Procedures Flashcards
1
Q
Laminectomy
A
- Removal of vertebral spinous processes
- Indications
- To treat nerve root compression
- S/S (3 Ps)
- Pain
- Paresthesia (numbness/tingling)
- Paresis (muscle weakness)
- S/S (3 Ps)
- To treat nerve root compression
2
Q
Laminectomy Locations
A
- Locations
- Cervical (neck)
- Pre-op assessment
- Breathing (primary), movement of upper extremities
- Pre-op assessment
- Thoracic (upper back)
- Pre-op assessment
- Cough (tests abdominal muscles) and bowel sounds
- Pre-op assessment
- Lumbar (lower back)
- Pre-op assessment
- Urine output and legs
- Pre-op assessment
- Cervical (neck)
3
Q
Laminectomy Post-op
A
- # 1 post-op answer
- → always log roll your patient
- Activity
- Do not dangle/sit on side of the bed
- Allowed to walk, stand and lie down without restrictions
- Limit sitting 20-30 min at a time
- Complications
- Cervical
- Watch for pneumonia
- Thoracic
- Watch for pneumonia and paralytic ileus
- Lumbar
- Watch for urinary retention
- Cervical
- Laminectomy w/fusion
- bone graft from the illiac crest (hip)
- Of two sites, which has the most:
- Pain? - hip
- Bleeding/Drainage? - hip
- Risk for infection? - hip/spine
- Risk for rejection? - spine
4
Q
Laminectomy Restrictions
A
- Restrictions (6 weeks)
- Don’t sit for longer than 30 minutes
- Lie flat and log roll for 6 weeks
- Lifting restrictions - no more than 5 lbs
- No driving
- Restrictions (permanent)
- Can never lift by bending at the waist (use knees)
- Cervical can never lift objects above their heads
- No horseback riding, off-trail biking, jerky rides
5
Q
Cytoscopy
A
- Visualization of the urethra and bladder
- Pre-op
- encourage fluids
- Given valium and demerol pre-procedure
- Post-op
- encourage fluids
- expected findings (just document
- Bladder spasm
- Burning
- urinary frequency
- pink-tinged urine
- Fall in BP and tachycardia sign of hemorrhage
6
Q
EEG
A
- Wash hair before probes are attached
- Wash hair after
- At least 4-5 hours of sleep the night before
- → can be sleep deprivation eeg
- NPO not necessary
- Try not to move during the procedure
- Eliminate caffeine for 24 hours before test
7
Q
EGD
A
- Way to visualize esophagus, stomach and duodenum
- Other purposes
- Remove polyps
- Take specimens
- Coagulate bleeding vessels
- Can not be done on an uncooperative client
- Can be sedated with valium
- NPO after midnight
- can eat when gag reflex returns (xylocaine given)
- Complications
- Perforation of gut
- Aspiration secondary to emesis
- Respiratory arrest (valium)
8
Q
Dialysis
A
- Dialysis
- Renal failure 3x/week
- 4-6 hours per session
- Renal failure 3x/week
- Hemodialysis
- Disequilibrium syndrome
- when fluid is exchanged too quickly
- Change in LOC
- NV
- HA
- Twitching
- Disequilibrium syndrome
- AV Shunt
- can only be used for a few weeks