quiz #1 - surgery

Question 1

surgery complications

Answer 1

-loss of tensile strength in CT (tendons, ligaments & fascia)
-mm weakness
-nerve damage
-skin lesions
-scar tissue
-pain
-loss of function

Question 2

removal & study of tissue to make a diognosis

Answer 2

diagnostic surgery

(breast biopsy, biopsy of skin lesion)

Question 3

exploration of body

Answer 3

exploratory

(exploration of abdomen for unexplained pain)

Question 4

removal/ replacement of defective tissue to restore function

Answer 4

curative

(total hip replacement)

Question 5

relief of symptoms or enhancement of function without cure

Answer 5

palliative

(resection of tumor to relieve pressure & P)

Question 6

reshape normal body structures/ improve appearance

Answer 6

cosmetic

(cleft lip repair, nose job)

Question 7

removal of tissue that does not yet contain cancer cells, but has a high probability of becoming cancerous

Answer 7

preventative / prophylactic

(removal of both ovaries)

Question 8

repair/ reconstruct deformities caused by injuries/ birth defects

Answer 8

reconstructive

(breast reconstruction after mastectomy, cleft lip repair)

Question 9

immediate surgery, condition life threatening (gun shot wound)

Answer 9

emergency surgery

Question 10

within 24-30 hrs, requires prompt attention (kidney stones)

Answer 10

urgent surgery

Question 11

planned for few weeks/ months, requires surgery at some point (cataracts)

Answer 11

required surgery

Question 12

patient will not be harmed if surgery is not performed but will benefit (scars, vaginal repairs)

Answer 12

elective surgery

Question 13

personal preference surgery (cosmetic)

Answer 13

optional surgery

Question 14

any surgical procedure required not admitting patient to hospital, called same-day or outpatient surgery

Answer 14

ambulatory surgery

(bone marrow biopsy, endoscopy or cardiac catheterization)

Question 15

entire span of surgery, including before, during & after the actual operation

Answer 15

perioperative care

1. pre-operative
2. intra-operative
3. post-operative

Question 16

begins with the decision to perform surgery & continues until patient reaches operating room

Answer 16

pre-operative phase

-assessment
-surgical consent
-preoperative education
-physical & psychosocial preparation

Question 17

includes entire surgical procedure until transfer of patient to recovery area

Answer 17

intra-operative phase

Question 18

begins with admission to recovery area & continues until client receives a follow up evaluation at home or is discharged to a rehabilitation unit

Answer 18

post-operative phase

Question 19

meds: decrease respiratory tract secretions, dry mucous membranes, interrupts vagal stimulation

Answer 19

Anticholinergics (scopolamine)

Question 20

meds: decrease gastric acidity & volume

Answer 20

Histamine 2-receptor antagonists (ranitidine)

Question 21

meds: decrease amount of anesthesia needed, helps reduce anxiety & pain, promotes sleep

Answer 21

Opioids (morphine)

Question 22

meds: promotes sleep, decreases anxiety & reduces amount of anesthesia needed

Answer 22

Sedatives

Question 23

meds: reduces nausea, prevents emesis, enhances pre-operative sedation, slows motor activity & promotes induction of anesthesia

Answer 23

Tranquilizers (diazepam, valium)

Question 24

protocol for preventing wrong site, wrong procedure, wrong person surgery was developed in 2003, called the…

Answer 24

“Universal Protocol: the Joint Commission”

Question 25

partial or complete loss of sensation of pain with or without loss of consciousness

Answer 25

anesthesia general & regional

Question 26

-acts on CNS to produce loss of sensation, reflexes & consciousness -vital functions such as breathing, circulation & temp control are regulated -when anesthetics are carefully withdrawn at end of surgical procedure, client will wake enough to follow commands & breathe independently

Answer 26

GENERAL anesthesia

Question 27

-uses local anesthetics to block conduction of nerve impulses in a specific region -patient does NOT lose consciousness -advantages include less risk of respiratory, cardiac or GI complications

Answer 27

REGIONAL anesthesia

Question 28

types of regional anesthesia

Answer 28

local: under epidural surface, local loss of sensation spinal: injected in lumbar area, CSF epidural block: several spinal nerves at once (headache not present after) peripheral nerve block: particular nerve/ group or nerves

Question 29

type of sedation where patient is free of pain, fear & anxiety, maintains independent cardiorespiratory function & ability to respond to verbal commands & tactile stimulation

Answer 29

procedural sedation (conscious sedation)

Question 30

time that the client requires recovering from the effects of anesthesia

Answer 30

immediate postoperative period

Question 31

3 postoperative complications

Answer 31

hemorrhage shock aspiration

Question 32

if patient lies still for long periods without moving their legs, blood may flow sluggishly through the veins, this is called...

Answer 32

venous stasis (> thrombophlebitis) to prevent: patients must be encouraged to move their legs frequently & do leg exercises

Question 33

post surgical massage considerations

Answer 33

-techniques -hydrotherapy -therapeutic exercise -adaptations to patient’s ADLs

Question 34

important considerations of the post-operative phase for massage therapists to consider

Answer 34

pain management skin integrity wound healing

Question 35

most common Tx for cancer

Answer 35

surgery

Question 36

types of CIs

Answer 36

general or systemic: condition affects the whole body local: condition affects a particular region absolute: cannot be treated under any circumstances relative: may be treated with caution or modification of technique

Question 37

systemic (general) CI's: absolute

Answer 37

-contagious infections -temp of 2º or more above normal -metastatic cancer -acute RA

Question 38

systemic (general CI's): relative

Answer 38

-mild contagious infection -temp less than 2º above normal -cancer in remission/ terminal -altered perception of P (MS, meds)

Question 39

local CI's: absolute

Answer 39

-undiagnosed lump -infectious/ contagious disease of skin -recent wounds/ burns -severe varicose veins

Question 40

local CI's: relative

Answer 40

-benign tumor/ cyst -sprain/ fracture -healing wounds/ burns -contusion

Question 41

6 surgical risks that RMTs need to be concerned about

Answer 41

clot formation edema reduced function infection anemia fever

Question 42

clot formation: avoid massage on ____ - this restriction applies for a period of ____ after client is ambulatory

Answer 42

lower extremities a week to 10 days

Question 43

common concern after surgery, especially if lymph nodes have been removed

Answer 43

edema / lymphedema usually occurs in limbs distal to removed nodes

Question 44

CI when treating edema

Answer 44

use of heat and all forms of thermotherapy (may increase swelling)

Question 45

which direction should you mobilize scars to prevent overstretching the healed tissue?

Answer 45

TOWARD the scar

Question 46

infection: loss of RBCs vs WBCs

Answer 46

RBCs: may become anemic WBCs: more susceptible to infection

Question 47

if the client has a systemic infection, massage is postponed until the client is symptom free for at least __ hours & medical clearance is given

Answer 47

48

Question 48

what is anemia?

Answer 48

results from decreased RBCs, can also be a side effect of several drugs causes fatigue, orthostatic hypotension, shortness of breath & intolerance to cold

Question 49

Tx considerations if client has anemia

Answer 49

-reduce Tx to 30 min -lighter pressure to prevent over tiring client -ensure client stays warm -if difficulty breathing, avoid prone position -while client is supine, elevate upper body -inquire about degree of dizziness

Question 50

if client has a fever, massage is CI'd because it will exacerbate symptoms & make client feel worse, once client has been fever free for __ hours & medical clearance is given, he or she may receive massage

Answer 50

48

Question 51

when is it safe to do hydrotherpay Tx after surgery?

Answer 51

when wounds are fully healed before submersion so there is no risk of infection unhealed wounds = absolute CI