define surgery | the area of medicine that addresses diseases, conditions, and traumatic injuries that are difficult or impossible to treat only with medicine |
ablative | excision or removal of diseased body parts (e.g., amputation, removal of appendix, cholecystectomy) |
define palliative | surgery for relief or reduction of intensity of disease symptoms; will not produce cure (e.g., colostomy, debridement of necrotic tissue) |
define perioperative | period encompasses the preoperative phase |
preoperative | before surgery |
define intraoperative | phase during surgery |
postoperative | phase after surgery |
informed consent | permission to perform a specific test or procedure before any procedure has begun |
atelectasis | an abnormal condition characterized by the collapse of lung tissue |
thrombus | an accumulation of platelets, fibrin, and cellular elements of the blood attached to the interior wall of a vessel, sometimes occluding the lumen |
embolus | a traveling or mobilized clot |
infarct | localized area of necrosis |
incisions | cuts produced surgically by a sharp instrument to create an opening into an organ or body space |
Anasthesia | absence of all sensation, including pain ( "an" meaning without "esthesia" meaning awareness of feelings) |
define conscious sedation more recently referred to as moderate sedation | pt is given drugs in that depress the central nervous system or provide analgesia to relieve anxiety or provide amnesia during surgical diagnostic procedures |
define prosthesis | an artificial replacement for missing parts of the body |
surgical asepsis | using sterile technique to protect against infection before, during, or after surgery |
define drainage or exudate | fluids from body cavity, wound, or other source of discharge that slowly sees from cells, tissue, or blood vessels through small pores or breaks in cell membrane |
define extubate | patient remove endotracheal tube from airway |
define dehiscence | the separation of surgical incisions or rapture of a wound closure |
define cachexia | ill health, malnutrition, and wasting as a result of chronic disease |
define evisceration | Protrusion of an internal organ through a wound or surgical incision, especially in the abdominal wall |
define paralytic ileus | a significant decrease in or absence of intestinal peristalsis that may occur after abdominal surgery, peritoneal trauma, severe metabolic disease, and other conditions |
define elective surgery | performed on bases of the pt choice such as bunionectomy, plastic surgery |
define urgent surgery | necessary for pt survival health such as excision of cancerous tumor, removal of gallbladder for stones, vascular repair for obstructed artery |
define emergency surgery or emergent surgery | must be done immediately to save for preserve function of the body part such as removal of perforated appendix, repair of traumatic amputation, control of internal hemorrhaging |
define anastomosis | surgical joining of two ducts or blood vessels to allow flow from one another; to bypass an area (example: billroth, joins stomach and duodenum) |
surgical terminology define -ectomy | surgical removal of ( example: cholecystectomy, removal of the gallbladder) |
surgical terminology define lysis | destruction or dissolution of (exmaple: lysis of adhesions removal of adhesions) |
surgical terminology define -orraphy | surgical repair ( herniorrhaphy, repair of a hernia) |
surgical terminology define -oscopy | direct visualization with a scope (example: cystoscopy, direct visualization of the bladder and urethra by means of a cystoscope) |
surgical terminology define -ostomy | opening made to allow passage of drainage (example: ileostomy, formation of an opening of the ileum onto the surface of the abdomen for passage of feces) |
surgical terminology define -pexy | fixation of (example: cecopexy, fixation or suspension of of the cecum to correct its excessive mobility) |
surgical terminology define -plasty | plastic surgery (example: mammoplasty, reshaping of the breast to reduce, lift, reconstruct) |
define inpatient surgical setting | pt hospitalization for surgery |
define one-day(some day surgery) surgical setting | pt is admitted that day surgery is scheduled and discharged the same day |
define outpatient surgical setting | pt (not hospitalized) is admitted to either short stay unit or directly to the surgical site |
define short stay surgical center surgical setting | independently owned agency; surgery is performed when overnight hospitalization is nit required ( also called ambulatory surgical center or 1 day surgery center) |
define short stay unit surgical setting | department or floor where a pt stay does not exceed 24 hours (sometimes referred to as an outpatient/observation unit) |
define mobile surgery unit surgical setting | a unit that moves from place to place; it moves to the pt instead of the pt traveling to the unit |
what is the preoperative consideration using garlic | potential for increasing bleeding |
what is the preoperative consideration using gingko biloba | potential increase for bleeding |
what is the preoperative consideration using st johns wort | should not be used with other psychoactive drugs, monoamine oxidase inhibitors, or serotonin reuptake inhibitors; discontinue before surgery because possible drug interaction |
define surgical effects on the body systems if a pt has seizures | ensure anti-seizure medication are at therapeutic levels to prevent postoperative seizures |
define surgical effects on the body systems if a pt has respiratory disorders | lung capacity is decreased and gas exchanged slowly; anesthetic agents reduce respiratory function, increased risk is sever hypoventilation |
define surgical effects on the body systems if a pt has cardiovascular diseases | hypotension & cardiac dysthymia's disease most common complication; early recognition & management before these complications become serious enough to diminish cardiac output depend on frequent assessment of pt vitals |
define why a surgery for which coughing would be contradicted or modified for intracranial | cough increases pressure (ICP), leading to cerebrospinal fluid leakage |
define why a surgery for which coughing would be contradicted or modified for eye | coughing increases ICO, which then increases intraocular pressure, causing pressure on suture line |
define why a surgery for which coughing would be contradicted or modified for ear | if pt must cough, mouth must be kept open to prevent pressure backup through Eustachian tube to middle ear, causing pressure on suture line |
define why a surgery for which coughing would be contradicted or modified for nose | if pt must cough, mouth must be kept open to prevent dislodgment of a clot with subsequent bleeding |
define why a surgery for which coughing would be contradicted or modified for throat | vigorous coughing may dislodge a clot subsequent bleeding |
define why a surgery for which coughing would be contradicted or modified for spinal | coughing increases spinal canal pressure |
nursing implications for diazepam( valium) for the preoperative period | monitor for respiratory depression, hypotension, drowsiness, and lack of coordination puts patient at fall risk |
nursing implications for H2 receptor antagonist such as famotidine (Pepcid) or ranitidine (Zantac) for the preoperative period | monitor for confusion and dizziness which put pt at fall risk |
nursing implications for antiemetics such as metoclopramide (reglan) or droperidol (inapsine) or zofran for the preoperative period | monitor for sedation & extrapyramidal reaction ( involuntary muscle movement, muscle tone change, abnormal posture); instruct pt to report any difficulty breathing |
anticoagulants special implications for the surgical patient | warfarin and aspirin are stopped several days before surgery; they prolong clotting times, which may lead to hemorrhage |
antihypertensives special implications for the surgical patient | may cause hypotension when combined with anesthetic agents & narcotics used for pain control |
anti seizure drugs special implications for the surgical patient | longtime use of certain seizure drugs such as dilantin, phenobarbital can interact with anesthetic drugs |
corticosteroids special implications for the surgical patient | if used for a long time may prolong bleeding & hamper the body's ability to heal; also may decrease the bodies ability to deal with the stress of surgery as a result of suppression of the adrenal glands |
diuretics special implications for the surgical patient | because of fluid loss during surgery, they can cause hypotension after surgery and decreased serum potassium levels |
herbal therapies special implications for the surgical patient | several therapies can affect clotting time ginseng may increase hypoglycemia with insulin therapy; therapies boxes for potential complication that may occur when herbal therapies are combined with traditional medications |
NSAIDS special implications for the surgical patient | inhibit platelet function and may prolong bleeding, leading to possible hemorrhage |
what does a circulating nurse do | count sponges, needles, and instruments with scrub nurse before surgery |
what does a scrub nurse do | count sponges, needles, insruments with circulating nurse; observe progress of surgical procedure |