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40 Cards in this Set
- Front
- Back
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serosanguineous drainage
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mixture of serum and red blood cells; light pink or pinkish color
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serous drainage
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clear drainage composed of serous portion of blood; clear
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sanguineous drainage
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contains or mixed with blood, immediately in post-op, decrease within a few days; dark red in color
24-48 hr post op |
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purulent drainage
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made up of white blood cells, liquefied dead tissue debris, and dead and alive bacteria; sometimes has odor, creamy, yellow, or green in color.
SIGN OF INFECTION |
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dehiscence
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disruption of the surgical site, edge are not approximated, separation of layers; guts DO NOT come out.
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desiccation
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dehydration, drying up, free of moisture
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evisceration
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protrusion of the guts through the incision
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fistula
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tunnel from organ to skin, from organ to organ, or cavity to cavity; anus to vagina
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ischmia
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deficiency of blood in a certain area
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maceration
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over hydration, softening through liquid
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necrosis
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death of tissue and/or cells
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Primary intention
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desired effects, no drainage or swelling and edges are well appoximated
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Secondary intention
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undesirable effects, no longer healing, scarring, edges are not appoximated
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Phases of wound healing
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hemostasis - first 24 hr (redness, swelling, and clotting)
inflammation - 4-6 days post- op Proliferation - couple weeks out of post-op (nutrient is important) Maturation - past 3 weeks and on |
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Post-op Vital SIgns
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Q 15 min
Q 30 min Q 4 hr |
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Document of dressing (three things)
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Clean, dry, intact
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Document of wound during care (COCA)
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Color
Odor Consistency Amount |
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Signs of hemorrhaging (two main)
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increased heart rate
decreased blood pressure |
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Malignant Hypothermal
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rare life-threating condition that is inherited
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Stages of surgery
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Induction - 100% O2, *muscle relaxant removes the ability to breath)
Maintenance - monitor VS and O2 sat (surgery is performed) Recovery - wean off gas, 100% O2, extricate ( remove trach tube) |
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Intra-op
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starts when you cross into OR and ends when you leave OR
surgery is done |
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Peri-op
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Data collection
preparing patient physically and emotional prepare family |
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Post- Op
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Starts the day after surgery (Ex. comes back at 2350 then it will start at midnight)
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Moderate Sedation
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trained RN can admin
Depress LOC NEVER leave alone!! wears off fast (short term) |
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Spinal Anesthesia
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CSF leak
spinal headache (increase fluids) subarachnoid space too high stops breathing used for lower surgery begins in toes and moves up |
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Epidural
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too high respiratory arrest
NO spinal headache NOT an RN skill |
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Local Aesthetia
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does not hit nerve
infiltrates tissue easy/simple begins superficial |
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Regional Anesthesia
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local injection into nerve
works on entire region patient is alert and aware |
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Balanced Anesthesia
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the use of other drugs to allow smaller doses of anesthesia.
Benzo (versaid-intraoperative amnesia- forget parts of surgery) |
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Stage One: Beginning
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warmth, dizziness, feelings of detached, still consciousness
*Reduce unnecessary noise* |
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Stage 2: Excitement
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Stuggles, shouting, irregular respirations, pupils dilate (still respond to light), rapid pulse
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Stage 3: Surgical Stage
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patient lies quiet, pupils small, pulse rate and volume are normal, respirations normal, skin pink or lightly flush
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Surgical Aseptic
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sterile procedures
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Surgical Time out
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happens between each procedure, and helps gather thoughts and make sure everyone know what is going on.
Joint Commission enforces |
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Opioids
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Morphine
Pain and Balanced Anesthesia Alerts: Respiratory depression |
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Benzodiazepines
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midazolam(versed- intraoperative amnesia)
Anti-anxiety (helps with sleep) Alerts: Respiratory depression and low level of conscious |
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Antiemetic
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prochlorperazine (Compazine) & metoclopramide (Reglan)
prevent and relieve nausea & vomiting *prevent aspiration* Alerts: CNS effects, dizziness, GI effects |
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H2 receptor antagonists
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cimetidine ( Tagamet)
prevents stomach acid production, decreases gastric secretion, and changes pH No Alerts |
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Anticholinergics
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atropine, glycopyrrolae (robinul)
dries up secretions Alert: decrease respirations, decrease chance of aspiration, pupils dilate |
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Vistral (hydroxirine)
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antiemetic
antihistamine drying effects anxielitic |
