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)
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2
Q

Laminectomy Locations

A
  • Locations
    • Cervical (neck)
      • Pre-op assessment
        • Breathing (primary), movement of upper extremities
    • Thoracic (upper back)
      • Pre-op assessment
        • Cough (tests abdominal muscles) and bowel sounds
    • Lumbar (lower back)
      • Pre-op assessment
        • Urine output and legs
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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
  • 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
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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
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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
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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
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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)
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8
Q

Dialysis

A
  • Dialysis
    • Renal failure 3x/week
      • 4-6 hours per session
  • Hemodialysis
    • Disequilibrium syndrome
      • when fluid is exchanged too quickly
      • Change in LOC
      • NV
      • HA
      • Twitching
  • AV Shunt
    • can only be used for a few weeks
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