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Pre-Op Lecture 02-08-06 (Misty)


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What does ablative surgery involve?
Removal of a diseased part
What does palliative surgery involve?
Procedures to reduce the intensity of a disease (pain, complications, etc.)
What is meant by the term, "procurement for transplant?"
Removal of an organ
Give examples of "major" surgery:
Coronary artery bypass

Colon resection
Give an example of a "minor" surgery:
Cataract extraction
Give an example of an elective surgery:
Hernia repair
What characterizes an elective procedure?
The client chose to have the procedure
What characterizes an urgent procedure?
Necessary but not really an emergency
Give an example of an urgent surgery
Removal of gallbladder
What characterizes an emergency procedure?
Must be done now (life-threatening or risk of losing body function)
Give an example of an emergency procedure:
Repair of perforated appendix
Define anesthesia:
an induced state of partial of total loss of sensation, occurring with or without loss of consciousness
List the desired effects of anesthesia:
* block nerve impulse transmission
* suppress reflexes
* promote muscle relaxation
* achieve a controlled level of unconsciousness (in some cases)
* slow body systems down (GI/GU, etc.)
Most anesthesia drugs are metabolized where?
The liver
Which organ excretes anesthesia drugs?
The kidneys
Define "general anesthesia:"
A reversible loss of consciousness induced by inhibiting neuronal impulses in several areas of the CNS
List the four most important desired effects of anesthesia:
* analgesia
* amnesia
* unconsciousness
* loss of muscle tone / reflexes
What are the four stages of general anesthesia?
1: analgesia & sedation (drowsy / dizzy / hearing exaggerated)
2: excitement, delirium (LOC/loss of eyelid reflex / irregular breathing / involuntary movements / vomiting may occur)
3: operative level (loss of reflexes/depressing of vital fctns./sensations are lost)
4: danger (resp. failure / cardiac arrest/possible death)
Why do surgical patients often have fluid/electrolyte imbalance?
* Fluid volume deficit with blood loss
* Electrolyte abnormalities as well as fluid loss with drainage tubes
* Hyperkalemia due to release of K from inside cells with trauma of surgery
* Fluid changes related to stress response of surgery
List an intervention for a nursing diagnosis of "risk for perioperative positioning injury:"
* Proper body positioning
List an intervention for the following nursing diagnosis: Risk for pressure ulcer formation
* Prevention of obstruction of circulation, respiration and nerve conduction
List the factors that influence an individual's response to surgery:
* Nutritional status
* Obesity
* Pulmonary status
* Coping mechanisms
* History of chronic illness
* Medications
* Sociocultural background
* Health beliefs/practices
A malnourished patient has a greater risk of what surgical complications?
* Poor wound healing
* Reduced energy stores
* Infection
An obese patient has a greater risk for what surgical complications?
* Decreased ventilatory and cardiac function
* Poor wound healing due to structure of fatty tissue (poor blood supply)
* Greater chance of evisceration from incision
Why does smoking increase the risk for pulmonary problems associated with surgery?
* Cilia of mucous membranes absent or hypoactive
* Lining of airways may be hypertrophied
* Alveoli are less compliant
List some chronic illnesses which can cause poor recovery from surgery:
* Diabetes
* Heart disease
* Liver disease
* Renal disease
List some respiratory complications that can occur post-op:
* Atelectasis
* Pneumonia
* Hypoxemia
* Pulmonary embolism
List some GI complications that can occur post-op:
* Abdominal distention
* Paralytic ileus
* Nausea / vomiting
* Urinary retention
How often should NG tube drainage be assessed post-op?
Every 8 hours
True or False: the nurse can irrigate the NG tube after gastric surgery without an order from the physician.

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