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Adult health 2 > Exam 1: surgical > Flashcards

Exam 1: surgical Flashcards

1
Q

Priority concepts with surgery

A

gas exchange, pain

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2
Q

Surgical care improvement project

Goal

A

reduce and prevent surgical complications

core measures: infections, venous thrombotic events, serious cardiac events, maintaining normothermia

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3
Q

ectomy

A

removal of an organ or gland

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4
Q

rrhaphy

A

repair

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5
Q

ostomy

A

providing an opening (stoma)

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6
Q

otomy

A

cutting into

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7
Q

plasty

A

formation or plastic repair

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8
Q

scopy

A

looking into

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9
Q

Ablative surgery

A

surgically destroy abnormal tissue or tumor

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10
Q

Curative surgery

A

resolve health problem by removing/repairing diseased tissue

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11
Q

Curative surgery

A

resolve health problem by removing/repairing diseased tissue

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12
Q

Diagnostic surgery

A

determine the origin and cause of a disorder by taking a tissue sample with the intention of diagnosing

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13
Q

Palliative surgery

A

increases the quality of life while reducing stressors on the body; non-curative

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14
Q

Preventative surgery

A

intervention with the intention that a condition will not develop

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15
Q

transplantation surgery

A

replace a malfunctioning structure

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16
Q

Reconstructive surgery

A

to improve functional ability on abnormal or damaged body structures

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17
Q

Timing of surgery: elective

A

planned, non-essential, non-acute problem

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18
Q

Timing of surgery: urgent

A

unplanned, required timely intervention, life threatening if treatment is delayed more than 24 to 48 hours

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19
Q

Timing of surgery: emergent

A

must be performed immediately to preserve life and limb

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20
Q

Surgical approach: simple

A

limited to defined anatomic location

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21
Q

Surgical approach: radical

A

involves dissection of tissue and structures beyond immediate operative site

22
Q

Surgical approach: minimally invasive

A

fiberoptic endoscopes, smaller incisions

23
Q

Surgical approach: endoscopic

A

diagnostic as well as therapeutic can be used in conjunction with open technique; uses natural body opening or porthole incisions

24
Q

Surgical approach: open

A

traditional opening of body cavity, more extensive surgical approach, might produce more postop pain, longer recovery time

25
Q

Pre operative: dietary restrictions NPO

A

patient advised nothing by mouth for 6 to 8 hours before surgery (decreases the risk for aspiration, patients should be given written and oral directions to stress adherence, surgery can be canceled if not followed)

26
Q

What is the general skin preparation for pre op patients

A

shower using antiseptic solution–CHG wipes

27
Q

How do you use an Incentive spirometer

A

place in sitting position

put mouthpiece in mouth and make a tight seal

take a slow deep breath, raise the blue piston and keep the blue tab between the arrows

as soon as you stop inhaling the piston will fall, continue to hold your breath for 5 seconds before breathing out. This forces the air down in your lungs

repeat this process 10 times, slowly, every hour while you are awake

28
Q

When does the intraoperative phase begin

A

transfer of the patient onto the OR bed and continues until the patient is admitted to the PACU or ICU

29
Q

What is the role of sterile drapes with microbes

A

surgical scrub reduced the number of resident bacteria (broad-spectrum, surgical antimicrobial solution, vigorous rubbing to create friction, scrub for another 3 to 5 minutes)

30
Q

Anesthesia: induced state

A

partial or total loss of sensation

occurs with or without LOC

31
Q

Anesthesia: purpose

A

block nerve transmission

suppress reflexed

promote muscle relaxation

achieve a controlled LOC

32
Q

General anesthesia

A

reversible LOC induced by inhibiting neuronal impulses in several areas of the CNS

involves a single agent of a combo agents

33
Q

4 stages of general anesthesia

A

Analgesia and sedation, relaxation
a. This stage can be initiated in a preoperative anesthesiology holding area, where the patient is given medication and may begin to feel its effects but has not yet become unconscious. This stage is usually described as the “induction stage”
i. Roll them into the operating room 2. Excitement, delirium
a. This stage is marked by features such as disinhibition, delirium, uncontrolled movements, loss of eyelash reflex, hypertension, and tachycardia
i. Airway reflexes remain intact during this phase and are only hypersensitive to stimulation
ii. Airway manipulation during this stage of anesthesia should be avoided
3. Operative anesthesia, surgical anesthesia
a. This is the targeted anesthetic level for procedures requiring general anesthesia. Ceased eye movements and respiratory depression are the hallmarks of this stage. Airway manipulation is safe at this level.
4. Danger/overdose
a. This stage occurs when too much anesthesia is given relative to the area of
surgical stimulation, which results in worsening of an already severe brain or medullary depression. This stage begins with respiratory cessation and ends with potential death

34
Q

Local anesthesia

A

briefly disrupts sensory nerve impulse transmission from a specific body area or region

delivered topically and by local infiltration

35
Q

Regional anesthesia

A

type of local anesthetic that blocks multiple peripheral nerves in a specific body region

nerve block
spinal block
epidural block

36
Q

Spinal vs epidural

A

spinal is usually quicker response due to direct into CSF

epidural is not as good with a longer onset (25-30minutes)

37
Q

When anaphylaxis occurs what is one of the signs

A

stridor (airway obstruction)

38
Q

W/ moderate sedation: amnesia is ____ and ____ return of ADL

A

short; rapid

39
Q

Post anesthesia care: phase 1

A

encompasses care of the patient from emergence until physiologically stable, including return of protective reflexes and motor function

40
Q

Post anesthesia care: phase 2

A

begins with the return of baseline LOC, patent airway with upper airway reflexes, manageable pain, and stable pulmonary cardiac and renal funcitoning

41
Q

Post anesthesia care: phase 3

A

23 hours observation suites in hospital units, and recovery care centers within hospital and community

42
Q

What is the protocols for post op vital signs

A

every 15 minutes for 1 hour, every 30 minutes for 2 hours and then, every 4 hours for 24 hours

43
Q

T/F the incidence of periop MI is expected to increase as the population ages and more surgical procedures are performed on older adults

A

T

44
Q

Thermoregulation: hypothermia

A

shivering increases oxygen demange up to 400%

impairs coagulation

causes decreased cerebral perfusion

45
Q

Thermoregulation: hyperthermia

A

this can be caused by an infectious process

sepsis

malignant hyperthermia (might occur or recur as late as 24 to 72 hours after surgery)

46
Q

Pain management priority

A

expected to attain and maintain optimal level of comfort

47
Q

Urinary retention is characterized by

A

inability to void over a 6 to 8 hours period

need foley placement

usually resolves within 48 hours

48
Q

Potential complications: wound healing

A

factors include advanced age, nutritional status, vascular disease, diabetes

49
Q

Potential complications: hemorrhage

A

most likely occurs within 48 hours post operatively; might be related to sutures or small vessel leakage

50
Q

Potential complications: infection

A

factors include:

hematoma
foreign body
dead space
hypothermia

51
Q

Potential complications: dehiscence and evisceration

A

usually occurs 3 to 10 days post op

52
Q
A

Adult health 2 (8 decks)

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