Med Surg

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Author:
lyssalu08
ID:
136767
Filename:
Med Surg
Updated:
2012-02-21 15:47:22
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med surg
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Description:
med surg Ch. 16
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  1. Inpatient
    refers to a pt admitted to hospital
  2. Outpatient
    (Ambulatory) Pt who goes to the surgical area the day of surgery and returns home the same day.
  3. Diagnostic
    • Performed to determine the origin and cause of a disorder or the cell type for cancer.
    • Ex: breast biopsy, colonoscopy
  4. Curative
    • Performed to resolve a health problem by repairing or removing the cause.
    • Ex: appendectomy, hysterectomy
  5. Restorative
    • Performed to improve a pts functonal ability.
    • Ex: Total knee replacement, hip replacement
  6. Palliative
    • To relieve symptoms of a disease process, but does not cure.
    • Ex: Colostomy, nerve root resection, tumor rebulking
  7. Elective
    • Planned for correction of a nonacute problem.
    • Ex: cataract removal, hernia repair, total joint replacement
  8. Urgent
    • Requires prompt intervention; may be life threatening if tx is delayed more than 24-48 hr.
    • Ex: Intestinal or bladder obstruction, kidney or ureteral stones, bone fx, eye injury
  9. Emergent
    • Requires immediate intervention because of life-threatening consequences.
    • Ex: Gunshot or stab, severe bleeding, abdominal aortic aneurysm, compound fx, appendectomy
  10. Minor
    • No significant risk; often done with local anesthesia
    • Ex: Incision and drainage (I&D), Implantation of a venous access device (VAD), muscle biopsy
  11. Major
    • Greater risk; usually longer and more extensive than a minor procedure
    • Ex: Mitral valve replacement, pancreas transplant, lymph node dissection
  12. Simple
    • only the most overtly affected areas involved in the surgery
    • Ex: simple/partial mastectomy
  13. Radical
    • Extensive surgery beyond area obviously involved; directed at finding a root cause
    • Ex: Radical prostatectomy, radical hysterectomy
  14. Minimally invasive surgery (MIS)
    • Surgery performed in a body cavity or body area with endoscopy; can correct problems, remove organs, take tissue for biopsy, re-route blood vessels and drainage systems.
    • Ex: Arthroscopy, tubal ligation, hysterectomy, lung lobectomy, caronary artery bypass, cholecystectomy
  15. Carboxyhemoglobin
    Carbon monoxide on oxygen-binding sites of the hemoglobin molecule, which decreases oxygen delivery to organs. (Comen in smokers)
  16. atelectasis
    collapse of alveoli; reduces gas exchange and causes intolerance of anesthesia (commen problem after general anesthesia)
  17. autologous donations
    Blood donation made by the pt a few weeks before surgery
  18. Directed blood donation
    Family or friends donate blood exclusively for their use.
  19. morbidity
    # of serious problems
  20. Mortality
    # of deaths
  21. dysuria
    painful urination
  22. nocturia
    awakening during nighttime sleep because of a need to void
  23. oliguria
    scant amt of urine
  24. What is needed for wound healing and blood clotting?
    K, Vit C and B
  25. Sodium
    136-145
  26. Chloride
    98-106
  27. Carbon dioxide
    23-30
  28. Glucose
    70-110
  29. Creatinine
    0.5-1.1 mg/dl or 44-97 umol/L
  30. Blood urea nitrogen (BUN)
    10-20 mg/dl or 2.1-7.1 mmol/L
  31. Prothrombin time (pro time, PT)
    11-12.5 sec, 85% to 100%, or 1:1.1 patient-control ratio
  32. International normalized ratio (INR)
    0.7-1.8
  33. Partial thromboplastin time, activated (aPTT)
    30-40 sec
  34. WBC
    5000-10,000
  35. Hemoglobin, total
    females 18-44: 12-16 g/dl or 117-155 g/L
  36. Hematocrit
    Females 18-44: 35-45%
  37. Which drugs are commonly allowed with a sip of water before surgery?
    Drugs for cardiac disease, respiratory disease, seizures, and HTN.
  38. What is the purpose of coughing?
    to expel secretions, keep the lungs clear, allow full aeration, and prevent pneumonia and atelectasis
  39. What is a common sign of a DVT?
    Sudden swelling in one leg; the pt may feel a dull ache in the calf area that becomes worse with ambulation.
  40. What are the benefits of mobility?
    Stimulates int. motility, enhances lung expansion, mobilizes secretions, promotes venous return, prevents joint rigidity, and relieves pressure.

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