Podcast
Questions and Answers
Which vitamin is essential for preventing bleeding during wound healing?
Which vitamin is essential for preventing bleeding during wound healing?
What is the primary characteristic of emergent procedures in palliative care?
What is the primary characteristic of emergent procedures in palliative care?
What type of suture is associated with immediate closure of a wound?
What type of suture is associated with immediate closure of a wound?
Which gas is represented by the color green in anesthesia identification?
Which gas is represented by the color green in anesthesia identification?
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Which sound is characterized as a high pitch musical sound typically associated with asthma?
Which sound is characterized as a high pitch musical sound typically associated with asthma?
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What does the presence of serous discharge indicate?
What does the presence of serous discharge indicate?
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Which anesthetic agent is known for causing muscle paralysis and may lead to malignant hyperthermia?
Which anesthetic agent is known for causing muscle paralysis and may lead to malignant hyperthermia?
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What is the primary focus of the circulating nurse in the operating room?
What is the primary focus of the circulating nurse in the operating room?
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Which part of the upper respiratory tract connects the nasal cavity to the larynx?
Which part of the upper respiratory tract connects the nasal cavity to the larynx?
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What are crackles in the lung sounds indicative of?
What are crackles in the lung sounds indicative of?
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What does the term 'surgical amnesia' refer to in the stages of anesthesia?
What does the term 'surgical amnesia' refer to in the stages of anesthesia?
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Which diet might be recommended if the gag reflex and flatus are present?
Which diet might be recommended if the gag reflex and flatus are present?
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What is the priority during the intraoperative stage of surgery?
What is the priority during the intraoperative stage of surgery?
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How often should a patient be monitored during the first hour after surgery?
How often should a patient be monitored during the first hour after surgery?
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What is a characteristic of barrel chest deformity?
What is a characteristic of barrel chest deformity?
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Which volatile liquid is specifically linked to respiratory depression?
Which volatile liquid is specifically linked to respiratory depression?
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What is a major objective of pre-operative teaching?
What is a major objective of pre-operative teaching?
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Which of the following factors is essential for informed consent?
Which of the following factors is essential for informed consent?
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What complication might arise from failing to teach early ambulation?
What complication might arise from failing to teach early ambulation?
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Which medication is classified as an anxiolytic in pre-operative care?
Which medication is classified as an anxiolytic in pre-operative care?
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What is the purpose of administering H2 blockers like Ranitidine before surgery?
What is the purpose of administering H2 blockers like Ranitidine before surgery?
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What is a primary reason for assessing medications on the day of surgery?
What is a primary reason for assessing medications on the day of surgery?
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In the context of post-operative care, what does Homan's sign assess for?
In the context of post-operative care, what does Homan's sign assess for?
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Which type of surgery is identified as curative?
Which type of surgery is identified as curative?
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What is a characteristic feature of funnel chest?
What is a characteristic feature of funnel chest?
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Which condition is associated with outward protrusions of the chest?
Which condition is associated with outward protrusions of the chest?
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Which of the following symptoms is NOT commonly associated with laryngeal cancer?
Which of the following symptoms is NOT commonly associated with laryngeal cancer?
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What is a key risk factor for obstructive sleep apnea?
What is a key risk factor for obstructive sleep apnea?
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What type of chest movement is characteristic of flail chest?
What type of chest movement is characteristic of flail chest?
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What is an appropriate treatment for hemothorax?
What is an appropriate treatment for hemothorax?
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What does the presence of continuous bubbling in a test tube thoracentesis indicate?
What does the presence of continuous bubbling in a test tube thoracentesis indicate?
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Which of the following is NOT a type of traumatic chest injury?
Which of the following is NOT a type of traumatic chest injury?
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What is necessary to do if a dislodged tube is found in a patient's chest?
What is necessary to do if a dislodged tube is found in a patient's chest?
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Which of the following would indicate a patient is experiencing respiratory acidosis?
Which of the following would indicate a patient is experiencing respiratory acidosis?
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Which of the following indicates a fully compensated ABG analysis?
Which of the following indicates a fully compensated ABG analysis?
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What are the three items that should be at the bedside of a patient with a test tube?
What are the three items that should be at the bedside of a patient with a test tube?
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What condition is associated with metabolic alkalosis?
What condition is associated with metabolic alkalosis?
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Study Notes
Pre-Operative Nursing
- Informed Consent must be obtained from the patient; involves voluntary agreement by a mentally stable individual of legal age, and confirmation by nearest kin in certain situations.
- Paternalism applies only in emergencies, allowing doctors to sign consent when necessary.
- Pre-Operative Teaching includes instructions on deep breathing and coughing exercises to prevent pneumonia, and leg exercises to reduce deep vein thrombosis risk.
- Homan's Sign helps assess for blood clots; positive indicates pain indicating clot, while negative indicates no blood clot.
- Splinting is done to apply gentle pressure on the incision site to prevent complications like dehiscence (wound opening) and evisceration (internal organs protruding).
- Early ambulation is encouraged post-surgery to prevent pneumonia and enhance recovery.
Pre-Operative Assessment
- Demographic Factors: Assess age, gender (higher compliance in males), and civil status.
- Medical History: Review for conditions like diabetes, cardiovascular diseases, and allergies; consider current medications that may affect surgery.
- Medication Management: Be cautious with steroid usage (to prevent stress responses), anticoagulants (risk of bleeding), and antibiotics like erythromycin.
Purpose and Types of Surgery
- Surgery Objectives: Can be diagnostic (identify diseases), curative (treatment), repairative (repair), reconstructive (cosmetic), or palliative (control symptoms).
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Surgery Classifications:
- Emergent: Immediate, life-threatening situations.
- Urgent: Required within 24-30 hours.
- Required: Scheduled within weeks/months.
- Elective: Non-life-threatening, should have but not urgent.
- Optional: At patient's discretion, often cosmetic.
Anesthesia Overview
- Anesthesia Types: General (major surgeries), regional (block nerves), local (specific areas).
- Stages of Anesthesia: Induction, excitement, surgical amnesia, danger/exhaustion where monitoring is crucial.
- Risk Management: Malignant hyperthermia possible; dantrolene sodium can be administered as a muscle relaxant if necessary.
Intraoperative Roles
- OR Team: Comprised of the surgeon (leader), assistant surgeon, scrub nurse (maintains sterile technique), circulating nurse (documentation and monitoring), and anesthesiologist (manages anesthesia).
Post-Operative Care
- Patient Monitoring: First hour - check every 15 minutes, next hour every 30 minutes, and subsequently every 4 hours.
- Complications: Watch for infection (post 5 days fever) and dehydration (immediate fever).
- Nutrition: Essential nutrients include protein for wound healing, Vitamin C for cell repair, and Vitamin K to prevent bleeding.
- Diet Progression: Start with NPO, then clear liquids, progressing to full liquid, soft diet, and regular diet as tolerated.
- Wound Closure Methods: Types of suturing categorized as primary (immediate), secondary (granulation), and tertiary (delayed). Discharge fluid characteristics (serous, sanguineous, cerosanguineous, purulent) indicate potential complications.
Respiratory Anatomy and Sounds
- Upper Respiratory Tract includes nasal cavity, pharynx, and larynx; functions to filter and humidify air.
- Lower Respiratory Tract includes trachea, primary bronchi, lungs, alveoli, and capillaries; involved in gas exchange.
- Normal Breath Sounds categorized as bronchial (high pitch), broncho-vesicular (moderate), and vesicular (low pitch).
- Abnormal Breath Sounds include wheezing, stridor, ronchi, crackles, and friction rub; indicative of various respiratory conditions.
Respiratory Disorders and Management
- Obstructive Sleep Apnea characterized by cessation of breathing; commonly affects the obese and smokers.
- Upper Respiratory Infections like viral rhinitis exhibit typical cold symptoms; managed with symptomatic therapies.
- Traumatic Respiratory Conditions such as pneumothorax and hemothorax require immediate intervention including thoracentesis or chest tube placement.
Acid-Base Balance in ABG Analysis
- ABG Ranges: Normal pH (7.35-7.45), HCO3 (22-26), and PCO2 (35-45).
- Compensation States: Fully compensated (normal pH), partially compensated (no normal values), un-compensated (either HCO3 or PCO2 normal).
- Clinical Implications: Respiratory acidosis indicated by increased CO2 due to inadequate breathing; metabolic acidosis linked to elevated potassium from diarrhea or injury.
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