Intro To Surgery Flashcards
Age
Infants struggle with temperature control and fluid regulation
Kids and anesthesia
Have a more traumatic awakening than adults
Elderly
Less cardiac reserve
- less physical capacity to cope with surgery
- general anesthesia put elderly at risk for MI and stroke
- risk for drug toxicity
Nutrition
- poor nutrition prior to surgery have greater risk for infection after and higher risk of poor outcome
- most people need atleast 1500 calories to promote good healing
Obesity
- adipose tissue does not heal as well= high infection risk
- harder to get patient up and moving
Smoking
- increased amount and thickness of mucous in the bronchioles
- decreases collagen formation in wound
Alcohol
- high risk to have bleeding disorders
- possible withdraw
Allergies
-bananas, kiwis, tomatoes, avocado allergies typically indicate latex allergy
Diabetes
- impaired healing
- increased risk of infection
Recent hear attack, heart failure
- increased surgical risk
- general anesthesia depresses cardiac function on top of already having cardiac issues
Chronic pain
- may have an increased pain tolerance to certain pain medications and may need more for surgery
- watch for withdraw
Asthma, COPD
- concerned about maintaining airway
- sensitive bronchioles that vasoconstrict
Upper respiratory infection
- often postpones the surgery due to risk of possible pneumonia
Fever
May indicate and infection or something more significant
Anticoagulants
Can impact the amount of blood loss
- need to be discontinued 48 before surgery
Cardiac drugs
Patient taking beta blockers tend to slow down the heart rate especially on top of use of anesthesia
Insulin
- will be npo so insulin needs will change
- stress of surgery can increase blood sugar
Herbs
Ginger and ginseng both prolong bleeding time
Surgical risk factors
Personal factors or characteristics that increase the risk of surgical experience and increase the risk of poor outcome
Pre-operative teaching
- teach as early as possible
- teach the norm and what to expect
- teach them about pain management and that it is available but they have to ask for it and describe it on the 0-10 scale
Diaphragmatic breathing
- helps prevent pneumonia
- Atelectasis: lungs do not fully inflate after surgery (use incentive spirometer to prevent this)
Splinting and controlled coughing
Coughing is a good thing to help expel debris
Leg exercises
Helps aid I. Prevention of blood clots and muscle strength
Bowel preparation
If not having surgery on GI tract DO NOT NEED laxatives or enemas
Skin preparation
- cleansing agent to decrease surgical site infections
- bathing yes, shaving probably not
NPO..check on oral meds
- done to prevent vomiting and aspiration
- typically become NPO midnight the night before surgery
- patient can do oral care if conscious and can follow orders
Voiding and vital signs
- before they go to surgery we want them to void
- set of vitals right before they go down
