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OTC med surg 1
Pre and Post op terms et pp questions
Question | Answer |
---|---|
Define Cellulitis | Inflammation of cellular or connective tissue |
Define Circulatory Overload | condition precipitated by the presence of more fluid volume than the circulatory system can manage |
Define Ecchymosis | The escape of blood into the tissues (bruising) |
Define Embolism | Obstruction of a blood vessel by a thrombus or foreign material formed or introduced elsewhere in the circulator system and transported to that point through circulation |
Define Extravasation | Inadvertent administration of a vesicant solution/drug into the SQ tissue |
Define Hematoma | Localized mass of blood in the tissue which creates a hard painful lump |
Define Infection at sight | bacterial invasion at venipuncture site resulting in an infectious disease process |
Define Infiltration | Inadvertent admin of a non-vesicant solution/drug into the SQ tissue |
Define Occluded Cannula | Cannula occlusion secondary to thrombus formation or drug precipitate |
Define Phlebitis | Inflammation of the tunica intima of a vein |
Define Septicemia | Systemic disease caused by presence of pathogenic microorganisms in the body |
Define Speed Shock | A systemic toxic reaction occurring when a foreign substance is infected too rapidly into the circulation |
Define Thrombophlebitis | Inflammation of a vein in conjunction with a thrombus |
Define Thrombus | Blood clot |
Define Vesicant | A fluid or drug that can cause phlebitis within the vein and tissue trauma if extravasated into tussue |
Define Inderation | Hard to the touch |
What does the term Surgery refer to? | opening or entering the body in some way to remove, repair, or replace organs or tissue |
What are the terms used to describe the different types of surgery? | Elective=not necessary to preserve life and time is not a factor. Urgent=required to prevent additional health problems (usually within 3 days). Emergency=essential for the preservation of life//health. |
What are 5 purposes of surgery? | Diagnostic-removal and study of tissue to determine diagnosis. Exploratory-to search for cause. Curative-removal of harmful growth or organ. Palliative-relieve symptoms/improve function. Cosmetic-improve appearance or function. |
List some common surgical risks. | Bleeding, breathing, impaired circulation, immobility, pain, skin integrity |
What are some important nutritional assessments for pre-op and why? | Ht,Wt=used to calculate anesthetic drugs et some surgical procedures. Labs=detect signs of malnutrition. Obesity=resp complications, healing complications. |
How does obesity effect the OR pt? | Increased adipose=decreased vessels which makes healing take longer. Decrease in respiratory ability, takes longer for anesthesia to leave the body. |
Why is malnutrition a risk factor for OR pt's? | Decrease in RBC (O2), Decrease in WBC's (ability to fight infection) leads to delayed wound healing and increased risk for injury. |
What 2 nutrients are of primary importance in the healing process? | Protein, Vit C |
What are some medications that can have an adverse affect on the surgery? | Anticoagulants, hypoglycemics, antineoplastics (delay wound healing (myosin)). |
Why are smoking and alcohol a big risk factor in surgical pt's? | Smoking increases the risk for cardio s/e while alcohol increases drug tolerance |
How could Diabetes Mellitus affect the surgical pt? | Changes their routine, increased risk of infection et delayed healing due to lack of macrophages, |
How would liver disease potentially affect the surgical pt? | Increased risk for bleeding et increased risk of drug toxicity. |
In what way would Respiratory disease affect a surgical pt? | Increase their chance of pneumonia as well as chance of atelectasis. |
Is a pt at an increased risk during surgery if they have a cardiovascular disease? Why? | Yes. Stress places an increased demand on the heart. They will also have an increased risk of fluid overload |
Why are pre-op teaching activities important? | They help decrease fear by decreasing the unknown, help to increase compliance et can help speed healing by informing pt on how to make good post op choices regarding activity et limitations. |
What two things help the most when it comes to deep breathing? | Incentive spirometry et TCDB |
What is the purpose of an incentive spirometer? | To inflate the lungs et remove secretions. While often necessary it is PAINFUL after surgery. |
How is TCDB beneficial? | Removes secretions |
When is coughing contraindicated? | Intracranial surgeries, eye, nose, throat, thyroid |
What are the benefits of early ambulation? | Associated with fewer complications et earlier D/C. Increases peristalsis et improves respiratory status while decreasing incidence of DVT |
What is a popular method of obtaining pain rating and how are pain meds admin? | Scale of 0-10; PCA,IM,IV,oral |
List some of the equipment that may need to be used post op. | NG tube/suction, IV, O2, Drains, Dressings, Catheter, Chest tube, CPM machine |
In summary for pre op TEACHING... | Orient to room, confirm procedure, inform on what to expect after sx, basic post op care |
Why do pre-op skin prep? | Remove as many microorganisms as possible, usually includes shaving |
What is the logic behind making pt NPO after MN? | Decreases risk of aspiration, N/V. Requires mouth care for comfort |
What are some reasons for requiring a bowel cleansing regimen? | Prevents BM during surgery, decreases distention et post-op ileus. Sometimes ATB are used to decrease organisms if bowel will be opened during surgery. |
Explain informed consent. | Physicians job to explain risks et options though nurses may clarify. Required for anything invasive et for blood transfusion. Pt MUST be competent |