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med surge Final
Ch 2 Sugery
Question | Answer |
---|---|
Admission Status: ambulatory (out pt) | Pt enters sitting, has sugery procedure,and is discharged on the same day |
Admission Status: Samd day admitt | Pt enters hospital,undergoes sugery asme day, remains for convalescence |
Admission Status: Inpatient | Pt is admitted to hospital, undergoes sugery same day and remains for convelance |
Major sugery | Involves extensive reconstruction or alteration in body parts that poses great risk to well being |
Minor sugery | Involves minimal alteration in body parts; often to correct deformities; involves minimal risk |
Elective sugery | Sugery Preformed on the basis of pt choice |
Urgent sugery | Sugery Necessary for pts health |
Emergency Sugery | Must be done immediately to save pt life or preserve function of body parts |
Diagnostic Sugery | Sugerical exploration to conform dx |
Ablation Sugery | Exscision or removal of diseased body part |
Palliative Sugery | Relieves or reduces intensity of disease symptoms |
Reconstruction Sugery | Restore function or apperance to traumatized or malfunction organ |
Transplant Sugery | Replace malfunction organ |
Constructive Sugery | Restores function loss or reduces as a result of congental abnormalities |
ST: Anastomosis | Surgical joining of two ducks or blood vessels to allow folw from one to another (bypass) |
ST:-ectomy | Surgical removal of a body part |
ST:-lysis | distruction of |
ST:-orrhaphy | sugerical repair of |
ST:-oscopy | direct visualization by a scope |
ST:-ostomy | opening is made to allow pallage of drainage |
ST:-otomy | opening in to |
ST:-pexy | fixation |
ST:-plasty | plastic sugery |
Deligation considerations for assistive personnel | Skills of assment (vit.) |
Deligation considerations for assistive personnel | assist in post operative exercise |
Deligation considerations for assistive personnel | Review turning method |
Deligation considerations for assistive personnel | Inform staff to inform when pt can not preform exercise correctly |
Deligation considerations for assistive personnel | Coordinat pt preperation/removals |
Deligation considerations for assistive personnel | Instruct ap in proper precautions |
Deligation considerations for assistive personnel | Observe/precaution of iv placement |
Deligation considerations for assistive personnel | Steril skills |
Deligation considerations for assistive personnel | Iniating and managing post/ pre operative care |
Deligation considerations for assistive personnel | to apply nasal cannula 02 mask basic comfort & hygiene measures |
Review of Medications:A | Allergy to medications |
Review of Medications:B | Bleedng tendencies |
Review of Medications:C | Cortisone or steroid use |
Review of Medications:D | Diabetes mellitus |
Review of Medications:E | emboli, previous embolic events |
Surgical Effects on body systems: Cardio | MI, dysrhythmias, and hypertension |
Surgical Effects on body systems: Endocrine | Liver disease alters motablism of drugs and Diavetes Mellitus cause pt to be susceptible to ingections and impaired wound healing |
Surgical Effects on body systems: Gastrointestinal | Hiatil hernia, ulcers, esophagel varices(pre/post op meds may be needed to control gastric acid) |
Surgical Effects on body systems:Immune | Aids, allerhies, immune dificiency ( disease slows the bodys ability to fight off infection/delay wound healing after sugery) |
Surgical Effects on body systems:Neurological | Seizres, myasthenia gravis, cerebal vascular accident(pt need a ck of therapiutic levels of meds NO muscel relaxants,communication, body paralysis, visual disturbances, high risk fo injury) |
Surgical Effects on body systems:Respiratory | Tumors, COPD, Emphysema, Asthma (Gas exchanged slowed, Anesthetic reduce resp function increasing risk for severy Hypoventilation) |
Surgical Effects on body systems:Uninary | Renal failure and Tumors (Impaired kidney function decreases wxcretion of anesthesia and alters acidbase balance) |
Lab test for surgical patient | uriaryalysis,cbc, Blood chemistry (endocrine, heptic, renal, and cardio functions),serum electrolytes (if potassium not adepuate sysrhythmias can occure during anesthesia) |
Diagnostic Imaging for the surgical patient | Chest roentgenogram & Electrocardiogram (used to view resp/cardio camage |
Inform Consent | Premission pbtained from the patient to preform a spicific test or procedure |
When should you not obtain concent? | If Pt is disorented, unconscious, mentally incompetent or under the influence of sedatives |
Gasrtric Preparation | NOP (GI)empty stomach & GoLYTELY (rappid evalcuate th bowels) |
Skin Preparation | dipliatory (w/o injury to the skin) and sddess for impairment ( infection, irritation, bruises, or lesions) |
Allergy considerations | No Latex |
Respiratory Preparation:Incentive Spirometry | to incourage deep brething, prevent/ treat atelectasis, inprove lung expansion, improve o2, post op pneumonia improvement |
Respiratory Preparation:Flow oriented insperatory spirometer | Measures inspiration not volume |
Respiratory Preparation:Volume oriented spiratometer | maintain known volum of inspiration |
Cardiovascular considerations: | Need to turn, cough, deep breath, leg exercise (to prevent thrombus, emboulus, infract) |
Vital signs | BP, Temp, Pulse, Respiratory, O2% |
Surgical Wound: Incisions | Cuts produced to open |
Surgical Wound:Closure | Suture, staples, steri-strips, transparent strips |
Anesthesia | General: Immobile, quiet, no recall |
Anesthesia stage:I | begins with the patient awake as administration of anesthetic agents |
Anesthesia stage:II | begining w/loss of consciousness and ends w/ onset of regular breathing and loss of eyelid reflexes |
Anesthesia stage:III | Behining w/onset of regular brething and ends w/ ceassation or respirations (operative phase) |
Anesthesia stage:VI | Behins w/the cessation of respirations and must be must be avoided |
Surgical: Induction | Administration and intubation |
Surgical: Maintenance | Positioning, Prep of skin |
Surgical: Emergence | anesthetics are decreased and pt awaken |
Regional Anesthesia | loss of sensation in one area of the body (nerve block, spinal anesthesia, epidural anest.,intervenious regional anest.) |
Local anesthesia | loss of sensation at the desired site (growth on skin/cornea of the eye) |
Conscious Sedation | CNS depressent drug |
Sugerical ABC's | A-airway B-Beathing C-circulation S-system review |
Activity | 1. level of alertness2. Cardio vascular3. Moter Status |
Paralytic ileus | a decrease in or absence of intestinal peitaneal trauma and severe metabolic disease and other conditions |