Care Surgical Patients

8/19/2019 Care Surgical Patients

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Abdomen Regions Organs

Right Hypochondrium Liver, Gallbladder, Right Kidney, Small Intestine

Left Hypochondrium Spleen, Colon, Left Kidney, Pancreas

Epigastrium Stomach, Liver, Pancreas, Duodenum, Spleen, Adrenal Glands

Right Lumber Region Gallbladder, Liver, Right Colon

Left Lumber Region Descending Colon, Left Kidney

Umbilical Region Umbilicus, Jejunum, Ileum, Duodenum

Right Iliac Fossa Appendix, Cecum

Left Iliac Fossa Descending Colon, Sigmoid Colon

Hypogastrium Urinary Bladder, Sigmoid Colon, Female Reproductive Organs


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ypes of surgery

Surgical procedures are commonly categorized by urgency, type ofprocedure, body system involved, degree of invasiveness, and specialinstrumentation.

Based on timing: Elective surgery is done to correct a non-life-threatening condition, and is carried out at the patient's request,subject to the surgeon's and the surgical facility's availability.Emergency surgery is surgery hich must be done promptly to save

life, limb, or functional capacity. ! semi-elective surgery is one thatmust be done to avoid permanent disability or death, but can bepostponed for a short time.

Based on purpose: E"ploratory surgery is performed to aid orcon#rm a diagnosis. $herapeutic surgery treats a previously

diagnosed condition. %osmetic surgery is done to improve theappearance of an otherise normal structure.

By type of procedure: !mputation involves cutting o& a body part,usually a limb or digit castration is also an e"ample. Resection is theremoval of all or part of an internal organ or part of the body.

(eplantation involves reattaching a severed body part.(econstructive surgery involves reconstruction of an injured,

https://en.wikipedia.org/wiki/Elective_surgeryhttps://en.wikipedia.org/wiki/Emergency_medicinehttps://en.wikipedia.org/wiki/Semi-elective_surgeryhttps://en.wikipedia.org/wiki/Exploratory_surgeryhttps://en.wikipedia.org/wiki/Cosmetic_surgery#Cosmetic_surgeryhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Replantationhttps://en.wikipedia.org/wiki/Reconstructive_surgeryhttps://en.wikipedia.org/wiki/Reconstructive_surgeryhttps://en.wikipedia.org/wiki/Replantationhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Cosmetic_surgery#Cosmetic_surgeryhttps://en.wikipedia.org/wiki/Exploratory_surgeryhttps://en.wikipedia.org/wiki/Semi-elective_surgeryhttps://en.wikipedia.org/wiki/Emergency_medicinehttps://en.wikipedia.org/wiki/Elective_surgery


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By body part: +hen surgery is performed on one organ system orstructure, it may be classed by the organ, organ system or tissueinvolved. E"amples include cardiac surgery )performed on theheart*, gastrointestinal surgery )performed ithin the digestivetract and its accessory organs*, and orthopedic surgery )performedon bones andor muscles*.

By degree of invasiveness of surgical procedures:inimally-invasive surgery involves smaller outer incision)s* toinsert miniaturized instruments ithin a body cavity or structure, asin laparoscopic surgery or angioplasty. y contrast, anopen surgical procedure such as a laparotomy requires a largeincision to access the area of interest.

By equipment used: /aser surgery involves use of a laser forcutting tissue instead of a scalpel or similar surgical instruments.icrosurgery involves the use of an operatingmicroscope for thesurgeon to see small structures.

https://en.wikipedia.org/wiki/Minimally-invasive_procedureshttps://en.wikipedia.org/wiki/Laparoscopic_surgeryhttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Open_surgeryhttps://en.wikipedia.org/wiki/Laparotomyhttps://en.wikipedia.org/wiki/Laser_surgeryhttps://en.wikipedia.org/wiki/Laserhttps://en.wikipedia.org/wiki/Scalpelhttps://en.wikipedia.org/wiki/Microsurgeryhttps://en.wikipedia.org/wiki/Microscopehttps://en.wikipedia.org/wiki/Microscopehttps://en.wikipedia.org/wiki/Microsurgeryhttps://en.wikipedia.org/wiki/Scalpelhttps://en.wikipedia.org/wiki/Laserhttps://en.wikipedia.org/wiki/Laser_surgeryhttps://en.wikipedia.org/wiki/Laparotomyhttps://en.wikipedia.org/wiki/Open_surgeryhttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Laparoscopic_surgeryhttps://en.wikipedia.org/wiki/Minimally-invasive_procedures


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Physical examination

0hysical e"amination should address not only areas a&ected

by the surgical procedure but also the cardiopulmonarysystem as ell as a search for any signs of ongoing infection)eg, upper respiratory tract, s1in*. +hen spinal anesthesia isli1ely to be used, patients should be evaluated for scoliosisand other anatomic abnormalities that may complicatelumbar puncture. !ny cognitive dysfunction, especially in

elderly patients ho ill be given a general anesthetic,should be noted. 0ree"isting dysfunction may become moreapparent postoperatively and, if undetected beforehand, maybe misinterpreted as a surgical complication.


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Testing

%% and urinalysis )glucose, protein, and cells* usually are done.Serum electrolytes and creatinine and plasma glucose are measuredunless patients are e"tremely healthy and 234 yr of age, theprocedure is considered very lo ris1, and use of nephroto"ic drugs isnot e"pected./iver enzymes are measured if abnormalities are suspected based onthe patient5s history or e"amination.

%oagulation studies and bleeding time are needed only if patientshave a history of bleeding diathesis or a disorder associated ithbleeding.E%6 is done for patients at ris1 of coronary artery disease )%!7*,including all men 8 93 and omen 8 34.:f a general anesthetic is to be used, a chest "-ray typically is done )or

a recent "-ray is revieed*, but its usefulness is limited, particularly inyounger patients and in patients ithout suspicion of heart or lungdisease.0ulmonary function testing may be done if patients have a 1nonchronic pulmonary disorder or symptoms or signs of pulmonarydisease.

0atients ith symptomatic %!7 need additional tests )eg, stresstesting, coronary angiography* before surgery.

http://www.msdmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/overview-of-coronary-artery-diseasehttp://www.msdmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/overview-of-coronary-artery-disease


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Patient Risk Factors

•History of CAD•History of heart failure•History of cerebrovascular disease•Diabetes requiring treatment with insulin

•Infections•Pulmonary Disease


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Fluid and electrolyte imbalances

;luid and electrolyte imbalances should be correctedbefore surgery. uids beforegeneral anesthesia to prevent severe hypotension oninduction?0 tends to fall hen general anesthesia is

induced.


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Nutritional disordersUndernutrition increases ris1 of postoperativecomplications in adults. @utritional status is assessed

preoperatively using history, physical e"amination, andlaboratory tests. :ndicators of undernutrition include thefolloingA! history of eight loss 8 B4C of body eight over D moor 3C over B moSuggestive physical e"amination #ndings )eg, muscle

asting, signs of speci#c nutritional de#ciencies*/o serum albumin levels

http://www.msdmanuals.com/professional/nutritional-disorders/undernutrition/overview-of-undernutritionhttp://www.msdmanuals.com/professional/nutritional-disorders/undernutrition/overview-of-undernutrition


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Care Surgical Patients

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