(1) Surgery Flashcards
What is anaesthesia used for?
- inducing sleep
- pain relief
- muscle relaxant
What is general anaesthesia used for?
Major surgery
What is spinal anaesthesia used for?
- co-morbidities
- ortho-surgery
- hernias
- vascular surgery
What is epidural used for?
- pain relief but able to mobilise
- Labour
- post-op pain management
What is the pre-op process?
- assess respiratory status
- clear secretions
- baseline mobility
- teach transfers
- education on type of surgery
What is the post-op process?
- co-ordinate treatment around pain control
- Increase TV in lungs
- Mobilise asap
- gradual return to pre-baseline status
What should be checked before starting treatment?
- monitors
- drips, catheter, O2 mask
- surgical site
- bedside chart
- pain
- positioning
What is the cycle of deconditioning?
- Prolonged rest
- Increased risk falls
- Increased confusion
- Constipation & incontinence
- Decreased appetite
- Increased risk dysphagia
- Further immobility
- Increased risk infection
What are general risks of surgery?
- Chronic post surgical pain (CPSP)
- Surgery time
- Blood loss
- Wound infection
What are symptoms of atelectasis?
- breathing difficulty
- chest pain
- cough
- decreased BS
What is the Rx for atelectasis?
- bronchodilators
- positioning unaffected side
- ACBT or percussion
- suction & CPAP
What are symptoms of hospital acquired pneumonia?
- cough
- dyspnea
- chest pain
- decreased O2 saturation
- increased RR & HR
- bronchial BS
- inspiratory crackles
How is hospital acquired pneumonia diagnosed?
- X-ray
- sputum samples
- blood tests
What is deep venous thrombosis (DVT)?
A static mass (clot) of platelets formed inside veins
What causes DVT?
impaired venous return (immobility)
What are signs of DVT?
localised pain in lower limb
What is a pulmonary embolism (PE)?
Is a mass of matter carried in the blood stream
What causes PE?
- clot in deep veins in leg breaks off and travels lungs
- big enough occlude pulmonary artery
- no perfusion
What are the clinical signs of PE?
- sudden SOB
- increased HR
- increased RR
- chest pain
What is peripheral vascular disease?
Narrowing of the arteries other than those in the heart or brain
What are the symptoms of peripheral vascular disease?
- hair loss on the feet & legs
- numbness and weakness legs
- brittle slow growing nails
- erectile dysfunction
How is peripheral vascular disease assessed?
- Ankle/brachial index - compares blood pressure in arms to BP in legs
- Treadmill exercise test - measure bp in arms and legs pre & post
What are the treatment options for peripheral vascular disease?
- reduce weight
- smoking cessation
- manage BP
- meds
- nutrition
- surgery (excision)
What are arterial ulcers?
Painful injuries on the skin caused by poor circulation
What causes arterial ulcers?
Poor blood supply due to PVD
What is the treatment for arterial ulcers?
- adequate blood supply to heal
- ABI give indication healing ability
What are venous ulcers?
Wounds on the skin that don’t heal easily due to poor blood circulation in the veins
What is the treatment for venous ulcers?
- decrease oedema
- increase venous return
- appropriate compression
Where are the venous ulcers usually located?
b/t knee and ankle
What are the causes for amputation?
- vascular/diabetes (70%)
- trauma (30%)
- tumour
What is involved in a pre-op amputation assessment?
- strength and ROM throughout
- balance ability
- vision, hearing, cognitive
- social hx
- educate re-optimal position for residual limb
- mobility
- transfer training
