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Clinical Nursing May Exam > Minor surgical conditions > Flashcards

Minor surgical conditions Flashcards

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1
Q

define abscess

A

localised collection of purulent material lined with granulation and fibrous tissue

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2
Q

what is the process of abscess formation?

A

pyogenic organisms cause cell death and inflammation

normally points and bursts for drainage

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3
Q

what are complications associated with abscesses?

A

toxaemia
pyaemia
sinus
skin necrosis

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4
Q

what are signs of an abscess?

A 
pyrexia
anorexia
vomiting
pain
swelling
discharge
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5
Q

how are abscesses treated?

A

drainage
antibiotics
analgesia

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6
Q

how is drainage provided to abscesses?

A

establishing drainage- lance with sterile scalpel and flush with saline, if deep or internal may need surgery for resection
maintaining drainage- keep open, regularly drain and flush

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7
Q

define cellulitis

A

non-localised distribution of pus through tissues

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8
Q

what causes cellulitis?

A

acute inflammation

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9
Q

what are signs of cellulitis?

A

pain
areas sensitive to touch
pyrexia
generalised swelling

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10
Q

how is cellulitis treated?

A

systemic antibiotics
anti-inflammatories
analgesia

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11
Q

define sinus

A

infected blind ending tract from a focus of infection to body surface or MM

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12
Q

describe the structure of a sinus

A

blind ended tract lined with granulation tissue

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13
Q

state examples of sinus

A

foreign body tract

anal furunculosis

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14
Q

list signs of a sinus

A

pyrexia
pain
sensitive to touch
disease specific signs

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15
Q

define a fistula

A

abnormal tract between 2 epithelial surfaces or connecting epithelial surface to skin

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16
Q

what are causes of fistulas?

A

injury or trauma

congenital

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17
Q

what are fistulas lined with?

A

epithelium

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18
Q

list signs of fistulas

A

chronic infection
visually abnormal
physically abnormal

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19
Q

how are fistulas treated?

A

surgical repair

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20
Q

define ulcer

A

loss of epithelial surface of a tissue

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21
Q

describe the structure of ulcers

A

shallow lesions

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22
Q

what are causes of ulcers?

A 
trauma aggravated by poor blood supply or infection
calici virus
chemicals
urine 
pressure
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23
Q

what are common affected areas of ulcers?

A

skin
GI tract
cornea

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24
Q

what are signs of ulcers?

A

pain
swelling
visual appearance
secondary problems including infection

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25
Q

how are ulcers treated?

A

remove cause
keep clean and dress if possible
surgery
often slow to heal

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26
Q

what are causes of corneal ulcers?

A

trauma
bacteria
eyelash or eyelid disorders

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27
Q

what are signs of corneal ulcers?

A

increased lacrimation
ocular pain
ocular discharge
blepharospasm

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28
Q

define decubitus ulcer

A

pressure sores

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29
Q

what are signs of decubitus ulcers?

A 
pain
open wound
pyrexia from secondary infection
sensitive around area
restricted movement
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30
Q

define cysts

A

abnormal sac filled with fluid or semi solid matter lined with epithelium

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31
Q

list the types of cysts

A 
sebaceous
interdigital
ovarian
hydatid
meibomian
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32
Q

define sebaceous cyst

A

swelling in skin arising in sebaceous gland, typically filled with yellowish sebum

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33
Q

define interdigital cyst

A

lesions growing between the toes

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34
Q

define ovarian cysts

A

fluid filled sacs in ovary or on surface

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35
Q

define hydatid cyst

A

larval cyst of a tapeworm occurring as a fluid filled sac containing daughter cysts in which scolices develop

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36
Q

define meibomian cyst

A

cyst in the eyelid usually due to blocked meibomian gland, typically in the middle of the eyelid

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37
Q

what are signs of cysts?

A 
swelling
visual appearance
restricted movement
secondary problems
dependent on type
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38
Q

define haematoma

A

accumulation of blood in tissues due to bursting capillaries

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39
Q

list some causes of haematomas

A

trauma
surgery
clotting or blood vessel abnormality

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40
Q

what are signs of haematomas?

A

swelling
pain
discolouration of skin

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41
Q

state the 3 types of ruptures/hernias

A

reducible
irreducible/incarcerated
strangulated

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42
Q

what is meant by a reducible hernia?

A

contents can be repositioned to original anatomical location

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43
Q

how are reducible hernias treated?

A

gentle pressure corrects

may be surgically repaired

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44
Q

what is a irreducible/incarcerated hernia?

A

contents cant be repositioned to original anatomical location due to adhesions or other complications

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45
Q

how are irreducible or incarcerated hernias treated?

A

surgery

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46
Q

what is a strangulated hernia?

A

contents devitalised due to restriction of blood vessels leading to necrosis
is a life threatening emergency

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47
Q

define rupture

A

protrusion of organs or soft tissue through unnatural opening or tear

48
Q

what is the main cause of ruptures?

A

trauma causing weakness to predispose tears

49
Q

what are signs of diaphragmatic rupture?

A

dyspnoeic as abdominal contents fall into chest

50
Q

how are diaphragmatic hernias treated?

A

surgery using IPPV once abdominal cavity opened as air fills thoracic cavity

51
Q

what is a ventral or abdominal rupture?

A

tear anywhere on abdominal wall other than umbilical or inguinal region

52
Q

define hernia

A

abnormal protrusion of organs or soft tissue through natural opening

53
Q

what predisposes to umbilical hernias?

A

young animals

poor handling at birth may influence

54
Q

how are umbilical hernias treated?

A

usually left alone unless large or already performing midline incision

55
Q

what is the effect of umbilical hernias?

A

usually just a small amount of fat protrudes

if large can involve abdominal cavity

56
Q

what are signs of inguinal hernia in females?

A

swelling by the groin extending to vulva

57
Q

what happens in males with inguinal hernias?

A

fat or intestine herniates into scrotal sac

58
Q

what can be complications of inguinal hernias?

A

strangulation or rupture

59
Q

how is severity of inguinal hernias determined?

A

ultrasound

radiography

60
Q

when do perineal hernias mainly occur?

A

older dogs with chronic constipation excessively straining causing gradual breakdown of muscle layers around anal sphincter

61
Q

define pre-op

A

before surgery

62
Q

define peri-op

A

start of GA to patient waking up from anaesthesia

63
Q

define post-op

A

return to normal after GA or surgery, including long and short term monitoring

64
Q

what is the period of recovery?

A

from post-op period, ending when full consciousness is present and physiological values are normal

65
Q

what is involved in pre-op period?

A

preparation
pre med
induction of GA

66
Q

what is the importance of post op period?

A

high percent of deaths in this time, mainly due to lack of monitoring

67
Q

define dysphoria

A

state of generalised unhappiness, restlessness or frustration

68
Q

what is needed for immediate post op management?

A

close monitoring until staying in sternal unaided
in clean comfy and dry kennel
safe area in case aggressive, thrashing or dysphoric

69
Q

when are ETT removed in dogs?

A

when swallow or move tongue

70
Q

when do ETT get removed in cats?

A

blink reflex

71
Q

what should you do to patients who have just been extubated?

A

extend neck and head and pull tongue forward to keep patent airway

72
Q

why is it important to monitor temperature post op?

A

heat is lost during anaesthesia and surgery

cold patients recover slower

73
Q

list the parameters that need monitoring during post op period

A 
TPR
BP
pain
eating and drinking
wounds
excretion
hydration
74
Q

when should you give IVFT post op?

A

if given peri operatively
animals at risk of AKI, CKD
sick animals
low BP

75
Q

when should you give water post op?

A

as soon as can hold in sternal themselves

76
Q

when should you give food to recovering patients?

A

soft bland food when fully conscious

rabbits as soon as possible

77
Q

what is the importance of monitoring rabbit droppings post-op?

A

observe for signs of gut stasis

78
Q

when is it especially important to monitor excretions post op?

A

surgery involving urogenital tract

79
Q

how should you care for rabbits post op?

A

keep low stress- reduce risk of gut stasis, keep away from predators
monitor defecation
pro-kinetics
eye lube

80
Q

what are signs of pain post op?

A 
pain scales
facial expression
changed behaviour
inappetence
reluctance to move
81
Q

how is pain post op managed?

A

analgesia

82
Q

what are signs of haemorrhage post op?

A 
slow CRT
pale MM
low BP
tachycardia
lethargy
dull behaviour
83
Q

how is post op haemorrhage managed?

A

surgery

exploration

84
Q

state risk factors for aspiration pneumonia post op

A

dental surgery
vomiting and regurgitation
brachycephalic
long surgery

85
Q

what are signs of aspiration pneumonia?

A

fluid from nose
crackles on lung auscultation
dyspnoea

86
Q

how is aspiration pneumonia managed post op?

A

close monitoring
oxygen
antibiotics and diuretics as needed

87
Q

how is long recovery times managed post op?

A

manage temperature

antagonise drugs

88
Q

what predisposes to gut stasis post op?

A

abdominal surgery

rabbits

89
Q

what are signs of gut stasis post op?

A

lack of faeces produced

inappetence

90
Q

how is gut stasis managed post op?

A

manage complicating factors such as pain
promotility agents
IVFT
careful monitoring

91
Q

what are signs of dehiscence post op?

A

strike through of dressing

disrupted sutures

92
Q

how is dehiscence managed?

A

surgery

93
Q

how is aggression and dysphoria managed post op?

A

anticipate before waking, place muzzle and buster collar

94
Q

what are signs of crashing post op?

A

bradycardia
apnoea
non-responsive

95
Q

how is crashing post op managed?

A

CPR

advanced life support

96
Q

when are opioids used post op?

A

routine surgery

providing strong analgesia

97
Q

what are examples of opioids used post op?

A

methadone
buprenorphine
fentanyl

98
Q

what are side effects of opioids?

A 
respiratory depression
bradycardia
panting
salivation
vocalisation
urination
defecation
99
Q

how long does methadone last?

A

4 hours

100
Q

what are the routes of admin of methadone?

A

IV
IM
SC

101
Q

what is the benefit of methadone?

A

large dose range so can tailor to individuals

102
Q

what are the routes of admin of buprenorphine?

A

IM
IV
SC
sublingual in cats

103
Q

how long does buprenorphine last?

A

6-12 hours

104
Q

how is fentanyl administered?

A

IV

dural patch

105
Q

what NSAIDs are used post op?

A

metacam

carprofen

106
Q

what are side effects of NSAIDs?

A 
vomiting
diarrhoea
lethargy
renal failure
gastric ulcers
107
Q

when are antiemetics used post op?

A

nauseous patients

108
Q

what antiemetics can be used?

A

maropitant
ranitidine
metoclopramide

109
Q

when is maropitant used and how is it administered?

A

GI pain relief

SC, IV, PO

110
Q

when is ranitidine used and how is it administered?

A

pro motility so used in rabbits

SC, IV, PO, every 8 hours

111
Q

when is metoclopramide used and how is it adminisered?

A

pro motility so used in rabbits

SC, IV, IM, PO

112
Q

what are side effects of anti emetics?

A

maropitant- pain on SC injection
ranitidine- hypotension, weakness, cardiac arrhythmia
metoclopramide- rare, behavioural changes, sedation

113
Q

when are antibiotics used post op?

A

orthopaedic patients
sick patients
surgery over 2 hours
already infected wounds

114
Q

when are probiotics used post op?

A

diarrhoea in post op period

rabbits to prevent gut stasis

115
Q

what antibiotics are used post op and how are they administered?

A

amoxicillin-clavulanic acid- IV, SC

cephalosporin and metronidazole- IV

116
Q

what are side effects of antibiotics?

A 
vomiting
neuro effects
nausea
diarrhoea
skin rash

Clinical Nursing May Exam (22 decks)

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