Test 6 Supplemental 2

Front 1

Define ambulatory surgery

Back 1

Surgery that does not require an overnight hospital stay.

Front 2

Define aneshtesia

Back 2

A state of narcosis, analgesia, relaxation and reflex loss.

Front 3

Define conscious sedation

Back 3

The use of sedation to depress the level of consciousness without altering the patient's ability to maintain a patent airway ane respond to physical and verbal stimuli.

Front 4

Define evisceration

Back 4

The protrusion of the organs through a surgical incision.

Front 5

Define first-intention healing

Back 5

A method of healing in which wound edges are surgically approximated in integumentary integrity is restored without granulating.

Front 6

Define informed consent

Back 6

This is a process in which patients make autonomous decisions based on the nature of their condition, their treatment options, and the risks involved.

Front 7

Define intraoperative phase

Back 7

The period of time from when the patient is transferred to the operating room table to when the patient is admitted to the postanethesia care unit.

Front 8

Define perioperative period

Back 8

The period of tiem that constitutes the surgical experience; this period includes the preoperative, intraoperative and postoperative phases.

Front 9

Define postoperative phase

Back 9

Period of time from the admission of the patient to the postanesthesia care unit to the follow-up examination in the clinical setting or home.

Front 10

Define preadmission testing

Back 10

The diagnostic testing done prior to a surgical procedure.

Front 11

Define preoperative phase

Back 11

The period of time from when the decision is made to carry out a surgical procedure to when the patient is transferred to the operating room table.

Front 12

Define second-intention healing

Back 12

The method of healing in whic wound edges are not surgically approximated and integumentary integrity is restored by granulation.

Front 13

Define third-intention healing

Back 13

The method of healing in which surgical approximation of the wound edges is delayed and integumentary continuity is restored by bringing opposite granulating tissue together.

Front 14

Define chemotactic gradient

Back 14

Immediately following an injury, the body releases substances that form a wall

Front 15

How long after tissue injury will blood vessels dilate to increase blood flow?

Back 15

Thirty minutes

Front 16

Define exudate

Back 16

Protein-rich fluids and fibrinogen

Front 17

How long after tissue injury will edema occur?

Back 17

Within four hours after injury

Front 18

What does phagocytosis do to prevent bacteria from spreading?

Back 18

Walls off foreign material

Front 19

What accumulates with large numbers of phagocytes?

Back 19

Pus

Front 20

What does compliment enhance?

Back 20

Chemotaxis and increases blood vessel permeability and cell lysis.

Front 21

What does tissue trauma include?

Back 21

Such problems as burns, accidents, ulcers, inflammatory diseases, and accidnetal posioning, as well as surgical intervenion.

Front 22

What are the five main categories of tissue trauma cause?

Back 22

Physical or mechanical trauma, thermal trauma, chemical exposure or ingestion, inflammatory disease and surgical intervention.

Front 23

What does soft tissue refer to?

Back 23

Layers of skin, fat and connective tissue that excludes bones and muscles.

Front 24

How do pressure ulcers form?

Back 24

If too much pressure is exerted on a bony site for too long.

Front 25

What is the first stage of pressure ulcers?

Back 25

Nonblanchable erythema, tissue swelling and congestion, complaints of discomfort, elevated skin temperature, cyanotic blue-gray color

Front 26

What is the second stage of pressure ulcers?

Back 26

Ulcers appear as a break in the skin through epidermis or dermis. An abrasion, blister or shallow crater may be seen. Necrosis follows

Front 27

What is the third stage of pressure ulcers?

Back 27

Ulcers extend into the subcutaneous tissues and appear asa deep crater with or without undermining of adjacent tissues.

Front 28

What is the fourth stage of pressure ulcers?

Back 28

Ulcers extend into the underlying structures, including the muscle and bone. The skin lesion may appear small, while a very large and deep ulcerated area is underneath.

Front 29

What is the treatment for stage one pressue ulcers?

Back 29

Ulcer is relieved by reducing pressure and any other contributing factors.

Front 30

What is the treatment for stage two pressue ulcers?

Back 30

In addition to reducing pressure, ulcers require treatment for broken skin with a moist dressing.

Front 31

What is the treatment for stages 3 & 4 pressure ulcers?

Back 31

Ulcers require debridement through wet-to-damp dressings, prescribed enzyme treatment (which dissolves necrotic tissue), flushing of exudate or surgical debridement.

Front 32

What is a hiatal hernia?

Back 32

A type of physical trauma in which the opening in a patient's diaphragm is enlarged and part of the esophagus and/or upper stomach moves into the lower portion of the thorax.

Front 33

What are the two categories for a hiatial hernia?

Back 33

Axial or paraesophageal

Front 34

When does axial or sliding hernia occur?

Back 34

When the upper stomach and the gastroesophageal junction are displaced upward and slide in and out of the thorax.

Front 35

What is a paraesophageal hernia?

Back 35

This occurs when all or a part of the stomach pushes up through the diaphgragm.

Front 36

50% of patients with an axial hernia will have what symptoms?

Back 36

No symptoms

Front 37

The axial hernia is most often associated with

Back 37

Acid reflux

Front 38

What are the most serious complications with hiatal hernia?

Back 38

Hemmorhage, obstruction of the esophagus and strangulation of the sliding segment.

Front 39

What are used to diagnose hiatal hernia?

Back 39

Health history, X-ray studies, barium swallow and fluoroscopy.

Front 40

What is frostbite?

Back 40

This occurs when exposure to freezing temperatures results in freezing of the fluids in a patient's cells and intercellular spaces ,causing cellular and vascular damage.

Front 41

What is the aim of treatment in frostbite patients?

Back 41

To minimize tissue damage, restore normal temperature and resotre circulation to the affected extremity.

Front 42

What is the first step in treating frostbite?

Back 42

Rewarm the extremity by use of a warm whirlpool at 37-40*C.

Front 43

What is the second step in treating frostbite?

Back 43

Elevate the extremity to reduce edema.

Front 44

What is the third step in treating frostbite?

Back 44

Protect the affected extremity from further injury and infection by applying a sterile dressing.

Front 45

What is the fourth step in treating frostbite?

Back 45

Forbid the patient's use of vasoconstrictors such as caffeine and nicotine.

Front 46

What are the three categories of burns?

Back 46

Thermal (includes electrical burns), radiation or chemical

Front 47

In burns, what does the depth of injury depend on?

Back 47

The temperature of the heat and the duration of contact with the source.

Front 48

Describe a superficial partial-thickness burn

Back 48

Involves injury or destruction of the epidermis as well as a parotion of the dermis. Skin may appear red and dry or be blistered and the injury is painful.

Front 49

Describe a deep partial-thickness burn

Back 49

Involves destruction of the epidermis and the upper layers of the dermis as well as injury to deper portions of the dermis. The wound is painful, appears red and exudes fluid. Hair follicles remain intact.

Front 50

Describe full thickness burns

Back 50

Involves total destruction of the epidermis, the dermis and in some cases the underlying tissue. The color of the burned area ranges from white to red. The wound is painlesss because the nerve endings are destroyed. Wound appears like leather, hair follicles and sweat glands are destroyed.

Front 51

What are the three zones of injury for a burned area?

Back 51

Zone of hyperemia, zone of stasis and zone of coagulation

Front 52

Define the inner zone

Back 52

Known as the zone of coagulation where cellular death occurs, this sustains the most damage.

Front 53

Define the middle area

Back 53

Known as the zone of stasis, has a compromised blood supply inflammation and tissue injury.

Front 54

Define the outer zone

Back 54

Known as the zone of hyperemia, this sustains the least damage

Front 55

What percentage of the total body surface that is burned sustains a local response?

Back 55

25%

Front 56

What does the initial shock period of a major burn cause?

Back 56

Tissue hypoperfusion and organ hypofunction decondary to decreased cardiac output.

Front 57

What is the secondary period of a major burn?

Back 57

Hyperdynamic and hypermetabolic phase

Front 58

Hemodynamic instability following a major burn results from

Back 58

Loss of capillary integrity due to a major shift of fluid, sodium and protein from the intravascular space into the interstitial spaces.

Front 59

What are chemical burns?

Back 59

Tissue trauma caused by caustic substances including medications, poisons and toxins.

Front 60

What three ways might chemical burns occur?

Back 60

Inhaled, ingested or touched.

Front 61

What two conditions is meant by inflammatory bowel disease?

Back 61

Two chronic conditions: Crohn's disease and granulomatous colitis.

Front 62

What is another term for Crohn's disease?

Back 62

Regional enteritis

Front 63

Where does Crohn's disease occur?

Back 63

Occurs in the distal ileum.

Front 64

Describe Crohn's disease

Back 64

Inflammation associated with this condition is subacute and chronic and extends through all layers of the bowel wall from the intestinal mucosa.

Front 65

How is diagnosis of Crohn's disease made?

Back 65

By gastronintestinal exam, stool exam, and barium enema with X-ray.