Ati Med Surg Surgery Test 1

Surgery? - The use of instruments during an operation. It treats injuries, diseases, and deformities. Surgical procedures are named according to? - The involved body organ, part, or location and the suffix that describes what is being done during the procedure. What reduces the invasiveness of surgical procedures? - Laser, Scope, and Robotic technologies Minimally invasive surgery includes? - Laparoscopic surgery (abdominal and pelvic cavity) and thoracoscopic surgery (chest and abdominal and pelvic cavity) -ectomy? - Removal by cutting -orrhaphy? - Suture of or repair -oscopy? - Looking into -ostomy? - Formation of a permanent artificial opening -otomy? - Incision or cutting into -plasty? - Formation or repair What are the types of urgency levels for surgery? - Emergency, Urgent, Elective, Optional Emergency surgery? - Immediate surgery needed to save life or limb without delay (Ruptured aortic aneurysm or appendix, Traumatic limb amputation, Loss of extremity pulse from emboli) Urgent surgery? - Surgery needed within 24-30 hours (Fracture repair, Infected gallbladder) Elective surgery? - Planned/scheduled, with no time requirements (Joint replacement, Hernia repair, Skin lesion removal) Optional surgery? - Surgery requested by the patient (Cosmetic surgery) Purposes of surgery? - Aesthetic, Diagnostic, Exploratory, Preventive, Curative, Reconstructive, Palliative Aesthetic surgery? - Requested by patient for improvement (Breast augmentation, Blepharoplasty) Diagnostic surgery? - To obtain tissue samples, make an incision, or use a scope to make a diagnosis (Biopsy) Exploratory surgery? - Confirmation or measurement of extent of condition (Exploratory laparotomy) Preventive surgery? - Removal of tissue before it becomes a problem (Mole or polyp removal to prevent cancer) Curative surgery? - Removal of diseased or abnormal tissue (Inflamed appendix, Tumor, Benign cyst, Hernia) Reconstructive surgery? - Correction of defects of body parts (Scar repair, Total knee replacement, Face lift, Mammoplasty) Palliative surgery? - Alleviation of symptoms when disease cannot be cured (Colostomy for incurable bowel obstruction, Debulking: removal of as much of a tumor as possible to relieve pain or pressure) What are the three phases in the surgical process? - Preoperative, Intraoperative, Postoperative Perioperative? - Refers to all three phases of the surgical process. It includes the time before, during, and after surgery What is the primary role as an LPN in the preoperative phase of the surgical process? - Assist in data collection and contribute to the patient's plan of care, Reinforce teaching and instructions given to the patient and family by the surgeon and RN, Provide emotional and psychological support for patients and families. Preoperative surgical phase? - Begins with the decision for surgery and ends with transfer to the operating room Intraoperative surgical phase? - Begins with transfer to operating room and ends with admission to perianesthesia care unit (PACU) Postoperative surgical phase? - Begins with admission to PACU and continues until recovery is complete The focus of preoperative care is to? - Help the patient achieve the best possible surgical outcome. This is done by ensuring the patient is as healthy as possible for surgery. Factors that influence surgical outcomes? - Age, Chronic Disease, Emotional Responses, Nutrition, Smoking and Alcohol and/or Drug Abuse A HCP may be required to provide medical clearance for surgery on a patient with? - Chronic Disease Anesthesia? - Reversible loss of sensation Local anesthesia? - Aware or conscious but not feeling pain during surgery What nutrition is required when screening and nourishing the preoperative patient? - Higher levels of protein (for tissue repair and healing), Vitamin C (for collagen formation), and Zinc (for tissue growth, skin integrity, and cell-mediated immunity) Eating before surgery? - Clear liquids: 2 hours, Light meal (toast/clear liquid): 6 hours, A meal containing meat or fat: 8 hours Food and fluids are restricted before surgery to? - Reduce the risk of pulmonary aspiration during surgery Instructions for postoperative care are given? - Before surgery Postoperative exercises include? - Deep breathing and coughing, Use of incentive spirometry, Leg exercises, Turning, How to get out of bed Deep breathing expands and ventilates the lungs to prevent? - Atelectasis Atelectasis? - The collapse of the alveoli in one or more areas of the lung from hypoventilation or mucous obstruction To deep breath, teach the patient to? - Sit up, Exhale fully, Take in a deep breath through the nose, Hold the breath and count to 3, Exhale completely through the mouth. This should be repeated hourly while awake, in sets of five, for 24 to 48 hours postoperatively. Incentive spirometry can be ordered to prevent atelectasis. It increases? - Lung volume, Alveoli expansion, Venous return When using an incentive spirometer, instruct the patient to? - Sit upright, at 45 degrees minimum, if possible. Take two normal breaths. Place mouthpiece of spirometer in mouth. Inhale until target is reached and hold breath for 3 to 5 seconds. Exhale completely. Perform 10 sets of breaths as ordered. Before surgery, patients with diabetes are instructed to? - Either hold their insulin or take half of their normal dose on the day of surgery Before performing surgery, the surgeon must obtain? - Written informed consent Prophylactic antibiotics may be timed to be given? (Surgery) - 1 hour before incision time. This timing has been shown to reduce surgical site infections. The OR is designed to enhance? - Aseptic technique (elimination of microorganisms) The OR temperature is recommended to be? - 68 to 77 degrees F (this reduces patient hypothermia) General anesthesia is given by? - IV or inhalation Induction? (Anesthesia) - The period from when the anesthetic is first given until full anesthesia is reached Adjunct agent? (Anesthesia) - A medication used with the primary anesthetic agents. These medications include, Opioids to control pain. Muscle relaxers to avoid movement of muscles during surgery. Antimetics to control nausea or vomiting. Sedatives to supplement anesthesia. What must the patient be before being discharge from the PACU? - Normothermic Emergence delirium? - Becoming agitated or acting wild for a short time after waking up from anesthesia First intention healing? (Primary intention) - The edges of the wound are approximated with staples or sutures Second intention healing? - The wound is usually left open. It heals by granulation Third intention healing? (Tertiary intention) - An infected wound is left open until there is no evidence of infection. Then the wound is surgically closed. Phase 1 wound healing? (Surgery) - Inflammatory response Phase 2 wound healing? (Surgery) - Granulation tissue forms Phase 3 wound healing? (Surgery) - Collagen deposited Phase 4 wound healing? (Surgery) - Wound contracts and heals Wound dehiscence? - The sudden bursting open of a wound's edge Evisceration? - The viscera spilling out of the abdomen Ambulatory surgery? - Outpatient or same day surgery that does not require an overnight hospital stay (short stay) Nurse's role in Surgery? (They are called perioperative nurses) - 1.Admit surgical patients 2.Perform initial assessments 3.Prepare patients for surgery 4.Assist patients in the procedures 5.Provide postoperative nursing care Laser surgery? - Uses laser instead of scalpel to cut tissues. Used for eye surgery Endoscopic surgery? - Uses endoscope. Used in laparoscopic (abdomen and pelvic cavities) and thoracoscopic (chest and thoracic cavities) surgeries Robotic surgery? - Uses robots. Example: da Vinci robot with 3 or 4 arms, one is camera and arms that act as surgeon's hands to cut, suction and suture, the 4th arm moves obstructions out of the way Types of surgery according to risk factors? - Major surgery, Minor surgery Major surgery? - Extensive physical assault and/or with serious risk. Examples: heart transplant, nephrectomy, craniectomy Minor surgery? - Minimal physical assault with minimal risk. Examples: removal of skin lesion, dilatation and curettage (D and C) Example of exploratory surgery? - Exploratory laparotomy (explor lap) is when abdomen is opened to find cause of unexplained pain Example of diagnostic surgery? - Biopsy of skin lesion or lump in breast tissue Example of preventive surgery? - Polypectomy, lumpectomy to prevent cancer Example of palliative surgery? - Gastrostomy provides tube feedings for swallowing problem Example of Cosmetic/Aesthetic Surgery? - Change shape of facial features (nose: rhinoplasty; blepharoplasty), remove wrinkles What are two types of curative surgery? - Albation and transplant Albation? - Remove tissue/body parts. Examples: cleft lip, arthritic joints and hernias to be corrected Transplant? - Replace malfunctioning organ or tissue to restore function. Examples: heart, liver, lung Example of constructive surgery? - Cleft palate repair Example of reconstructive surgery? - Skin graft after burns Role of LPN in the preoperative phase of surgery? - ting in data collection and contribute to the patient's plan of care orcing teaching and instructions given to patient and family by RN and surgeon: NPO, preop consent, preop teaching, preop checklist, preop meds ding emotional and psychological support to patient and their families Protein? (Nutrition before surgery) - Tissue repair and healing Vitamin B₁₂, folic acid? (Nutrition before surgery) - Maturation of RBC Zinc? (Nutrition before surgery) - Tissue growth, skin integrity and immunity Iron? (Nutrition before surgery) - Given 2-3 weeks prior to surgery to correct anemia Vitamin C? (Nutrition before surgery) - Collagen, antibody and capillary formation Prosthesis? - Hearing aids, contact lenses, eyeglasses, dentures, artificial limbs, or other devices used to maintain appearance or function Laboratory tests prescribed prior to surgery to detect imbalances and kidney functions? - Serum electrolytes, blood urea nitrogen (BUN) and creatinine are corrected preoperatively. Complete Blood Count? (CBC) - "Detects anemia, Detects infection/inflammation, Detects clotting and bleeding problems