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84 Cards in this Set
- Front
- Back
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diagnostic surgery
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involves the removal and study of tissue to make an accurate diagnosis
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exploratory surgery
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is more extensive procedure than a biopsy. It usually requires opening a body cavity to diagnose and to find out the extent of a disease process
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curative surgery
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performed to remove diseased tissue or to correct defects
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ablation
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refers to removal of tissue
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palliative surgery
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relieves symptoms or improves function without correcting the basic problem
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cosmetic surgery
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can be performed to correct serious defects that affect appearance
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variables affecting surgical outcomes
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age, nutritional status, fluid and electrolyte balance, medical diagnoses, drugs and habits
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increased risk for surgical complications (age and diseases)
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people over 70 years old who are frail, or have cardiovascular disease, renal disease, or diabetes
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surgical outcomes regarding nutritional status (malnourished)
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malnourished patients are at risk for poor wound healing and infection
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surgical outcomes regarding nutritional status (obese)
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more likely to have postoperative respiratory and wound complications, healing process is slower than usual
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surgical outcomes regarding fluid balance (why is it important? )
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to maintain blood volume and urine output
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surgical outcomes regarding fluid balance (excess body fluids)
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overload the heart, aggravating the stress of the surgery
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surgical outcomes regarding fluid balance (electrolyte imbalances)
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dangerous cardiac dysrhythmias
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importance of diuretics
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balancing fluid overload, play a part in creating electrolyte imbalances including potassium deficit
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surgical outcomes regarding medical diagnoses (bleeding disorders or taking anticoagulants)
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at risk for excessive bleeding
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surgical outcomes regarding medical diagnoses (heart disease)
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risk for cardiac complications related to anesthesia and the stress of surgery
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surgical outcomes regarding medical diagnoses (chronic respiratory disease)
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increases the risk for pulmonary complications as a result of anesthesia or hypoventilation
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surgical outcomes regarding medical diagnoses (liver disease)
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impaired wound healing and may experience drug toxicity arising from the inability to metabolize drugs effectively
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surgical outcomes regarding medical diagnoses (diabetes mellitus)
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heal more slowly, greater risk for infection
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surgical outcomes regarding habits (recreational drugs)
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increase heart rate, alter cardiac function and increase the need for higher than usual doses of anesthesia
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herbal medication
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discontinue 1 to 2 weeks before surgery
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alcoholic patients
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may need a higher than normal dose of anesthetic agent because of increased drug tolerance
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consent form
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before surgery a patient must sign this legal document. Its states that the patient has been informed about the procedure to be performed, alternative treatments, and the risks involved and that the patient agrees to the procedure. Patient must by fully alert and aware to sign, must have a witness
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unable to sign consent form (mental status of patient)
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confused, mentally incompetent or under the influence of drugs and with no witness
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bowel cleaning purpose
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reduces risk of contamination, prevent postoperative distention until the normal bowel function returns, it prevents constipation and straining in the postoperative period. straining can cause pressure on surgical wound
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skin incision
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microorganisms can enter the wound
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skin preparation
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intended to reduce the number of organisms near the incision site
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shaving hair before surgery
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must be done right before surgery to allow less time for organisms to multiply
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removal of nail polish before surgery
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for circulation and to use pulse oximeter
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allergies before surgery
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must be clearly identified on a wrist band and in the patient's chart
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before taking preoperative medications
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ask patient to void for safety reasons
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preoperative checklist
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all laboratory and radiology reports are with the chart, jewelry, prostheses, and nail polish have been removed, patient has voided, premedication has been given, vital signs have been recorded and that the consent form has been signed
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"hand off"
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considered a transfer of primary responsibility of care from one health care provider to another
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safety straps
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are applied carefully because of the risk of impaired circulation or nerve damage cause by pressure
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anesthetic agents
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used to alter sensation so that surgical procedures can be performed painlessly and safely
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local anesthetics
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often the agents of choice for older adult patients, may be administered topically, by local infiltration and by nerve blocking techniques
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topical anesthetics
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applied directly to the area to be anesthetized
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local filtration
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anesthetic agent is injected into and under the skin around the area of treatment
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nerve block
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administered by injecting an anesthetic agent around a nerve to block the transmission of impulses
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post spinal headache
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caused by the leaking of cerebrospinal fluid at the puncture site. relieved by lying flat, more common in women than men
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epidural anesthesia
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does not cause a post anesthesia headache
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treatment of severe spinal headache
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injecting a small amount of the patients blood into the epidural space at the site of the previous subarachnoid puncture, forming a blood patch that prevents further leaking
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passive range of motion exercises
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performing this until mobility returns is vital to prevent thrombus formation
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preanesthetic medications
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reduce anxiety without causing excessive drowsiness, induce perioperative amnesia and reduce the amount of anesthesia required
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general anesthesia
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acts on the CNS causing loss of consciousness, sensation, reflexes, pain perception, and memory
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balanced anesthesia
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allows lower dose levels of each drug, the use of multiple drugs
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endotracheal tube
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inserted into the patients trachea to permit administration of the maintenance inhalation anesthesia and to control mechanical ventilationm
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malignant hyperthermia
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characterized by increasing body temperature and metabolic rate, tachycardia, hypotension, cyanosis, and muscle rigidity
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hypothermia
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body temperature is lower than normal
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cryoanesthesia
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cooling or freezing of a local area to block painimpulses
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conscious sedation (complications)
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respiratory depression, and apnes, hypotension, excessive sedation approaching that of general anesthesia, and agitation and combativeness
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conscious sedation (what does it do?)
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employs intravenous drugs to reduce pain intensity or awareness without loss of reflexed
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shock
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effect of anesthesia or loss of blood, may result from low blood volume.
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hypoxia
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inadequate oxygenation of body tissues
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hypostatic pneumonia
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an infection of the lungs associated with immobility
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atelectasis
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collapse of a portion or all of a lung
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wound healing (complications)
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dehiscence, evisveration, and infection
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dehiscence
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reopening of the surgical wound
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evisveration
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when body organs protrude through the open wound
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paralytic ileus
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if peristalsis stops completely, the patient is said to have this
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thrombophlebitis
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inflammation of veins with the formation of blood clots
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thrombi
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clots that cling to the walls of blood vessels are called thrombi, they break loose and flow with the blood called emboli
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postoperative vital signs
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monitored every 5 to 15 minutes
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impeding shock (signs and symptoms)
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rapid, thread pulse, restlessness, decreasing blood pressure, decrease urine output
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detecting early signs of hypoxia
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monitor the patient's respiratory status
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reduce the risk of aspiration
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position the unconscious patient on one side
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after spinal anesthesia (patient's abilities?)
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regains the ability to move the legs before the sensation returns
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discharge from the postanesthesia care unit (what conditions must be met before being discharged?)
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vital signs are stable, respiratory and circulatory functions are adequate, the patient has minimal pain, the patient is awake or can be waken easily, complications are absent or are under control, the gag reflex is present
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penrose drain
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soft tube that permits passive movement of fluids from the wound
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active drain
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type of drain that is attached to collection devices that create suction to draw fluid from the wound
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vacuum assisted closure devices
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used to apply negative pressure to certain open wounds
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what to do when dehiscence or evisceration occurs?
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cover the wound with sterile dressings saturated with normal saline and to notify the physician
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signs and symptoms of wound infection (when does it develop?)
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the third to fifth day after the operation
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methicillin resistant staphyloccus aureus
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highly contagious organism that requires patient isolation
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signs and symptoms of pneumonia
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dyspnea, fatigue, fever, cough, purulent or bloody sputum and "wet" breath sounds
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prevention of pneumonia and atelectasis
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frequent position changes and coughing and deep breathing exercises, turn patient every 2 hours
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incentive spirometer
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device used to promote lung expansion
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if a patient develops pneumonia (treatment)
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rest, oxygen and antibiotics
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prevention of thrombophlebitis and related pulmonary emboli
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leg exercises, early ambulation, and frequent position changes
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signs and symptoms of pulmonary embolism
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dyspnea, tachypnea, chest pain, and hemoptysis
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postoperative care regarding urinary retention (not being able to void)
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if patient does not void within 6-8 hours, catheterization is usually performed to empty bladder
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postoperative care regarding nutrition (patient's diet)
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patients are traditionally given clear liquids at first and then full liquids, if liquids are retained the diet is advanced to include soft foods and then regular foods
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