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Flashcards in Care of the Surgical Patient Deck (52):
1

preoperative phase

from the decision of surgery to transfer into the operating room

2

Intraoperative phase

from transfer to the operating room to admission to the PACU

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postoperative phase

starts at admission to the PACU and ends when completely recovered from surgery.

4

Emergency surgery

needed to be done immediately; life threatening situation

5

urgent

not an emergency; requires prompt intervention 24-48 hours

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elective

non urgent, non acute problem, not life threatening but surgery is preferred treatment

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optional

not critical to survival or function

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diagnostic

to make or confirm a diagnosis

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ablative

to remove a diseased body part

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restorative

to restore function to a traumatized or malfunctioning tissue

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palliative

to relieve or reduce intensity of an illness; is not curative

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constructive

to restore function in congenital anomalies Ex. cleft palate

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transplantation

to replace organs or structures that are diseased or malfunctioning.

14

Minor degree of risk

low risk to patient; fewer complications; often same day surgery

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Major degree of risk

high risk to patient; more complicated; increased blood loss; vital organs involved; increased risk of post operative complications

16

What are some advantages of same day surgery?

Same day procedures-cheaper
less stress
less risk of HAI'sq

17

What are some disadvantages of same day surgeries

need more knowledge base & proper education
baseline info
limited activity at home and need more social support

18

What are some components of pre-surgical testing?

CBC, Basic metabolic panel, chest X-Ray, EKG/ECG,

19

What information would be included in a current problem nursing assessment?

What are they having surgery on

20

What information would be included in a vital signs nursing assessment

VITALS

21

Antibiotics

mycins--potentiate MS relaxants

22

Anticoagulants

Increase bleeding time, problem with cloting, should be stopped several days prior to surgery

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Aspirin NSAIDS

same as anticoagulants

24

Antihypertensives

When used with anesthetics can cause hypotension

25

Diuretics

Loss of K+ . Hypokalemia will cause cardiac problems and arrhythmia. (getting rid of excess water)

26

Corticosteroids

Steroids--when stopped suddenly will cause CV collapse; also anti-inflammatory and will delay wound healing.

27

Tranquilizers

potentiate narcotics and barbiiturates which will decrease BP and cause CNS depresssion

28

Support system

sociocultural needs

29

Sedatives

diazepam (Valium); midazolam (versed), lorazepam (Ativan) to alleviate anxiety and decrease recall of events related to surgery

30

Anticholinergics

Atropine and Glycopyrrolate (Robinul) decrease pulmonary/oral secretions and prevent laryngospasm

31

Narcotic Analgesics

Morphine to facilitate patient sedation and relaxation and to decrease the amount of anesthetic agent needed.

32

Neuroleptanalgesic agents

fentanyl citrate-droperidol (Innovar) cause a general state of calmness and sleepiness

33

H2-histamine receptor antagonist

cimetidine (Tagamet) and ranitidine (zantac) to decrease gastic acidity and volume

34

General anesthesia

Inhalation or Intravenous--produces CNS depression, analgesia, relaxation and reflex loss.

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Patients are not arousable, are unable to maintain breathing and require mechanical ventilation. Cardiovascular function may be impaired.

General Anesthesia

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Beginning stage of anesthesia

initial feeling of detachment as the client is receiving the medication and is starting to work on the body.

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Excitement stage of anesthesia

the person is excited and may be taking, crying or shouting

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surgical anesthessia

the patient is unconscious and still the medication is doing what it is suppossed to do.

39

medullary depression

too much anesthesia has been administered or it is being broken down differently in the body.

40

Regional Anesthesia

Local anesthetic injected around nerves

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Patient is awake and aware of surroundings. This has a less systemic effect. it is good for the elderly and those with cardiac and respiratory problems.

regional anesthesia

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epidural anesthesia

agent is injected into the epidural space that surrpounds the dura mater of the spinal cord.

43

what is an advantage of epidural anesthesia

no headache

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what are some disadvantages of an epidural

need more precise technical administration. Can be used post operative also for pain control.

45

spinal anethesia

agent injected through the dura mater and into the subarachnoid space surrounding the spinal cord.

46

Produces anesthesia to lower extremities, perineum and lower abdomen. Side effects are headache and hypotension

spinal anesthesia.

47

Hypoxia

inadequate ventilation due to airway occlusion, anadvertent intubation of esophagus instead of trachea.

48

What are some causes of respiratory depression

medications, aspiration of secretion or vomitus, the positioning of the patient on the table.

49

Hypoxia can cause

brain damage in minutes-patient must be monitored carefully-O2 levels, pulse ox, peripheral circulation.

50

how is Hypothermia intenionally cuased

bypass surgery

51

how is hypothermia unintentionally caused

low room temp, cold IV fluids, inhaling cold gases, open body cavity, decreased muscle activity, age, medications,

52

How do you rewarm a patient with hypothermia

graduallly. Room temperature, warm IV fluids, dry sheets. Monitor patient slowly.