surgical procedures

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surgical procedures
2014-04-04 01:31:03

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  1. anesthesia=
    absense of sensation
  2. Sedation
    drowsiness may provide minamal pain relief
  3. Tranquilization
    creates calmness, no pain relief
  4. analgeisia
    pain relief
  5. local anesthesia
    absence of feeling in a specific part of the body
  6. general anesthesia
    loss of sensation and conciousness
  7. Pre-med drug
    creates calmness
  8. pre-med
    pain relief
  9. pre-med
    strictly to counteract the side effects of the tranquilizers/sedatives and analgesics
  10. tell me about induction drugs
    • they create a smooth rapid transition from conscious to unconscious 
    • it is possible for the patient to enter an excitement phase
    • usually injected or inhaled
  11. what about maintenance drugs
    • they produce and maintain anesthesia
    • they are generally inhaled (isofluorane)
    • or injected (propofol)
  12. the pre Sx patient assessment includes
    • a physical exam,
    • some diagnostic tests 
    • the AHT may create a problem list
    • assign a patient status number 1-15 (1 being best)
  13. When should IV fluids be started
    and at what rate?
    • before Sx! 
    • 2x the maintenance and then moving onto 10mls/kg/hr
  14. How often should monitoring during Sx b recorded?
    every 5 minutes in a perfect world, but its usually more like 10
  15. Types of monitoring?
    physical and mechanical
  16. during monitoring, what should be closely watched
    • heart rate as well as rhythm
    • blood pressure
    • CRT
    • Mucous membrane color
    • respiratory
    • blood loos
    • temp
  17. the re breathing system is for patients that are 
    under 7-10 kg
  18. prepare a leak test in an anesthetic machine
    • close pop off valve
    • place thumb over breathing hose
    • fill system with oxygen using flush valve
    • watch manometer until it hits 30
    • wait and watch that the needle is basically still
    • briefly release thumb while watching flutter valve
    • open pop off valve with thumb still on hose
  19. definition of wound
    types of wounds?
    • disruption of the normal state of tissue 
    • surgical and traumatic
  20. wound stages?
    • Inflammatory 
    •           bleeding, clotting,platelets/leukocytes
    • Proliferation
    •            granulation tissue
    • Maturation
    •          strengthening of the tissue, scar fades
  21. abrasion
    • shallow, 
    • exposes dermis
  22. laceration
    • can be superficial or deep
    • an avulsion is a laceration with a flap of skin
  23. degloving injury
    • usually after HBC, or falling from a truck
    • tears skin and tissue right off
  24. puncture/bite wounds
    • lots of underlying damage
    • always contaminated
    • often causes an abscess
  25. burns
    • blistering 
    • usually accompanied by a secondary infection
  26. decubitus ulcer

    • pressure ulcers often on elbows etc
    • always provide clean and dry thick bedding
    • precursor=red/white area of skin
  27. steps in wound treatment
    • stabilize patients
    • cover wound w clean dressing
    • prep/pack wound
    • scrub EDGES of wound
    • lavage
    • start anesthesia if not already
    • debridement 
    • closure
  28. what kind of instructions would you send the client after surgery
    • verbal
    • demo
    • handouts
    • invite client to call back
  29. types of bandages
    • protective
    • compressive
    • support/stabilization/immobilization
  30. home care instructions?
    • keep any bandaging clean and dry
    • check toes if necessary 2x/day fo temp, color,odor
    • watch for chaffing
    • prevent licking
    • restrict activity
  31. post Sx care
    • VERY close monitoring
    • check incision several times/day
    • eval. for
    •           pain
    •           appetite
    •           behavior
    • prevent self trauma
    • TPR changes are early warning signs
  32. Sterilizaion
    COMPLETE destruction of microorganisms & spores
  33. disinfection
    destruction or inhibition of growth of most microorganisms
  34. antisepsis
    inhibition of growth of some microorganismson tissue
  35. sanitation
    general cleanliness
  36. what should be in the center of the pack
    chemical sterilization indicator
  37. packs should be labelled with
    contents, date and initial
  38. when is a pack no longer considered sterile
    about 4 weeks
  39. cold sterilized tools are often used for
    "dirty procedures" like abscess draining
  40. after Sx, the instruments should be
    • immediately rinsed in cold water
    • scrubbed with soft brush and mild dishsoap
    • placed in ultrasonic cleaner
    • soak in surgical milk
    • AIR DRY
    • inspect
    • organize into packs