Flashcards in Exam 1 Chapter 5 Deck (141)
diagnostic (eg. biopsy, exploratory laparotomy)
curative (eg. excision of a tumor or an inflamed appendix)
reparative (eg.multiple wound repair)
reconstructive or cosmetic (eg. mammoplasty or a facelift)
palliative (eg. to relieve pain or correct a problem-gastrostomy tube)
patient requires immediate attention; disorder may be life-threatening.
Eg: severe bleeding
bladder or intestinal obstruction
gunshot or stab wounds
within 24-30 hours
acute gallbladder infection
kidney or ureteral stones
patient needs to have surgery
plan within a few weeks or months
prostatic hyperplasia without bladder obstruction
patient should have surgery
failure to have surgery not catastrophic
Repair of scars
decision rests with patient
surgical intervention should be tailored to?
predicted benefit of the intervention
Elderly people frequently do not report symptoms because?
fear of serious illness.
acceptance of symptoms as part of the aging process.
Protective measures for the elderly patients
adequate padding for tender areas.
moving patient slowly
protecting bony prominences
Surgical risk for the elderly patients
decrease ability to respond to stress.
increase vulnerability to changes in circulating volume and blood O2 levels.
pulmonary edema (excessive or rapid IV solutions).
increase susceptibility to hypothermia.
surgical risk for the obese patient
shallow respirations when supine=hypoventilation and pulmonary complications.
nursing management for the obese patient before surgery.
careful assessment of the cardiopulmonary status.
thorough wound assessments.
when does the preoperative phase begins and ends?
begins when the decision to proceed with surgical intervention is made, and ends with the transfer of the patient onto the OR table.
Nursing activities during the preoperative phase
base line evaluation of..
H and P (history and physical)
identification of allergies or genetic issues.
ensuring necessary labs have been done or will be performed.
arranging appropriate consultations
providing education about recovery from anesthesia and postoperative care.
what is the primary purpose of the informed consent process for surgical services?
To ensure patients, or their representative is provided information necessary to enable him or her to evaluate the proposed surgery before agreeing to it.
who obtains the informed consent?
it is the responsibility of the performing surgeon.
How should the nurse determined patient's nutritional needs?
measurement of body mass index (BMI) and waist circumference.
BMI of less than 18.5
great than 25 BMI
BMI greater than 30
A waist circumference measurement of greater than 40 inches for men and 35 inches in women is associated with?
increased cardiac risk.
Nutrients important for wound healing.
Arginine (amino acid)
carbohydrates and fats
Vitamin C, E, A, K, B complex
Alcohol withdrawal syndrome or delirium tremens may be anticipated?
between 48 and 72 hours.
The patient with diabetes undergoing surgery is at risk for?
hypoglycemia = during anesthesia or postoperatively from inadequate carbohydrates or excessive administration of insulin.
hyperglycemia= stress of surgery because it triggers increased release of catecholamines .
surgical patients with type 1 diabetes are at risk for developing?
ketoacidosis : absence or inadequate amount of insulin.
acetone breath (fruity odor similar to overripe apples)
signs of adrenal insufficiency
patients with uncontrolled thyroid disorders (hyperthyroid) are at risk for?
patients with hypothyroid disorders are at risk for?