Pre-Op Lecture 02-08-06 (Misty)
Terms
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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:
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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:
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* analgesia
* amnesia
* unconsciousness
* loss of muscle tone / reflexes - What are the four stages of general anesthesia?
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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?
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* 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:
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* 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?
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* 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:
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* 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
* UTI - 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.
- False