Surgical Techniques - Care of Patients with Special or Complex Needs 2-B Flashcards Preview

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Flashcards in Surgical Techniques - Care of Patients with Special or Complex Needs 2-B Deck (62)
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1

includes preoperative, intraoperative, and postoperative phases

perioperative

2

resistance of the skin to deformation

skin turgor

3

patients with reproductive issues of gender issues

sexually-related disorder

4

patients whose small anatomical structures alter the size of equipment and instruments needed for a surgical procedure

pediatric

5

patients with asthma, medication allergies, or latex allergies

severe allergy

6

non-native speaking patient in which English is not their primary language; requires a translator; has cultural or religious practices that vary from the majority of the population

language, cultural, or religious barriers

7

patient who has a cognitive disorder that primarily effects reasoning, memory, perception, and problem solving due to disease processes, such as dementia and Alzheimer's disease

geriatric

8

patient who faces humiliation or embarrassment because of their size, often causing them to delay seeking health care, sometimes with devastating consequences

bariatric

9

patients with anemia, hemophilia, or bloodborne pathogen diseases

hematological disorder

10

patients with diabetes, anorexia, bulimia, liver dysfunctions, and renal dysfunctions requiring dialysis

metabolically impaired

11

patients with neuromuscular disease, paralysis, physical deformities that are congenital in nature or acquired and sensory impairment

physically challenged

12

patients with Down's syndrome, PTSD, OCD, ADHD, fetal drug or alcohol syndrome

mentally or emotionally challenges

13

patients who have an infectious disease that could spread microorganisms to staff or other patients

isolation

14

patients with physical wound or injury, such as a fracture or blow

trauma

15

includes immunocomprimised patients, such as cancer patients on chemotherapy, patients with AIDS or who are HIV positive, transplant patients on immune-suppression medications, and burn patients

aseptically critical

16

patients who consume a substance in amounts or with methods neither approved nor supervised by medical professionals

substance abuse

17

pregnancies with a greater chance of complications

high-risk pregnancy

18

in this stage, the world becomes meaningless and overwhelming, and life makes no sense. The patient is in a state of shock.

denial

19

Empty feelings present themselves in this stage, and grief enters on a deeper level. This feels as though it will last forever.

depression

20

This stage is marked by calm and acknowledgment. This is not a period of happiness and must be distinguished from depression.

acceptance

21

Patients in this stage may feel guilty or remorse that they did not change their lifestyle or heed warning signs.

anger

22

In this stage, the normal reaction to feelings of helplessness and vulnerability is often a need to regain control or postpone death.

bargaining

23

In this stage, patients experience a reaction to practical implications relating to the illness or loss. Sadness and regret pre-dominate this stage.

depression

24

This stage is often confused with the notion of being "all right" or "OK" with what has happened.

acceptance

25

The first reaction to learning of terminal illness or the death of a cherished loved one is to disallow the reality of the situation.

denial

26

This is the second stage of grieving.

anger

27

Secretly, patients in this stage may make a deal with God or a higher power in an attempt to postpone the inevitable.

bargaining

28

This stage is about acknowledging that an illness is a reality or that a loved one is physically gone and recognizing that this new reality is the permanent reality.

acceptance

29

Aging patients may be mentally confused for a variety of reasons, so it is important to speak ______ and distinctly.

slowly

30

Many aging patients experience problems _____, making it important for you to speak loudly and clearly.

hearing

31

Handle aging patients gently but _____, without rushing them.

firmly

32

Allow patients to be as _____ as possible.

independent

33

Specialized monitoring equipment and temperature control units may be used on aging patients to more closely monitor their _____ _____ and alert the OR team to any emergencies.

vital signs

34

Aging patients are more prone to postoperative complications such as hypotension, _______, cerebral edema, and hypoxemia.

hypothermia

35

Aging patients present special challenges to the anestheologist because fitting a _____ may be difficult due to loss of teeth.

mask

36

Aging patients have a diminished and slower _____ _____; therefore they are more inclined to thrombus formation and my require antiembolic stockings.

heart rate

37

Patients need to be _____, not pulled, during transfer to and from the operating table since skin is thin and sensitive.

lifted

38

Decrease of blood supply to kidneys inhibits _____ and makes patient susceptible to infections.

filtering

39

Blood loss must be monitored and promptly _____.

replaced

40

Aging patients are more prone to _____ infections.

respiratory

41

Positioning an aging patient can be a challenge, not just because their skin is more easily damaged but for reasons of structural integrity. _____ become porous and less dense.

Bones

42

A 36-year-old male Buddhist monk comes in for a same-day hernia repair. Male monks cannot come in contact with a woman, since this can be interpreted as a breaking of vows. Which of the following is NOT an option in caring for this patient?
1) have the patient self-bathe as part of pre-op prep
2) have anestheologist induct the patient early, since there is a mixed gender surgical team
3) observe surgeon's request for an all-male staff
4) all of the above

2) have anestheologist induct the patient early, since there is a mixed gender surgical team

43

A horse tramples a 12-year-old girl, resulting in massive internal injuries. Her parents are out of town, but the camp counselors have spoken with them and they are on a flight home. After being rushed to the hospital, the surgical team discovers pooled blood in her abdomen and significant damage to her kidney. Her medical alert card state that under no circumstances is she to receive blood because of her parents' beliefs. The counselor, the girl's legal guardian, has refused to sign the release at the parents' explicit direction. The tension between the high value placed on life (Hippocratic oath, life devoted to healing) in direct opposition with a religious belief that places an equally high value on the soul and the hereafter. Which of the following is the most defensible position for the surgical team to take?
1) administer a blood transfusion, since the patient's life is at stake.
2) perform all necessary life-saving surgeries without a blood transfusion
3) stop surgery and sew her up
4) coerce the camp counselor into signing a waiver to allow for blood transfusion

2) perform all necessary life-saving surgeries without a blood transfusion

44

A 72-year-old Native American grandmother arrives carrying a dream catcher her young grandson has made for her especially for this surgery. She wants to bring it into surgery. A 5-year-old boy from India is being assisted with his pre-operative routine and the nurse goes to cut several strings ties to each of his wrists. He draws back in fear, crying out that she will cut his soul. Which of the following are other examples of items requiring special exemption or a mutually acceptable compromise?
1) medicine bundles
2) bits of red ribbon
3) special charms on chains, bracelets, bundles, or talismans
4) rosary beads
5) all of the above

5) all of the above

45

A description of those who need special language, cultural, or religious considerations include all of the following EXCEPT:
1) those with cultural or religious practices that vary from the minority of the local population
2) those whose language is not the primary language of the local population
3) those whose religious or cultural customs prevent them from receiving blood transfusions or donated organs
4) those who may not completely understand doctor's orders because they are non-native speakers

1) those with cultural or religious practices that vary from the minority of the local population

46

permanent loss of consciousness, permanent coma, and in a persistent vegetative state (PVS)

higher brain death

47

results from the cessation of heart function

cardiac death

48

irreversible loss of all functions of the brain, including the brain stem

whole brain death

49

A DNR order indicates that the patient and/or the family has made a decision to _____ lifesaving efforts.

decline

50

The official order is charted in the patient's medical records after the DNR document has been _____ by the patient or a family member.

signed

51

DNR orders can be incorporated into a(n) _____ _____, or by informing hospital staff.

advance directive

52

Many types of surgery provide _____ benefits to patients who either will not survive long-term or who do not wish resuscitation in the OR, so the precise procedures that can and cannot be performed should be designed to prevent ambiguity.

pallative

53

Unless instruction for a DNR are in effect, hospital staff will make every effort to help patients whose hearts have stopped or who have stopped _____.

breathing

54

_____ issues may arise if a DNR order is not in place and when the decision is left to the family members.

Ethical

55

Patients who benefit from a DNR order are those who have _____ or other debilitating illnesses.

terminal

56

The decision to become an organ donor is personal. In many states, this decision is verified on the individual's _____ _____ or other identification cards.

driver's license

57

Organ and tissue donation can occur with a decreased donor, who can give kidneys, pancreas, liver, lungs, heart, intestinal organs, and with a live donor, who can give a _____ or a portion of the liver, lung, or intestine.

kidney

58

A donor must be free of _____ _____. At the time of death, the donor's families will be asked to assist in completing a health history of the donor.

infectious disease

59

The process for procurement is organized through tissue and organ procurement agencies who locate _____, register recipients, and organize procurements.

donors

60

A computer program matches donor organs with recipients based on certain characteristics. These include _____ type, tissue type, height, and weight. The length of time the patient has been waiting, the severity of the patient's illness, and the distance between the donor's and the recipient's hospitals also figure into who is the best match for a specific organ.

blood

61

At the hospital, the donor is maintained on _____ support and the condition of each organ is carefully monitored by the hospital medical staff and the procurement coordinator.

life

62

The _____ operation takes place after the transport team arrives t the hospital with the new organ.

transplant