Flashcards in MedSurg Start: Module 7: Nursing Care of the Post Operative Patient Deck (123)
Difference between Medical v Surgical Patients?
Both have a system pathology BUT...
Surgery is the critical TREATMENT of a surgical patient's pathology (medical is a diagnosis).
Different Surgical Purpose Types?
Different Surgical Degrees of Urgency?
Gathering information/Going into the body and trying to find out what is occurring - maybe obtain tissue in order to diagnose
Ex: Diagnostic Biopsy of the Breast; HCT or Hgb Drops lead to Exploratory Surgery
Procedure in order to cure a problem
Repairs something that is wrong that is already there - not adding just fixing
Ex: Dislocated Shoulder needs to be put back in place
Ex: Ligament repair
Recreating something normally in the body but generally using "Aftermarket Parts" or other materials
ex: Using titanium or ceramic or plastic to replace a hip
Ex: Reconstructive breast surgery post mastectomy
Not looking for a cure, but a procedure to provide better comfort
ex: If a chest tumor is pressing on the diaphragm they have trouble breathing, so a surgery could reduce the size and help with comfort.
Degree of Urgency: Emergent
A procedure that needs to be done IMMEDIATELY or else there will be serious consequences
Degree of Urgency: Urgent
A procedure that has a little more time than emergent, but still needs to be done within 24 hours
ex: most appendix surgeries
Degree of Urgency: Required
A procedure that must occur within the next few days/weeks
ex: Myocardial ischemia surgery must be done within 2 weeks
Degree of Urgency: Elective
A procedure that SHOULD/COULD be done, but you choose whether to do it or not
ex: A total hip replacement could be elective where you determine time and day
No serious consequences for not getting this
2020 Made this type of urgency more difficult and caused financial strains for hospitals
Possible Surgical Settings
Ambulatory or Same Day Surgery
Outpatient Surgical Setting
Done in the office, and you can often go home/drive home after - not done in the ER
ex: Blemish removal in the MD office
Ambulatory or Same Day Surgery Setting
Often a same day surgery that is invasive but is small and allows for ambulation in for the procedure and being brought to the car in a wheelchair allowing them to not have a need to spend the night
ex: Laparoscopic cholecystectomy
A special device that goes down a tube to remove the gall bladder in pieces - small openings from it can be covered with bandaids and the person can leave same day
Inpatient Surgery Setting
A surgery involving overnight stay potentially even for a few days
ex: Open cholecystectomy (gallbladder removal)
ex: total joint replacement (sometimes Ambulatory, but often inpatient)
Time between decision to proceed with surgery and arrival in the operating room
This period can take months if it is an elective history
This period allows for teaching, preparation, etc
Time actually in the OR
Not just while surgery is occurring, but when they are physically in the OR as well
Starts with admission to PACU and ends with the last post-op follow up visit!
Post Anesthesia Care Unit
How might the peri operative phases change in length?
Based on the urgency of the surgery
What two important things does Informed Consent do?
1. protects the medical team
2. Protects the patient
What things must informed consent be?
1. Signed voluntarily
2. Signed by a person of legal age or emancipated minor
3. The person must be mentally Competent and able to understand information
Informed consent is a legal mandate required for what kinds of procedures?
Invasive Procedures (biopsy, PICC line insertion)
Procedures requiring sedation
Procedures involving radiation
Peripherally inserted central catheter
It is put in the periphery (arm) and travels up and sits in the central vessel (subclavian vein right before the right atrium to the heart)
What is one situation that does not need informed consent?
A life saving emergency procedure
Informed consent requires patient education from ____
The physician!! (or advanced practitioner like PA or NP)