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Med Surg Exam 1 tables

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mattisensept's version from 2017-06-04 23:04

Suffixes

Question Answer
Ectomy Excision or removal of
LysisDestruction of
Orrhaphy Repair of suture of
OscopyLooking into
OstomyCreation of opening into
OtomyCutting into or incision of
PlastyRepair or reconstruction of
memorize

Psychosocial assessment of Preoperative patient

Question Answer
Situational Changes Define current degree of personal control, decision making, and independence, Determent the presents of hope and anticipation of positive results, consider the impact of sx. & hospitalization & possible effects on lifestyle, Identify support systems including family and other caretakers.
Concerns with the unknownIdentify specific areas and degree of anxiety and fears r/t sx., identify expectations of sx., changes in current health status, effects on daily living, sexual activity
Concerns with body image Identify current roles or relationships and view of self, determine perceived or potential changes in role or relationships and their impact on body image.
Past Experiences Review previous sx experiences, hospitalizations & treatments, determine responses to those experiences, identify current perception to those experiences
Knowledge Deficit Identify the amount and type of preoperative info the patient wants, assess understanding of sx. procedure, prep, interventions, preoperative activities & expected outcomes, identify accuracy of the received info.
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Section 3

Question Answer
Astraglus, ginseng increase bp before and during sx
Garlic, vit E, fish oils increase bleeding
Kava, valerianExcess sedation
In general..Discontinue all herms 2-3 weeks before surgical procedure.
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Health examination and physical examination of preoperative patient

Question Answer
Cardiovascular Presence of angina, hypertension, Heart failure, renal, diabetes, any coagulation drugs, Prosthetic heart valves, implants, edema (noting location and severity), neck veins for distention, bilateral baseline BP, cap refil, pulses
Respiratory Presence of infection, chronic obstructive pulmonary, asthma, CPAP machine, smoking hx, baseline 02 sat and RR and rhythm, observe for cough, dyspnea, auscultate lungs
Neurological Orientation, baseline mental states, confusion, past hx of strokes,
Genitourinary Infection or preexisting disease, ability to void, color, amount, pregnancy status
Hepatic system Substance abuse, ETOH and IV use, inspect color and sclera for jaundice
Integumentary Skin status, current or previous skin ulcers, inspect skin for rashes, boils, inspect mucous membranes, skin moisture and temp.
Gastrointestinal Patterns of food, fluid intake, recent weight changes, pattern of bowl movements, dentures, weight, auscultate abdomen
Immune Immunodeficiencies or autoimmune disorders, corcicosteroirds, immunosuppressant drugs
Laboratory and diagnostic Review results and labs
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Section 5

Question Answer
ABG, plus oxRespiratory and metabolic function, oxygen status
Blood glucoseMetabolic status, diabetes
Blood urea nitrogen, creatinineRenal function
Chest X-ray Pulmonary dx, cardiac enlargement, heart failure
CBC: RBC, HgB, Hct, WBCAnemia, immune status, infection
ElectrocardiogramCardiac disease, dysrhythmias
Electrolytes Metabolic status, renal function, diuretic side effects
hCGpregnancy status
Liver function testsLiver status
PT, PTT, INR, platelet count Coagulation status
Pulmonary function studiesPulmonary status
Serum albuminNutritional status
Type and cross match Blood available for replacement
UrinalysisRental status, hydration, UTI
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Common preoperative diagnostic studies

Question Answer
AntibioticsPrevent post op infection
AnticholinergicsDecrease oral and respiratory secretions, prevent N/V, provide sedation
AntidiabeticsStabilize blood glucose
AntimeticsIncrease gastric emptying, prevent N/V
BenzodiazapinesReduce anxiety, induse sedation
Beta BlockersManage hypertension, decrease HCL acid production, increase Ph, Decrease gastric volume
Opiods Relieve pain during preoperative procedures
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Anesthesia

Question Answer
Moderate to deep sedationSedative, anxiolytic and or anagesic drugs used, Patient breath w/o assistant, responsive, monitor therapeutic procedures
Monitored anesthesia careProvide max flexibility to match sedation levels to patient needs and procedural requirements, used in conjunction w/regional or local anesthesia, minor therapeutic and diagnostic procedure
General anesthesia Loss of sensation with loss of consciousness, combo of hypnosis, analgesia, amnesia, inhalation agents, skeletal muscle relaxation, elimination of couching, gagging, vomiting. requires advanced airway management.
Local anesthsiaLoss of sensation w/o loss of consciousness, induced topically or via infiltration, IV of Sub Q,
Regional anesthesia Loss of sensation to a region of the body w/o loss of LOC, involves blocking a nerve or group of nerves by administering a local anesthetic, -spinal & epidural
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Post Op complicaitons

Question Answer
Neuropsychologic Delirium, Fever, hypothermia, pain, congnitve dysfunction
Gastrointestinal Delayed emptying, distention & flatulence, hiccups, N/V, Ileus
UrinaryInfection, Retention
RespiratoryAirway obstruction, aspiration, atelectasis, bronchospasm, hypoventilation, hypoxemia, pneumonia, pulmonary edema, pulmonary embolus
Cardio Dysrythmeias, hemorrhage, hypertension, hypotension, superficial thrombophlbitis, venous thromoembolism
Integumentary Dehiscense, hematoma, infection
Fluid & electrolyte imbalance Acid-Base disorders, Electrolyte imbalance, fluid deficit or overload
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