Term
|
Definition
-Inflammation of the vermiform appendix (pouch at the end of the intestines)
-common cause of acute abdominal pain
-Affects 10% of population, most commonly adolescents |
|
|
Term
|
Definition
-Caused by obstruction in the appendiceal lumen (can be caused by hard feces, foreign body, tumor, or inflammation)
-b/c of reduced blood supply tissue necrosis occurs and can lead to perforation of appendix and contents spill into peritoneal space |
|
|
Term
| Classifications for Appendicitis |
|
Definition
-simple
-gangrenous
-perforated |
|
|
Term
| Risk Factors for Appendicitis |
|
Definition
-adolescent males
-diet low in fiber and high in carbs |
|
|
Term
| Clinical Manifestations of Appendicitis |
|
Definition
-RLQ pain(may be mild, continuous, or generalized)
-rebound tenderness at McBurney's point
-low grade fever
-anorexia
-nausea and vomiting
-less acute in older adults often leads to delayed diagnosis |
|
|
Term
| Complications of Appendicitis |
|
Definition
-perforation(can occur w/i 24hrs.)
-peritonitis
-abscess |
|
|
Term
| Diagnostic Tests for Appendicitis |
|
Definition
-Abdominal Ultrasound(most effective and fast)
-Abdominal x-rays
-Intravenous Pyelogram(IVP):dye usually w/urinary issues but is used to visualize other areas.
-urinalysis
-pelvic exam
-WBC w/diff (looks at the amt of infection) |
|
|
Term
| Pharmacologic Therapies for Appendicitis |
|
Definition
-IV fluids to maintain volume prior to surgery
-third-generation cephalosporin antibiotics such as rocephan |
|
|
Term
| Perioperative Nursing Care |
|
Definition
| nursing care provided during any or all of the three phases of surgery |
|
|
Term
| Classifications of Surgery |
|
Definition
-Emergency: performed immediately and necessary to preserve life. Ex.hemorrhage, femoral fracture, skull fracture, appendectomy
-Elective: preferred treatment for the condition but isn't immediately life threatening. Ex. hip replacement, tonsillectomy |
|
|
Term
| Preoperative Nursing Care |
|
Definition
-each pt responds differently to surgery
-requires thorough history and physical assessment to establish a baseline |
|
|
Term
| Preoperative Client and Family Teaching |
|
Definition
-has a positive effect on physical and psychological well-being before and after surgery
-less pain and anxiety with appropriate teaching
-begin teaching as soon as pt learns of the upcoming surgery
-asses the clients need for information and readiness to learn |
|
|
Term
| Preoperative Client and Family Teaching points |
|
Definition
-diagnostic tests
-arrival time
-Preparation for surgery (NPO, skin prep, catheter, bladder elimination, pre-op meds, handling of valuables, meds on the morning of surgery, informed consent, timetable, post-op routine, pain control) |
|
|
Term
|
Definition
| It is the surgeon/physician responsibility to explain the procedure. It is the nurse's duty to answer any additional questions and witness the signing of the consent, assuring that coercion did not occur and that the patient was in an appropriate condition to sign legally. |
|
|
Term
| Preoperative Client Preparation |
|
Definition
-assist w/bathing, grooming, changing into operating gown
-ensure client remains NPO
-remove nail polish, lipstick, and makeup
-ensure pt ID, blood, and allergy bands are correct, legible, secure
-remove hairpins and jewelry
-complete skin and bowel prep
-insert catheter, IV line, or NG tube as ordered
-remove dentures, artificial eye, contact lenses
-verify consent before admin of meds
-record height/weight in chart
-admin preop meds
-ensure client safety once meds are administer
-verify that all ordered diagnostic tests are in the chart
-have client empty bladder
-vitals
-document all preoperative care
-verify pt identity w/surgical personnel
-prepare client's room for postop care and have supplies ready for pt return |
|
|
Term
|
Definition
| The time during which the patient is transported to the operating room, receives anesthesia, undergoes surgical intervention, and is transferred to the recovery room. |
|
|
Term
| Nursing Responsibilities During Intraoperative period |
|
Definition
-patient safety
-maintain asepsis
-initiate activities that facilitate completion of the surgical procedure w/minimal anesthesia time and patient trauma |
|
|
Term
|
Definition
| physician whose primary responsibility is to perform the operative procedure |
|
|
Term
| Surgical Team: Assistant to the Surgeon |
|
Definition
| responsible for preparation of the operative site, exposure of the operative field with the use of retractors, and sponging and suctioning blood or fluid. May be a nurse, surgeon, or surgical tech. |
|
|
Term
| Surgical Team: Anesthesiologist |
|
Definition
| a physician who specializes in the administration of anesthesia; an anesthetist is a nurse, dentist, or anesthesia assistant who is specially trained in the administration of anesthesia. Responsible for airway insertion, maintaining a patent airway, adequate exchange of respiratory gases, monitors fluid and blood loss, provide IV replacement, monitor respiratory and cardiac function |
|
|
Term
| Surgical Team: Scrub Assistant |
|
Definition
| responsible for maintaining a sterile environment and preparing sterile instruments, hands instruments to surgeon, advising circulating nurse when additional supplies are needed, ensures all team members adhere to principles of surgical asepsis. |
|
|
Term
| Surgical Team: Circulating nurse |
|
Definition
| RN who manages and coordinates the activities in the operating room, brings needed supplies and meds, and removes used or contaminated items, supervises/confirms/records the final sponge and instrument count, accompanies the anesthesiologist and pt to the PACU |
|
|
Term
|
Definition
Determined by:
-the site of the operation
-type of anesthesia
-maintenance of respiratory and cardiac function
-age and size of pt
-preexisting physical limitations or disease conditions |
|
|
Term
| Skin Preparation and Draping |
|
Definition
-Purpose is to reduce the # of microorganisms
-clean in a circular motion from the inside out
-Be sure that pt isn't alert to betadine! |
|
|
Term
| Postoperative Nursing Care |
|
Definition
| Immediate postoperative care begins when the client has been transferred from the OR to the PACU |
|
|
Term
|
Definition
Immediately assess:-
-Vitals
-surgical site
-mental status and LOC
-hydration status
-pain (use caution with pain meds while anesthesia is still on board) |
|
|
Term
| Postoperative Nursing Care |
|
Definition
-general appearance
-vital signs
-LOC
-emotional status
-quantity of respirations
-skin color and temperature
-discomfort/pain
-nausea/vomiting
-Type IV fluids and flow rate
-Dressing site(always check under pt)
-urinary output (min of 30 ml/hr and needs to void w/i 8 hrs of surgery)
-Client safety (side rails, call bell, bed low) |
|
|
Term
|
Definition
-Activity Level
-Diet (may be NPO or clear liquid)
-Medications
-Frequency of VS assessment
-IV Fluids
-Lab Tests |
|
|
Term
| Common Postop Complications |
|
Definition
Cardiac: Shock, hemorrhage, DVT, PE
Respiratory: Pneumonia, atelectasis
Elimination: urinary retention, altered bowel elimination, absence of peristalsis |
|
|
Term
| Surgical Wound Complications |
|
Definition
Dehiscence: separation of the layers of surgical wound
Evisceration: protrusion of body organs through a wound; can be caused by coughing, sneezing, or vomiting;EMERGENCY! |
|
|
Term
|
Definition
| state of narcosis, analgesia, relaxation, and loss of reflexes produced by pharmacologic agents. |
|
|
Term
|
Definition
| anesthesia is injected around nerves so that the region supplied by these nerves is anesthetized. |
|
|
Term
|
Definition
| inflammation of a vein in conjunction with formation of a thrombosis. |
|
|
Term
|
Definition
| alveolar collapse; incomplete expansion of the lung |
|
|
Term
|
Definition
| absence of bowel sounds for a period of time |
|
|
Term
| Patient-controlled Analgesia (PCA) |
|
Definition
| allows the pt to self-administer pain meds with pre-set intervals and maximums |
|
|
Term
|
Definition
| device used to stimulate circulation and prevent DVT |
|
|
Term
|
Definition
| wound edges are surgically approximated and integumentary continuity is restored without granulation. |
|
|
Term
|
Definition
| wound edges are not surgically approximated and integumentary continuity is restored by the process know as granulation. |
|
|
Term
|
Definition
| surgical approximation of wound edges is delayed and integumentary continuity is restored by apposing areas of granulation |
|
|
Term
|
Definition
| fleshy projections formed on the surface of a wound not healing by first intention. |
|
|
