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65 Cards in this Set

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Define ambulatory surgery
Surgery that does not require an overnight hospital stay.
Define aneshtesia
A state of narcosis, analgesia, relaxation and reflex loss.
Define conscious sedation
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.
Define evisceration
The protrusion of the organs through a surgical incision.
Define first-intention healing
A method of healing in which wound edges are surgically approximated in integumentary integrity is restored without granulating.
Define informed consent
This is a process in which patients make autonomous decisions based on the nature of their condition, their treatment options, and the risks involved.
Define intraoperative phase
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.
Define perioperative period
The period of tiem that constitutes the surgical experience; this period includes the preoperative, intraoperative and postoperative phases.
Define postoperative phase
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.
Define preadmission testing
The diagnostic testing done prior to a surgical procedure.
Define preoperative phase
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.
Define second-intention healing
The method of healing in whic wound edges are not surgically approximated and integumentary integrity is restored by granulation.
Define third-intention healing
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.
Define chemotactic gradient
Immediately following an injury, the body releases substances that form a wall
How long after tissue injury will blood vessels dilate to increase blood flow?
Thirty minutes
Define exudate
Protein-rich fluids and fibrinogen
How long after tissue injury will edema occur?
Within four hours after injury
What does phagocytosis do to prevent bacteria from spreading?
Walls off foreign material
What accumulates with large numbers of phagocytes?
Pus
What does compliment enhance?
Chemotaxis and increases blood vessel permeability and cell lysis.
What does tissue trauma include?
Such problems as burns, accidents, ulcers, inflammatory diseases, and accidnetal posioning, as well as surgical intervenion.
What are the five main categories of tissue trauma cause?
Physical or mechanical trauma, thermal trauma, chemical exposure or ingestion, inflammatory disease and surgical intervention.
What does soft tissue refer to?
Layers of skin, fat and connective tissue that excludes bones and muscles.
How do pressure ulcers form?
If too much pressure is exerted on a bony site for too long.
What is the first stage of pressure ulcers?
Nonblanchable erythema, tissue swelling and congestion, complaints of discomfort, elevated skin temperature, cyanotic blue-gray color
What is the second stage of pressure ulcers?
Ulcers appear as a break in the skin through epidermis or dermis. An abrasion, blister or shallow crater may be seen. Necrosis follows
What is the third stage of pressure ulcers?
Ulcers extend into the subcutaneous tissues and appear asa deep crater with or without undermining of adjacent tissues.
What is the fourth stage of pressure ulcers?
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.
What is the treatment for stage one pressue ulcers?
Ulcer is relieved by reducing pressure and any other contributing factors.
What is the treatment for stage two pressue ulcers?
In addition to reducing pressure, ulcers require treatment for broken skin with a moist dressing.
What is the treatment for stages 3 & 4 pressure ulcers?
Ulcers require debridement through wet-to-damp dressings, prescribed enzyme treatment (which dissolves necrotic tissue), flushing of exudate or surgical debridement.
What is a hiatal hernia?
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.
What are the two categories for a hiatial hernia?
Axial or paraesophageal
When does axial or sliding hernia occur?
When the upper stomach and the gastroesophageal junction are displaced upward and slide in and out of the thorax.
What is a paraesophageal hernia?
This occurs when all or a part of the stomach pushes up through the diaphgragm.
50% of patients with an axial hernia will have what symptoms?
No symptoms
The axial hernia is most often associated with
Acid reflux
What are the most serious complications with hiatal hernia?
Hemmorhage, obstruction of the esophagus and strangulation of the sliding segment.
What are used to diagnose hiatal hernia?
Health history, X-ray studies, barium swallow and fluoroscopy.
What is frostbite?
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.
What is the aim of treatment in frostbite patients?
To minimize tissue damage, restore normal temperature and resotre circulation to the affected extremity.
What is the first step in treating frostbite?
Rewarm the extremity by use of a warm whirlpool at 37-40*C.
What is the second step in treating frostbite?
Elevate the extremity to reduce edema.
What is the third step in treating frostbite?
Protect the affected extremity from further injury and infection by applying a sterile dressing.
What is the fourth step in treating frostbite?
Forbid the patient's use of vasoconstrictors such as caffeine and nicotine.
What are the three categories of burns?
Thermal (includes electrical burns), radiation or chemical
In burns, what does the depth of injury depend on?
The temperature of the heat and the duration of contact with the source.
Describe a superficial partial-thickness burn
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.
Describe a deep partial-thickness burn
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.
Describe full thickness burns
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.
What are the three zones of injury for a burned area?
Zone of hyperemia, zone of stasis and zone of coagulation
Define the inner zone
Known as the zone of coagulation where cellular death occurs, this sustains the most damage.
Define the middle area
Known as the zone of stasis, has a compromised blood supply inflammation and tissue injury.
Define the outer zone
Known as the zone of hyperemia, this sustains the least damage
What percentage of the total body surface that is burned sustains a local response?
25%
What does the initial shock period of a major burn cause?
Tissue hypoperfusion and organ hypofunction decondary to decreased cardiac output.
What is the secondary period of a major burn?
Hyperdynamic and hypermetabolic phase
Hemodynamic instability following a major burn results from
Loss of capillary integrity due to a major shift of fluid, sodium and protein from the intravascular space into the interstitial spaces.
What are chemical burns?
Tissue trauma caused by caustic substances including medications, poisons and toxins.
What three ways might chemical burns occur?
Inhaled, ingested or touched.
What two conditions is meant by inflammatory bowel disease?
Two chronic conditions: Crohn's disease and granulomatous colitis.
What is another term for Crohn's disease?
Regional enteritis
Where does Crohn's disease occur?
Occurs in the distal ileum.
Describe Crohn's disease
Inflammation associated with this condition is subacute and chronic and extends through all layers of the bowel wall from the intestinal mucosa.
How is diagnosis of Crohn's disease made?
By gastronintestinal exam, stool exam, and barium enema with X-ray.