Surgical Interventions Flashcards
1
Q
Surgical Interventions
A
- Craniotomy
- Infratentorial Surgery (Cerebellum)
- Supratentorial Surgery (Cerebrum)
2
Q
A surgical procedure that involves an incision through the cranium to remove accumulated blood or tumor
A
Craniotomy
3
Q
Craniotomy: Complications
A
- Increased ICP from cerebral edema
- Hemorrhage
- Obstruction of the normal flow of CSF
3
Q
Craniotomy
Pre-op Intervention
A
- Explain procedure
- Ensure informed consent
- Make sure pre-op clearance is ok as per doctor’s order
- Prepare to shave clients head as prescribed
4
Q
Craniotomy
Post-op Interventions
A
- Monitor V/S and neuro status q 30mins - 1hr
- Monitor increased ICP
- Monitor for decreased LOC, motor weakness or paralysis, aphasia, visual changes, and personality changes
- Maintain mechanical ventilation and slight hyperventilation for the 48hrs to prevent increase ICP as per doctor’s order
- Avoid neck or hip flexion and maintain head in midline neutral position
- Provide quiet environment
- Monitor head dressing frequently for signs of drainage
- Mark areas of drainage at least once/shift
- If on Ventriculostomy:
a. Maintain suction of drain
b. Record amount and color
c. notify MD if drainage is greater than 30-50ml
- Record strict measurement of I/O hourly
- Monitor electrolyte values
- Apply ice pack or cool compresses as prescribed for periorbital edema and ecchymosis
4
Q
Positioning of pt after Craniotomy
A
- It varies
- Incorrect positioning may cause serious and possibly fatal complications
5
Q
FLAT POSITION WITHOUT HEAD ELEVATION or may order head of bed 35-40 degrees
DO NOT ELEVATE HEAD in the acute phase of care after surgery without MD order
A
Infratentorial Surgery (Cerebellum)
6
Q
HEAD OF BED ELEVATION 30 DEGREES to promote venous outflow through the jugular vein
DO NOT LOWER HEAD OF BED WITHOUT MD ORDER
A
Supratentorial Surgery (Cerebrum)
