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Care of a surgical patient


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Tyresha Warren


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[Front]


define surgery
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the area of medicine that addresses diseases, conditions, and traumatic injuries that are difficult or impossible to treat only with medicine

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Care of a surgical patient - Details

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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 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
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 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