UNIT 4 & 5 - Surgery

Question 1

Types of operating theatre

Answer 1

1. Orthopedics
2. ENT
3. Emergency
4. Neurosurgery
5. Cardiothoracic
6. Ophthalmology/ Eyes

Question 2

Preoperative phase

Answer 2

Begins when the patient and surgeon decide that surgery is necessary and ends when patient ends in operating theatre or procedural bed.

Question 3

Intraoperative phase

Answer 3

Begins when the patient is transferred to the operating room bed and end when the patient is transferred to postoperative recovery room.

Question 4

Intraoperative core team

Answer 4

Circulating nurse, Contingency team (Cardiovascular perfusionist) Anesthesiologist, Surgeon, Scrub Nurse

Question 5

Postoperative phase

Answer 5

Lasts from admission to the recovery room to complete recovery from surgery and last follow-up physician visit.

Question 6

Elective surgery

Answer 6

Procedure that is preplanned.

Can be scheduled in advance based on patient’s choice

Question 7

Urgent surgery

Answer 7

Must be done within 24-48h to preserve health

Question 8

Emergency surgery

Answer 8

Done immediately

Question 9

Major surgery

Answer 9

May be elective, urgent or emergency

involves major body organs or life-threatening situations

E.g., Ruptured Spleen, Amputation, Colostomy, Hysterectomy

Question 10

Minor surgery

Answer 10

Primary elective that is brief and carries low risks whilst resulting in fewer complications.

Performed in office, outpatient, same-day

E.g., Teeth extraction, Skin biopsy, Cataract extraction

Question 11

Diagnostic surgery

Answer 11

To make or confirm a diagnosis

E.g., Bronchoscopy, Biopsy. Exploratory laparotomy

Question 12

Ablative surgery

Answer 12

To remove a diseased body part. Example Appendectomy

Question 13

Palliative surgery

Answer 13

To relieve or reduce the intensity of an illness, is not curative.

Question 14

Reconstructive surgery

Answer 14

To restore function to traumatized or malfunctioning tissue

To improve self-concept. Example: Plastic surgery, skin graft

Question 15

Transplantation surgery

Answer 15

To replace organs or structures
that are diseased or malfunctioning

Example: Kidney, heart

Question 16

Constructive surgery

Answer 16

To restore function in congenital
anomalies. Example: Cleft palate repair

Question 17

Nurse’s responsibilities on arrival of patient to OT

Answer 17

1. Correct patient
2. Signage of informed consent
3. Correct surgery
4. Established NPO status, pre-medication as ordered, allergies, appropriate clothing

Question 18

General anesthesia

Answer 18

Administration of anesthetic drugs is by inhalation or intravenous route

Question 19

Jana experienced loss of consciousness after inhaling general anesthesia. The surgical team waited until it was time for incision.

Answer 19

Induction

Question 20

Veondre had her stomach incised under general anesthesia and her surgery was completed.

Answer 20

Maintenance

Question 21

Yulia began to wake up from her general anesthesia

Answer 21

Emergence

Question 22

Phases of general anesthesia

Answer 22

Induction
Maintenance
Emergence

Question 23

Regional anesthesia

Answer 23

Agent injected near a nurse in or around the operative site

Patient remains awake and loses sensation in a specific area of the body

Question 24

Examples of regional anesthesia

Answer 24

nerve blocks
caudal anesthesia
spinal anesthesia

Question 25

Nerve blocks

Answer 25

injecting local anesthesia around a nerve trunk supplying the area of surgery such as the jaw, face and the extremities

Question 26

Caudal anesthesia

Answer 26

injection into the epidural space through the caudal in the sacrum used for procedures on lower extremities or perineum

Question 27

Spinal anesthesia

Answer 27

injecting local anesthesia into the subarachnoid space through a lumbar puncture, causing sensory and motor blockage For surgery of lower abdomen, perineum, legs but can cause hypotension, headache and urine

Question 28

Anticoagulants increase surgical risk

Answer 28

Hemorrhage

Question 29

Diuretics increase surgical risk

Answer 29

Electroyle imbalance

Question 30

Sedatives increase surgical risk

Answer 30

Hypotensive effects of agent

Question 31

Antidiabetic medications increase surgical risk

Answer 31

Abnormal blood sugar

Question 32

What criteria makes a patient fit for discharge from recovery room?

Answer 32

Patient is awake, cough well, expel/spit out the oral cavity, deep breath at normal rate and depth. Moves 2 - 4 extremities voluntarily or on command and can lift head Stable BP & pulse within 10 - 20 mmHg of pre-op values Awake, alert and oriented in time, place Skin color pink and warm