GI surgeries

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Author:
selggur29
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207662
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GI surgeries
Updated:
2013-03-16 17:08:13
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GI Surgeries
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GI surgeries
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  1. Indirect Inguinal Hernia
    sac formed from the peritoneum that contains a portion of the intestine

    common in men b/c they follow the tract that develops when the testes descend into the scrotum
  2. Direct inguinal hernia
    pass through a weak point in the abdominal wall

    occur in older adults
  3. Femoral hernias
    protrude through the femoral ring. Pulls peritoneum and urinary bladder into the sac

    common in obese/pregnat women
  4. umbilical hernias
    congenital (infancy) or aquired (increased intra-abdominal pressure.

    common in obese people
  5. Incisional (ventral) hernias
    • occur at the site of a previous surgical incision.
    • Inadequate healing of the incision from post op wound infections, poor nutrition or obesity
  6. Hernias are classified as...?
    reducible-contents can be placed back into abdominal cavity by gentle pressure

    irreducible-can not be placed back, immediate surgical evaluation

    strangulated-blood supply to the herniated segment of the bowel is cut off by pressure form the hernial ring (ischemia, obstruction);signs of strangulation include distention, n/v, pain, fever, & tachycardia
  7. How do you assess for a hernia?
    • *inspect while pt is lying and again when standing (may disappear hen lying if reducible)
    • *perfor valsalva amneuver to see bulging
    • *auscultate for bowel sounds
  8. Truss
    a pad made with firm material to keep abdominal contents from protruding, teach pt to assess the skin and protect with light powder
  9. Minimall Invasive inguinal hernia repair (MIHR)
    *surgery with laparoscope "herniorrhaphy"

    *several small incisions to determine defect, intestinal contents placed back into wall
  10. hernioplasty
    reinforces the waekened outeide abdominal muscle wall with a mesch patch
  11. How does a pt prevent irritation of hemorrhoids?
    • *prevent constipation
    • *increasing fiber, raw vegetables, and fruits
    • *drink plenty of water
    • *avoid straining
    • *exercise regularly
    • *maintain healthy weight
  12. Hemorrhoidectomy
    *resection of the hemorrhoid; causes alot of pain

    *pt first bowel movement is painful enough to cause tem to black out
  13. McBurneys Point
    Common area for appendicitis pain; abdominal pain moves from abdomin to RLQ b/w anterior iliac crest and the umbilicus
  14. Assessment of appendicitis
    • *abdominal pain followed by n/v
    • *periumbilical and epigastric pain
    • *anorexia
    • *Mcburneys point pain
    • *pain after the release of pressure applied "rebound" tenderness
    • *increased WBC' with shift to the left
  15. Appendectomy
    removal of infalmed appendix

    laproscopy-uncomplicated

    Laparotomy-larger incision for complications
  16. Peritonitis
    is a life-threatening, acute inflammation of the visceral/parietal peritoneum an endothlial lining of the abdominal cavity

    caused by bacteria or chemicals

    when not diagnosis and tx is delayed, hypovolemic shock can occur as blood is being shunted to area of inflammation
  17. Caring for a pt with suspected appendicitis
    administer IV fluids to prevent electrolyte and fluid imbalances; opioid analgesics and antibiotics

    do NOT administer laxatives, NEVER apply heat-both can cause perforation
  18. assessment of peritonitis
    • *ask pt about abdominal pain (shoulder or chest pain); abdomen will look board like
    • *diminishing bowel sounds
    • *high fecer, tachycardia
    • *decreased urine output
    • *hiccups
  19. Surgical treatment for peritonitis
    *focuses on controlling the contamination, removing foreign material, and draining collected fluid

    *laparotomy or laproscopy to repair/remove perforated organ, irrigation of the peritoneum

    *maintain pt in semi-fowlers after to promote abdominal draining
  20. Mechanical intestinal obstruction
    bowel physically blocked by problems outside of the intestine (adhesions),  in the bowel wall (Chron's disease), or in the intestinal lumen (tumors)
  21. Nonmechanical intestinal obstruction
    peristalsis is decreased or absent as a result of neuromuscular disturbance, resulting in a slowing of the movement or a backup of intestinal contents
  22. Intussusception

    Volvulus
    *telescoping of the intestine

    *twisting o the intestine

    both causes of mechaniical obstruction
  23. Common causes of intestinal obstruction
    Age 65 or older, deverticulitis, tumors and fecal impactions

    Mechanical= adhesions, tumors, appendicitis complications, hernias, fecal impactions chrons disease

    nonmechanical=hadeling of the intestines during abdominal surgery, peritonitis, electrolyte imbalances
  24. Obstipation
    no passage of stool
  25. Intestinal obstruction surgery treatment
    exploratory laparotomy-MIS done ith laprocope to diagnos cause and remove or repair site.
  26. Calculous cholecystitis
    chemical irritaion and inflammation result from gallstones (cholelithiasis) that obstruct the cystic duct, gallbladder neck, or common bile duct

    bile has a toxic effect on the gallbaldder could cause perfrmation and peritonitis
  27. Acalculous Cholecystitis
    inflammation occuring without gallstones; is typically associated with decrease in blood flow, twisting of of the gallbladder neck
  28. Chronic cholecystitis
    results when repeated episodes of cystic duct obstruction cause chronic inflammation; jaundice
  29. The four F's of risk or gallstones
    • female
    • forty (20-60)
    • fat
    • fertile (increased pregnancies)
  30. Key features of cholecustitis
    • epigastric pain
    • pain after high fat or high volume meal
    • anorexia
    • n/v
    • rebound tenderness
    • belching
    • jaundice
  31. dyspepsia

    eructation
    indegestion

    belching
  32. extracorporeal shock wave lithotripsy
    *only in patients of healthy weight, cholesterol based stone and good gallbladder function

    shock waves break up large stones to be passed
  33. cholecystectomy
    surgical removal of gallbladder (laproscopic)

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