occluding the lumen of the vessel thrombus
dislodged thrombus that has potential to travel to the lungs, heart, or brain, where a vessel may be occluded embolus
localized area of necrosis caused by a thrombus or embolus infarct
cuts produced by a surgically sharp instrument to create an opening into an organ or body cavity incision
means the absence of pain anesthesia
results in an immobile, quiet pt who does not recall the surgical procedure general anesthesia
stage that begins with the pt awak until they lose consciousness Stage I anesthesia
stage that begins with the loc and ends with the onset of regular breathing and and loss of eyelid reflexes Stage II anesthesia
stage that begins with the onset of regular breathing and ends with the cessation of respirations. aka operative or surgical phase Stage III anesthesia
stage that begins with the cessation of respirations and must be avoided or cardiopulmonary resusitation mut occur Stage IV anesthesia
phase in which anesthetics are administered to endotracheal intubation induction phase
phase in which the pt is positioned, skin is prepped for incision, and the surgical procedure maintenance phase
phase in which anesthetics are decreased, and the patient begins to awaken emergence phase
results in the loss of sensation an the area of the body regional anesthesia
local anesthetic is injected into a nerve, blocking the nerve supply to the operative site nerve block
anesthesiologist performs a lumbar puncture and introduces local anesthetic into the csf of the subarachnoid space spinal anesthesia
a safer procedure than spinal anesthesia, where the anesthetic is injected into the epidural space outside the dura mater and the depth of anesthesia is not as great as spinal anesthesia epidural anesthesia
local anesthesia is injected via IV into an extremity below the level of the tourniquet after blood has been withdrawn intravenous regional anesthesia (Bier block)
involves the loss of sensation at the desired site, inhibits nerve conduction until the drug diffuses into circulation local anesthesia
administration of cns depressants or analgesia to relieve anxiety conscious sedation
what must a patient undergoing conscious sedation maintain? a patent airway, airway reflexes, and able to respond appropriatley to physical and verbal stimuli
an artificial replacement for a missing body part prosthesis
holding area outside of the operating room preanesthesia unit
protection against infection before, during and after surgery by the use of sterile technique surgical asepsis
the removal of fluids from a body cavity, wound, or other source of discharge drainage
all substance that have seeped from cells or blood vessels through small pore breaks in the cell membrane exudate
the separation of a surgical incision or rupture of a wound closure dehiscence
ill health, malnutrition, and wasting as a result of chronic disease cachexia
protrusion of an internal organ through a wound or surgical incision evisceration
an abnormal condition characterized by a collapsed lung atalectasis
the way the pain is affecting the patient emotionally suffering
how long does it take for bowel activity to return post op? 3 to 4 days
normal peristalsis? 5 to 30 gurgles per one minute
a decease in or absence of intestinal peristalsis that may occur after abdominal surgery, peritoneal trauma, and severe metabolic disease and other conditions paralytic ileus
hiccup singultus
an involuntary contraction of the diaphragm followed by a rapid closure of the glottis hiccup
loss of potassium after tissue breakdown, especially after severe trauma or crush injury catabolism
Created by: ahughes0919
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