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surgical procedure suffix
- -ectomy= removal by cutting.
- -oscopy= look into
- -ostomy=formation of a permant opening.
- -otomy=incision/cutting into.
- -plasty= formation or repair.
surgery urgency level & purpose
- emergany: immediate-ruptured aortic.
- urgent: surgery w/i 24-30hrs-fracture repair.
- diagnostic: obtain sample for diagnosis-biopsy
- palliative: alleviation of symptoms when cannot be cured-rhizotomy.
perioperative surgical phases
- periop-3 phases
- preop-begin decision of surgery, transfer to op room.
- postop-recovery room.
experience anxiety during surgery.
- anxiety and fear.
- fear of not waking up. (postpone surgery)
cancellation of surgery
can result if pt has not been NPO as ordered.
deep breath, cough, spirometry leg exercises.
prevent development of atelectasis (collapse lung caused by hypo ventilation or mucus obstruction preventing some alveoli from opening and being fully ventilated).
- sit up 45 degreesminimum
- take 2 normal breaths, place spirometer in mouth.
- inhale till target,designed by spirometer light or rising ball is reached and hold breath for 3-5 seconds.
- exhale completlty
- perform 10 sets breath each hr.
chronic oral steroid therapy
don't stop taking.
used during surgery prevent pain.
two types anesthesia
- general: iv/inhaled.anxious pt. lose sensation and consciousness.
- local:sedation of specific body part, no sleep.
- muscular disease triggered by general anesthetic agent.
- symtom: high fever and respiratory acidosis.
- stop surgery, anesthesia discontinued.
- oxygen 100% is given.
- pt cooled with ice and ice infusions solutions
- antidote: dantrolene sodium.
spinal and epidural block
- spinal block a local agent into subarachnoid space.
- epidural block local in epidural space.
- both lower extremities.
- respiratory depression.
- twilight sleep
- minimal sedation that doesn't cause the complete loss of consciousness.
pt safty interventions
- bed in low position, rails up.
- call button is close to reach.
- assist with ambulation.
- 1 or 2 health care wker should assist pt, dangle first.
- crackles in the lungs, pt should deep breath and cough.
- listen again to see if cleared.
- airway is compressed immediately support airway, call dr.
- situp, give oxygen, no fluids.
ineffective breathing d/t pain
pain slows healing, give morphine to help relax for deep breathing and cough.
ambulate pt, immobility decreases movement of mucus secretion.
ineffective tissue perfusion.edema
- leg exercise hrly.
- apply thigh length compression stocking
- avoid pressure under knees.
- give anticoagulants or plasma expanders.
hinders deep breathing and coughing and hinder walking. increasing complications and longer stay in hospital & health cost.
effectivly used for postop pain relief.
wound healing phases
- 1: inflammatory response. fever
- 2:granulation tissue forms. feel better
- 3: collagen deposited. raised.
- 4: collagen deposited.flat.
- healing by 3rd intention, infected wound is left open until there is no evidence of infection and then the wound is surgically closed.
bursting open wound edges.
- viscera spilling out abdoman
- intestine spill out.
- lead to shock.
- something let loose/gave way.
dehiscence or evisceration
- 1: pt in low Fowler with flexed knees.
- 2: cover wound with sterile dressing/towel, moisten with warm steral normal saline.
- 3: call dr
- 4: appy pressure over wound.
- inject zophan if pt vomits meds.
- don't give over 5ml injection.
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