general surgical conditions Flashcards
what are the aims of preoperative and post op rest physiotherapy?
-prevent & minimise the adverse physiological change associated with major surgical procedures
-prevent post op pulmonary complications
-exercise capacity
functional recovery
what surgical conditions will need resp physio ?
-abdominal surgery (as patient will struggle deep breathing)
-ENT surgery
-thoracic surgery
-cardiac surgery
what is lung volume reduction surgery?
-a surgery in which some of the diseased lung tissue is removed - done in cases where medications and rehab is not working on a patient suffering from emphysema, COPD etc
what is video assisted thoracic surgery (VATs)?
a procedure which involves a tiny camera going through a small incision made in chest
what is important to note about the op notes for physio?
-what was done
-why was it done
-how long was the surgery
-any intra op events
-estimated blood loss - fatigue etc
-post op instructions - NB
why is pain management important to manage post op?
-minimise secondary unwanted physiological effects eg tachycardia
-minimise secondary resp dysfunction
-minimise sec psychological distress
-allow pt to start rehab
what are the key physio pain management points for assessment?
-always assess the adequacy of pain relief before treatment
-always check vital signs RR, BP, HR sats
-check motor and sensory function of lower limbs before mobilising if someone had epidural
-always liaise with medical and nursing staff before treating a pt
what is atelectasis?
the collapse of all or part of the lung
what are the affects of general anaesthetic on patients lungs?
-reduced muscle tone and reduced lung volume
-reduced much-cilary clearance (cilia on airway)
reduced compliance & increased resistance
-atelectasis (collapse)
what effect can immobility have on the lungs?
-reduced lung volumes
-reduced much-cilary function
-impaired resp muscle function
define a post op pulmonary complication
pulmonary abnormality that produces inevitable disease or dysfunction
what are common resp post op problems?
-atelectasis (not complication)
-ineffective cough - due to incision and pain
-retained secretions due
-hypoxaemia - low O2 in blood
-decreased exercise tolerance
what are examples of post op pulmonary complication PPC?
-resp infection
-pneumonia
-pneumothroax
-bronchospasm
-pleural effusion
-resp failure
what can PPC’s lead to?
-increased mortality
-increased length of stay
list patient risk factors for PPC?
-age
-presence of resp problem before op eg COPD
-obesity
-smoking
-reduced level of peioperative activity
-preoperative anaemia
