Bb Surgical Patient Fall 14.ppt

Bb Surgical Patient Fall 14.ppt - Surgery Surgical Settings...

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Surgery
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Surgical Settings Traditional-In Patient Trends today- Ambulatory (same day or outpatient) Short-stay (23 hour stay)
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Scientific Knowledge Base: Classification of Surgery Seriousness Major- big manipulation of body parts Minor- not so big manipulations Urgency Elective- no urgency, cosmetic surgery, carpal tunnel release, nothing life threatening. Urgent- if not taken care of, bad things will happen– tumor Emergency- if you do not have surgery, you will die– car wreck, abdominal aneurism, hemorrhaging, intracranial hemorrhage Purpose Diagnostic- exploratory Ablative- removal of necrotic tissue Palliative- to provide comfort reconstructive/restorative procurement for transplant Constructive- Cosmetic-
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Surgical Risk Factors Smoking- vasoconstriction, blood clotting, respiratory problems, slower healing rate Age- Young- poor immune system Old- tissues are not as pliable, necrotic diseases Nutrition- promotes healing Obesity- stress on the heart, delays healing– adipose tissue lacks vascular strength Obstructive sleep apnea- Immunocompetence- inability for the body to heal itself quicky Fluid and electrolyte balance- renal problems Pregnancy- no elective surgeries are done
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Knowledge Aids in Planning Care How procedures named? combining a body part or organ to a suffix. Append-ectomy- remove End-oscopy- look inside Fasi-otomy- to open something
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PERIOPERATIVE NURSING Preoperative- when the patient realizes they will have surgery Intraoperative- when patient rolls into OR Postoperative- into recovery room, coming out of anesthesia– monitor airway, temperature, circulation, level of consciousness. Take vitals every 15 min. Perioperative- operative process as a while
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Preoperative Assessment Nursing History Medical history Previous surgeries Medication history Allergies Smoking habits Alcohol and substance abuse Family support Occupation Feelings Cultural and spiritual factors Coping resources Body image Patient expectations
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PREOPERATIVE PHASE Comprehensive Assessment Lab tests/Diagnostic procedures completed/evaluated to establish the baseline Conditions stabilized Emotional/Physical/Legal preparation Preop TEACHING- week before
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LEGAL/ETHICAL RESPONSIBILITIES ID- check patient ID– right patient, right sight Advance directives- noted before surgery -DNR -Living wills -Durable power of attorney Informed consent
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Informed Consent When needed?- blood, invasive procedures, anesthesia
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