operative experience Flashcards
Assessment for cholecystitis
RUQ pain, may radiate to right shoulder
Pain w/deep inspiration while palpating right subcostal area
Intense pain w/nausea/vomiting after eating high fat foods
Rebound tenderness
Fever
Older adults: may have absence of pain or fever; delirium may be initial symptom or localized tenderness
Cholecystitis post op instructions
Avoid heavy lifting 4-6 weeks
Clear liquids solid food as peristalsis returns
Report sudden increase in drainage, foul odor, pain, fever, jaundice
Showers instead of baths until drain removed
Diet
Low-fat diet
Decrease dairy, avoid fried foods, chocolate, nuts, gravies
Avoid gas forming foods
Weight reduction
Fat-soluble vitamins/bile salts
Appendicitis
Clients present with:
Periumbilical pain, anorexia, N/V
Inflammation increases pain shifts to RLQ
Pain increases at McBurney’s Point
teaching for appendicits
Keep NPO (pre-op)
Prep for OR
IV fluids PRN
HOB elevated 30 to 45 degrees
Advance diet as tolerated (post-op)
Resume normal activities in 2–4 weeks
Bariatric surgery
Incentive spirometry, coughing, and deep-breathing
Sequential compression devices
Ambulation
Activity
Diet
64 ounces of fluid or more each day
60-100 grams of protein per day
Start with a liquid diet; advance to solid foods
Avoid foods with high amounts of sugar and starch
Post-op complications
Pulmonary embolism
Infection
Anastomosis leak
Dumping syndrome
orders
consent
assessment
procedure
general aneshesia
causes loss of sensation, consciousness, memory
major surgery
complete muscle relaxation
Volatile (inhaled – nitrous oxide);
IV (opioids, propofol, ketamine);
muscle relaxers (succinylcholine)
regional anestesia
causes reduction in sensation in select body parts due to blockage of the spinal cord
Local anasthesia
topical anaestetic to skin or mucous membrane
phases of general anesthesia
Induction
Maintenance
Emergence
