Cardiothoracic and Abdominal Surgeries Flashcards
what are the two types of abdominal surgery approaches?
laparoscopy and open incision
what is a laparoscopic approach?
minimally invasive - small openings with a camera
diagnostically taking things out
what is an open incision approach?
laparotomy
done for exploratory reasons or taking things out (like gall bladder removal etc)
when is a gastric bypass indicated?
- BMI of 40 or more
- BMI of 35 or more with one or more related comorbid conditions
are there implications for a laparoscopy?
no
are there implications/precautions for an open incision?
yes, no BLT!!
what are other abdominal surgery precautions?
- log rolling out of bed
- no heavy lifting more than 5-10lbs
what is a thoracotomy?
incision into the chest from jugular notch to just below xiphoid process
what is the most common approach for a thoracotomy?
posterolateral
what lines might be used in a thoracotomy?
- chest tube
- oxygen * because breathing is restricted
- telemetry
- Foley catheter
- IV
- NG tube to keep area empty if surgery involved esophagus
- central venous line
what are some mobility precautions for abdominal surgeries?
- cut through linea alba which means core stability is impaired
- GI system is disrupted, so expect N/V
- did they suffer significant blood loss?
- are they even allowed to get up?
what are some mobility precautions for cardiothoracic surgeries?
- ROM is okay as long as there’s no pain, encouraged!
- PT is needed early to prevent pulmonary complications
- maintaining protectiveness of median sternotomy
what is a median sternotomy?
most common incision for cardiac surgery
what are some post-op PT interventions for these surgeries?
- coughing / deep breathing exercises
- ROM / positioning
- splinting
- monitor for nerve injury (brachial plexus / ulnar nerve palsy)
- make sure HOB is elevated for better tolerance
