chapter 42

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evguerra
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20758
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chapter 42
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2010-05-30 01:16:41
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care surgical patient
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LVN /CHRISTENSEN
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  1. ABLATION
    An amputation or excision of any part of the body or removal of a growth or harmful substance
  2. Anesthesia
    Therapy designed to relieve or reduce intensity of uncomfotable symptoms without cure
  3. Atelectasis
    an abnormal condition charecterized by the collapse of a lung
  4. cachexia
    Ill health malnutrtion and wasting as a results of a chronic disease
  5. Catabolism
    Tissue breakdown
  6. Dehiscence
    The seperation of a surgical incision or rupture of a wound closure
  7. Drainage
    the removal of fluids from a body cavaity wound or other source of disharge by one or more methods
  8. Embolus
    if a thrombus is dislodge it can travel to the lungs heart or brain where the vessel can be occluded
  9. eviseration .
    protrusion of an internal organ through a wound or surgical incsion especially in the abdominal wall( when insides are coming out
  10. exudates
    • substance that have slowly seeped from cells or blood vessels through small pores or break in cell membranes
    • (e.g perspiration,pus serum )
  11. INCENTIVE SPIROMETRY
    A respiratory device used at the bedside at regular intervals to encourage the patient to breath deeply
  12. incision
    Cuts produced surgically by a sharp instrument to create an opening into an organ or spae into the body
  13. infarct
    Without an adequate blood supply localized area of necrosis <--(premature death of cells and living tissues)
  14. informed consent
    permission to obtain from the patient to perform a specific test or procedure
  15. palliative
    therapy designed to relieve or reduce intensity of uncomfortable symptoms without cure
  16. singuluts
    (HICCUP) Is an involuntary contraction of the diaphragm followed by rapid closure of the glotts
  17. surgical asepis
    Protection against infection before suring or after surgery by the use of the sterile technique
  18. thrombus
    an accumulation of platelets fibrin clotting factors and cellular elements of the blood attached to the anterior wallof a vessle sometimes occluding the lumen of the vessel
  19. Identify the purpose of Surgery
    The restoration of function to a lacerated arm is........
    constructive surgery-restores function lost or reduced as a results of congential anomalies
  20. Identify the purpose of Surgery
    Removal of the appendix is ......
    Ablation-excision/removal of diseased body part
  21. Identify the purpose of Surgery
    A breast biopsy is....
    Diagnostic- Surgical exploration that allows MD to confirm diagnosis may involve removal of tissue for further diagnostic testing
  22. Identify the purpose of Surgery
    A colostomy usually will not produce cure
    Palliative- releives or reduces intensity of disease symptoms will not produce cure
  23. Identify the purpose of Surgery
    Total Hip Replacement
    Constructive surgery- restores function lost or reduced as a results of congenial anomalies
  24. Identify the purpose of Surgery
    closure of an aterial septal defect in the heart ......
    Reconstructive- restores funstion lost or appearance to traumatized or malfunctioning tissue
  25. Identify the purpose of Surgery
    Internal fixation of a right fibula....
    reconstructive- restores function or appearance or traumatized or malfunctioning tissue/bone
  26. Identify the purpose of Surgery
    Removal of a mole that has an abnormal apperance
    reconstrutive-restores function os appearrance to traumatized or malfunctioning tissues/bones
  27. Explain the urgency of the following types of surgeries
    Elective
    Performed on basis of patients choice
  28. Explain the urgency of the following types of surgeries
    Emergency
    must be done immediately to save life or preserve function of body part
  29. Explain the urgency of the following
    Urgent
    necessary for patients health
  30. List why these factors can make a difference in a patients reaction to surgery
    Nutrition
    nutrtional needs vary with patients age and physical requirement patinetns who maintain a sound nutrtional diets tends to recover more quickly.Surgery decreases a patients appetite and alter metabolic functions the nurse observes for malnutrition.
  31. List why these factors can make a difference in a patients reaction to surgery
    socioeconomic and cultural needs
    nursing froma multicultural perspective assists nurses to have a frame of reference in approaching patients with respect and individually tailor care that promotes recovery
  32. anasthesia
    an=without pain esthesia= awarness of feeling
  33. THREE CATEGORIES OF AN ANESTHESIA
    GENERAL ANASTHESIA
    IMMOBILE QUIET PT WHO DOES NOT RECALL THE SURGICAL PROCEDURE MAY BE GIVEN VIA IV OR INHALATION
  34. FOUR STAGES OF ANASTHESIA
    STAGE 1
    BEGINS WHEN WHEN PATINET IS AWAKE AND ANASTHETIC AGENT BEGINS AND ENDS WHEN PT LOSES CONSCIOUSNESS
  35. STAGE 2
    • BEGINS WITH LOSS OF CONSICIOUSNES AND ENDS WITH ONSET OF REGULAR BREATHING AND LOSS OF EYELID REFLEXES
    • EXCITEMENT OF DELIRIUM PHASE INVOLUNTARY MOTOR ACTIVITY
    • NOT TO RECEIVE STIMULUS INCREASE THE CATECHOLAMINE PRODUCTION INCLUDING HR AND BP
  36. STAGE 3
    BEGINS WITH THE ONSET OF REGULAR BREATHING AND ENDS WITH THE CESSATION OF RESPIRATIOND. OPERATIVE OR SURGICAL STATE
  37. STAGE 4
    BEGINS WITH CESSSATION OF RESPIRATORY AND MUST BE AVOIDED OR IT WILL NECESSITATE THE INITIATION OF CPR AND MAY LEAD TO DEATH
  38. THREE PHASES
    INDUCTION
    ADMINISTRATION OF AGENTS AND ENDOTRACHEAL INTUBATION
  39. MAINTENANCE
  40. INCLUDES POSITIONING THE PATIENT PREPARAtion OF SKIN AND INCSION AND SURGICAL PROCEDURE ITSELF
    • SIDE EFFECTS OF ANESTHETIC AGENTS
    • CARDIOVASCULAR DEPRESSION OR IRRATIBILITY
    • RESPIRATORY DEPRESSION
    • LIVER AND KIDNEY DAMAGE
  41. EMERGENCE PHASE
    • ANESTHETIC ARE DECREASED AND PTR IS AWAKEN EXTUBATION IS OFTEN ACCOMPLISHED BEFORE TRANSFER TO PACU
    • POST ANASTHETIC CARE UNIT
  42. REGIONAL ANESTHESIA
    • LOSS OF SENSATION IN AN AREA OF THE BODY NO LOSS OF CONSCIOUSENESS BUT USUALLY SEDATED. GIVEN INFILTRASTION AND LOCAL APPLICATION
    • 1. NERVE BLOCK
    • 2. SPINAL ANASTHESIA
    • 3. EPIDERAL ANETHESIA
    • 4. IV REGIONAL ANESTHESIA
    • ADVANTAGE SHORT AND ONSET AND SHORT RECOVERY TIME
  43. spinal anesthesia
    agent may move up in the spinal cord and breathing affected headache
  44. conscious sedation
    used for procedure that do not require complete anesthesia but rather a depressed level of consciousness. retain patent and airway reflexes
  45. local anesthesia
    loss os sensation at desired site. agent inhibits nerve conduction until the drug diffuses intocirculation loss of pain or sensation and touch in motor autonomic activites injected or applied topically uses on minor surgery procedure
  46. responsibilities of the circulating nurse
    • prepares operating room with necessary equipment and supplies and ensures that equipment is functionl. arranges sterile and non sterile supplies performs patient assesment
    • checks medical record for completeness. assists in safe transfers of patient to operating room
  47. responsibilities of the scrub nurse
    • arranges sterile technique and instrument in manner prescribed for procedure. gowns and gloves surgeon as they enter the operating room.
    • assist with surgical draping of patgient,
    • hands surgeon instruments sponges and necessary supplies during procedure.
    • maintain count of sponges needles and instrument so none will be misplaced or lost in wound
  48. A-AIRWAY
    MAINTAIN POTENCY
  49. B-BREATHING
    EVALUATE DEPTH RATE SOUNDS RHYTHM AND CHEST MOVEMENT
  50. C-CONSCIOUSENSNESS
    ABLE TO TO EXTUBATE PT RESPONDS TO COMMANDS
  51. C-CIRCULATION
    MONITOR TEMP PULSE RESPIRATORY AND BP EVERY 10-15 MIN
  52. S-SYSTEM REVIEW
    • ASSESS NEUROLOGICAL FUNCTIONS MUSCLE STRENTH AND RESPONSE
  53. URINE OUTPUT
    AVERAGE 30 ML PER HOUR

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