surg tech ch 3+4

positioning for bariatric patients

-Reverse Trendelenburg position: expanding total lung, Improves pulmonary function

sequential compression devices in bariatric Patients.

-Supine position really is at risk for obsese people, need to get them up immediately -venous compression device is in the room and the patient is fitted with sequential compression devices (SCSs). must be used to reduce the incidence of DVT

reasons for performing pediatric surgery and the highest risk for death in children

Accidents 1-15y Highest risk of death is blunt force trauma to a child's head. Motor vehicle accidents leading cause for mobility in children

different religious beliefs explored in the book

Buddhist reincarnation last thoughts determine rebirth

different definitions of death

Cardiac death: irreversible loss of cardiac and respiratory function. Permanent absence of a heartbeat. Higher-brain function: irreversible loss of higher brain function. Brain stem continues to provide respiration,blood pressure,and a heartbeat without the assistance of a respirator. Whole-brain death: irreversible loss of all function of the entire brain.Law as what defines death in the legal courts. Flat eeg unresponsiveness and reflexes and decreasing body temp

coping mechanisms

Denial, Rationalization, Regression, Repression

Describe the need for extra time for general anesthesia reversal in bariatric patients.

Due to decreased pulmonary function, increasing anesthesia due to their size and increases post op time due to their fat absorbing(adipose tissue) making them wake up slower Higher concentration of anesthesia due to adipose tissue, recovering time increased due to adipose tissue soaking up the anesthesia

bariatric procedures and describe a common incidental finding and procedure performed during bariatric surgery

During adnominal procedures on obese patients gulstones are often found The gallbladder (colilathiasis) is normally removed

types of life-support treatment

Feeding tube, defibrillation, urinary catheter Ordinary: used to prolong life that the physician is morally obligated to provide without imposing an additional burden on the patient Extraordinary: pose an undue burden on the patient and may be costly. If someone has one life threatening condition... dont add another Futile

obtaining consent for organ donation

If the patient's wishes are known, next of kin must sign the donation form Facilities procurement coordinator does this portion

possible complications associated with bariatric surgery including possible post-operative complications

Increased risk to obsese patients included post op thrombophlebitis (inflammation of the veins) Anesthetic issues, respiratory failure, thromboforitis

common comorbidity conditions of geriatric patients

Integumentary, musculoskeletal, cardiovascular, respiratory

trauma center ratings and the services provided

Level 1- all required needs for 24 hr basis highest level surgical care

Maslow's Hierarchy of needs

Model human development and progression physiological, safety, love/belonging,esteem, self actualization

complications of birth and resulting infant injuries

Most common is bone fracture in the clavicle usually as a result of shoulder dystonia. Meaning the shoulders don't fit through the birth canal

Dr. Hans Selye's definition of stress

Nonspecific response of the body to any demand

physiological response to temperature changes that is missing in an infant less than 6 months of age and the importance of this response

Peds particularly neonates lack the ability to shiver and little fat therefore poor insulation Newborns lose heat through radiation, convection, conduction, and evaporation

Palliative procedure

Relieves symptoms without curing the cause

positioning considerations for pregnant surgical patients

Supine position and you need small rolled sheet under right hip to take weight of the uterus off the aorta to maintain normatensive level Slight lateral shift

potential complications associated with pediatric surgery including complications associated with antibiotic therapy

Use of penicillin or a combination of amino-glycoside or third generation cephalosporin Fever is the initial sign of post op infection with pediatrics. Adults sometimes normally run a fever. Side effects are similar to adults except Sulfamides - increased incidents of excess of belly ribbons sutomentrbence - over growth of cedif due to antibiotic suppression of normal health bacteria

Types of Euthanasia:

good death Passive: when the physician does nothing to preserve life Active: requires action that speeds up the process of dying such as morphine. Voluntary or involuntary.

surgical implications associated with transplant patients

immo suppressant drugs for transplant patients CST remember these patients have a hard time fighting infection especially immunocompromised

developmental stages and different needs of pediatric patients

neonate - first 28 days infant - 2-18 mon toddler 19-30 mon preschooler- 31 mon-5y School age 6-12 year adolescent 13-18 y

Elizabeth Kubler-Ross

psychologist who created the 5 stages of grief: denial(coping), anger, bargaining, depression, acceptance

shock seen in children

septic : most common for children Hypovolemic (neonate) shock and bradycardia is the physiological response. Neonates have low blood pressure.... Shock = poor tissue perfusion Dehydration for hypovolemic shock (Tachycardia is the adult response)

potential complication associated with ventilation in bariatric patients

they have short large necks which make induction the most difficult part

Therapeutic Procedures

treat or manage a disease