Fundamentals

Major Surgery involves

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Involves extensive reconstruction or alteration in body parts; poses great risks to well-being. Examples include coronary artery bypass, colon resection, removal of larynx, resection of lung lobes

Minor surgeries involves

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minimal alteration in body parts; often designed to correct deformities; involves minimal risks compared with major procedures. Examples include cataract extraction, facial plastic surgery, tooth extraction

Classification of surgery based on Urgency

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Elective: based on choice for example bunionectomy, facial plastic surgery

Urgent: Necessary for patient's health. Not emergency For example: prostatectomy, removal of gall bladder for stones

Emergent surgery: must be done immediately. Examples include control of internal hemorrhaging

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Purpose classification:

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Diagnostic: Surgery to confirm diagnosis or to test. examples breast mass biopsy

Ablative: Removal of diseased body part. Examples include amputation or removal of gall stones

Palliative: Relieves or reduces intensity of a disease symptom. NO CURE. Example: Colostomy, debridement of necrotic tissue

Reconstructive or restorative: restores function or appearance to malfunctioning tissues. Example includes joint fixation, scar revision

Constructive tissues: Restores function lost from congenital anomalies. example: closure of atrial septal defects in heart

Cosmetic: improved personal appearance example include rhinoplasty to reshape nose

Surgical Risk Factors

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üAge

üObesity

üNutrition

üSmoking

üImmunocompromised

üObstructive Sleep Apnea

üCoagulopathies

üFluid Imbalances

üElectrolyte Imbalances

üPregnancy

üETOH Use

üCardiovascular Disease

üDuration of Anesthesia & Length of Procedure

üPostoperative Nausea & Vomiting

üDiabetes

üRespiratory Conditions

Preoperative assesxments

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üMedical & Surgical Hx (Complete H&P)

üAnesthetic Hx

üDiagnostic Screening (based on hlth status & current problem)– include Type & Crossmatch

üMedication Reconciliation

üAllergies (latex, meds, iodine/shellfish)

üETOH use– withdrawal life threatening w/in 24 hrs

üComplete physical assessment (H2T) + VS

üPt understanding & knowledge

Pre-op lab test

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Role of RN in informed consent

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witness that informed consent was obtained and confirm and patient's questions were answered

Consent for blood products and surgical product is gotten by the