Intro To Surgery

Question 1

Age

Answer 1

Infants struggle with temperature control and fluid regulation

Question 2

Kids and anesthesia

Answer 2

Have a more traumatic awakening than adults

Question 3

Elderly

Answer 3

Less cardiac reserve

• less physical capacity to cope with surgery
• general anesthesia put elderly at risk for MI and stroke
• risk for drug toxicity

Question 4

Nutrition

Answer 4

• 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

Question 5

Obesity

Answer 5

• adipose tissue does not heal as well= high infection risk

- harder to get patient up and moving

Question 6

Smoking

Answer 6

• increased amount and thickness of mucous in the bronchioles
• decreases collagen formation in wound

Question 7

Alcohol

Answer 7

• high risk to have bleeding disorders

- possible withdraw

Question 8

Allergies

Answer 8

-bananas, kiwis, tomatoes, avocado allergies typically indicate latex allergy

Question 9

Diabetes

Answer 9

• impaired healing

- increased risk of infection

Question 10

Recent hear attack, heart failure

Answer 10

• increased surgical risk

- general anesthesia depresses cardiac function on top of already having cardiac issues

Question 11

Chronic pain

Answer 11

• may have an increased pain tolerance to certain pain medications and may need more for surgery
• watch for withdraw

Question 12

Asthma, COPD

Answer 12

• concerned about maintaining airway

- sensitive bronchioles that vasoconstrict

Question 13

Upper respiratory infection

Answer 13

• often postpones the surgery due to risk of possible pneumonia

Question 14

Fever

Answer 14

May indicate and infection or something more significant

Question 15

Anticoagulants

Answer 15

Can impact the amount of blood loss

• need to be discontinued 48 before surgery

Question 16

Cardiac drugs

Answer 16

Patient taking beta blockers tend to slow down the heart rate especially on top of use of anesthesia

Question 17

Insulin

Answer 17

• will be npo so insulin needs will change

- stress of surgery can increase blood sugar

Question 18

Herbs

Answer 18

Ginger and ginseng both prolong bleeding time

Question 19

Surgical risk factors

Answer 19

Personal factors or characteristics that increase the risk of surgical experience and increase the risk of poor outcome

Question 20

Pre-operative teaching

Answer 20

• 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

Question 21

Diaphragmatic breathing

Answer 21

• helps prevent pneumonia

- Atelectasis: lungs do not fully inflate after surgery (use incentive spirometer to prevent this)

Question 22

Splinting and controlled coughing

Answer 22

Coughing is a good thing to help expel debris

Question 23

Leg exercises

Answer 23

Helps aid I. Prevention of blood clots and muscle strength

Question 24

Bowel preparation

Answer 24

If not having surgery on GI tract DO NOT NEED laxatives or enemas

Question 25

Skin preparation

Answer 25

• cleansing agent to decrease surgical site infections

- bathing yes, shaving probably not

Question 26

NPO..check on oral meds

Answer 26

• 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

Question 27

Voiding and vital signs

Answer 27

• before they go to surgery we want them to void

- set of vitals right before they go down