MS SURGERY TOPIC Flashcards by JARED CROIX LEDESMA

branch of medicine concerned
with the treatment of diseases,
deformities, & injuries through
manual procedures called
operations.

surgery

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excision or removal

▪ECTOMY

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destruction or separation

lysis

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repair or suture

▪ORRAPHY

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looking into

▪OSCOPY

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creation of opening

▪OSTOMY

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repair of scar or tissue

▪PLASTY

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Encompasses a client’s total surgical experience,
including the preoperative and postoperative
phases.

▪THE PERIOPERATIVE PERIOD

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Refers to activities performed by the
professional nurses during these phases.

▪THE PERIOPERATIVE NURSING

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Begins with the decision to perform surgery and
ends with the client’s transfer to the operating
room (OR) table.

▪PREOPERATIVE

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Begins with the client’s received in the OR and
ends with his admission to the Post Anesthesia
Care Unit (PACU) or Recovery Room.

▪INTRAOPERATIVE

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Begins when the client is admitted to

PACU/Recovery Room and extends through follow-
up home or clinic evaluation.

▪POSTOPERATIVE

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THE PERIOPERATIVE TEAM

▪THE ANESTHESIOLOGIST OR NURSE
ANESTHETIST

▪THE PROFESSIONAL REGISTERED OR NURSE

▪THE CIRCULATING NURSE

▪THE SCRUB NURSE

▪THE PACU NURSE

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Makes a preoperative assessment to plan the
type of anesthetic to be administered and
evaluate the client’s physical status.

▪THE ANESTHESIOLOGIST OR NURSE
ANESTHETIST

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Makes preoperative nursing assessment and
documents the intra-operative client care
plan.

▪THE PROFESSIONAL REGISTERED OR NURSE

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Manages the OR and protects the safety and
health needs of the client by monitoring the
conditions in the OR.

▪THE CIRCULATING NURSE

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▪Responsible for scrubbing for surgery,
including setting up sterile tables and
equipment and assisting the surgeon and
surgical technicians during the surgical
procedure.

▪THE SCRUB NURSE

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▪Responsible for caring for the patient until
the patient has recovered from the effects of
anesthesia, is oriented, has stable vital signs,
and shows no evidence of hemorrhage.

▪THE PACU NURSE

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CONDITIONS Requiring Surgery

▪Obstruction or
blockage
▪Perforation
▪Erosion
▪Tumor

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CATEGORIES
of Surgical Procedure

▪According to PURPOSE
▪According to URGENCY
▪According to MAGNITUDE or
EXTENT of surgery

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▪used to determine the cause of an illness or
disorder
▪verify a suspected diagnosis.

▪DIAGNOSTIC

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Tending to overcome disease and promote
recovery
▪Removal of disease organs or tissues.

▪CURATIVE

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Restoration, construction,
reconstruction, or
improvement in the shape and
appearance of body structures
that are missing, defective, or
damaged.

▪RECONSTRUCTIVE

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Affording relief but not cure

▪PALLIATIVE

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done totally at the client’s discretion, e.g., cosmetic surgery

▪OPTIONAL SURGERY-

procedures that are scheduled at the client’s convenience, e.g., cyst removal, repair of scars, & simple hernia or vaginal repair

▪ELECTIVE SURGERY-

warranted for conditions necessitating intervention within a few weeks, e.g., cataract surgery, thyroid disorder

▪REQUIRED SURGERY

indicated for a problem requiring intervention within 4 to 48 hours, e.g., some cancers, acute gallbladder infection, appendicitis, & kidney stones.

▪URGENT OR IMPERATIVE SURGERY

describes a procedure that must be done immediately to sustain life or maintain function, e.g., trauma

▪EMERGENCY SURGERY

▪High risk ▪Extensive ▪Prolonged ▪Large amount of blood loss ▪Great risk of complication

▪Major surgery

▪Generally, not prolonged ▪Leads to a few serious complications ▪Involves less risk

▪Minor surgery

▪Age ▪Obesity ▪Immobility ▪Malnutrition ▪Emergency ▪Endocrine related condition ▪Steroid therapy

▪General Risk Factors

▪Pneumonia ▪Cardiac arrest ▪Renal failure ▪Stroke ▪Pulmonary emboli ▪Sepsis; peritonitis ▪Hypovolemic shock

Major Causes of Death

Pre-op Defense Mechanism

1. Regression 2. Denial 3. Intellectualization

PSYCHOLOGIC ASPECT

Fear of the unknown ▪Allow the patient to ask questions Include significant others

To ensure that the client understands the nature of the treatment, including the potential complications and disfigurement.

INFORMED CONSENT

Circumstances Requiring Consent

Any surgical procedure where a scalpel, scissors, suture, or hemostat of electrocoagulation may be used.

Entrance into a body cavity – e.g., paracentesis, bronchoscopy, cystoscopy, colonoscopy, & proctosigmoidoscopy.

Circumstances Requiring Consent

General anesthesia, local infiltration, regional block.

witness is desirable

a nurse, physician, or another authorized person.

▪Preoperative preparation: Four phases

1. At the physician’s office before admission to the healthcare facility. 2. Upon admission and during days before the operation. 3. The night before the surgery 4. Morning of surgery

PREPARATION ON THE EVENING BEFORE SURGERY

1. Preparing the skin 2.Preparing GIT 3. Preparing for anesthesia 4. Promoting rest and sleep

If general anesthesia ▪ Foods and fluids are restricted for

8-10 hours before the operations.

NPO/NBM If general anesthesia

after midnight (8-10 hrs).

Water be given up to ___ hours before surgery,

needed ▪ Insert gastric tubes/ intestinal tubes

ENEMA

Guidelines for Preop Fasting The American Society of Anesthesiologists (ASA)

2-4-6-8 Rule

Clear liquid, e.g., water, tea or coffee without milk fasting

2 hrs

Breastmilk fasting

4 hours

non-human milk fasting

6 hours

light meals fasting

6 hours

fatty food or meats fasting

8 hours

▪Done the evening before surgery to complete respiratory, cardiovascular, and neurologic examinations.

Preparing for anesthesia

PREPARATION ON THE DAY OF SURGERY

A. EARLY MORNING CARE B.Pre-Operative Medication C. Transporting the Patient to Surgery

▪To allay anxiety, reduce pharyngeal secretions, reduce the effect of _______, and create ________.

anesthesia, amnesia

▪Goals of Care

▪ Asepsis ▪ Homeostasis ▪ Safe administration of anesthesia

If there is any doubt about the sterility of the item, it’s considered

UNSTERILE.

Hernia repair, mastectomy, & bowel resection position during surgery

Dorsal Recumbent

Lower abdomen and pelvic surgeries position

Trendelenburg’s

Vaginal repairs, D & C, rectal surgery, & abdominal– perineal resection position

Lithotomy

Spinal surgeries and laminectomy position

Prone

Kidney, chest, & hip surgeries position

lateral

▪Total loss of consciousness and sensation ▪Produces amnesia ▪IV, inhalation,& rectal

GENERAL ANESTHESIA

▪Reduce all painful sensations in one region of the body without inducing unconsciousness.

regional

▪Cognitive and coordination may be impaired, but ventilatory & cardiovascular functions are not affected.

▪Minimal sedation

▪It depressed the level of consciousness that does not impair the patient’s ability to maintain a patent airway and to respond appropriately to physical stimulation and verbal command.

▪Moderate sedation

a drug induced state during which patient cannot be easily aroused but can responds purposefully after repeated stimulation.

▪Deep Sedation

Stage 1: Analgesia/Induction Stage

(loss of pain sensation)

Stage 1: Analgesia/Induction Stage

Noises are exaggerated; even low voices or a low or minor sound seem loud and unreal. The nurse should avoid making unnecessary noises or motions when anesthesia begins.

STAGE 1OF ANESTHESIA

Analgesia/Induction Stage

stage 2 of anethesia

Excitement/Delirium

stage 3 of anesthesia

surgical

stage 4 of anesthesia

Medullary/Stage of Danger

Airway remains intact but hypersensitive to stimulation Airway manipulation should be avoided (placement or removal of ET or LMA)

Stage 2 : Excitement/Delirium

Surgery can be safely performed. stage of anesthesia

Stage 3 : Surgical

Lethal stage.! of anesthesia

Stage 4: Medullary/Stage of Danger

is useful for short periods but less often used for longer abdominal surgery

Intravenous anesthesia

is the agent of choice, but it causes powerful respiratory depressant.

Thiopental

in which an anesthetic agent is injected around the nerve.

Regional anesthesia

Achieved by injecting a local anesthetic into the spinal canal in the space surrounding the dura mater  Block sensory, motor and autonomic functions.

Epidural Anesthesia

Are much higher in doses because it is not in direct contact with the cord or nerve roots

Epidural Anesthesia

Type of extensive conduction nerve block that is introduced into the subarachnoid space at the lumbar level between L4 and L5.

Spinal Anesthesia

Keep the patient lying flat on the bed and well-hydrated.

Spinal Anesthesia cont.

Local anesthesia is administered with

epinephrine

An “unpleasant, subjective, sensory and emotional experience associated with actual or potential tissue damage or described in terms of such tissue”

Pain

a “basic human right”

oPain relief

MS SURGERY TOPIC Flashcards

(86 cards)