Assessing and Managing the Acutely Ill Adult Surgical Patient (eBook)

Fiona McArthur-Rouse, Sylvia Prosser (Herausgeber)

eBook Download: PDF

2008
John Wiley & Sons (Verlag)
978-0-470-69124-3 (ISBN)

Infos

Assessing and managing the acutely ill adult surgical patient focuses on major surgical conditions and interventions commonly encountered in District General Hospitals which potentially require intensive monitoring and intervention. It emphasizes the importance of thorough assessment and interpretation of clinical data, and provides the necessary knowledge to help nurses make sense of their findings and to integrate theory and practice in relation to surgical care.

Part one addresses principles of surgical care for all patients undergoing surgery - including pre-operative assessment and preparation, the peri-operative period and post-operative recovery, post-operative pain management and psychosocial aspects of surgery - which underpin the knowledge and rationale for practice. Part two considers specific surgical conditions and interventions, organised according to surgical specialities. Each chapter considers the underlying patho-physiology, investigation and diagnosis, assessment, monitoring and management of common acute surgical conditions within that specialty.

Fiona McArthur-Rouse is a Principal Lecturer in the Department of Adult Nursing Studies, Faculty of Health, Canterbury Christ Church University. Sylvia Prosser was formerly a Principal Lecturer Faculty of Health, Canterbury Christ Church University.

Inhalt

Assessing and Managing the Acutely Ill Adult Surgical Patient 1
Contents 5
Preface 9
Contributors 11
Acknowledgements 13
Part 1 Principles of Caring for Acute Surgical Patients 15
1 Pre-operative Assessment and Preparation Curie Scott, Fiona J McArthur-Rouse, Jane McLean 17
Introduction 17
Pre-operative assessment 17
Pre-operative preparation 22
2 The Peri-operative Phase Luke Ewart and Sandra Huntington 31
Introduction 31
The peri-operative environment 31
Patient admission to the operating department 34
Physiological monitoring of the surgical patient 34
The triad of anaesthesia 35
Airway management of the anaesthetised patient 41
Transfer and positioning of the patient 43
Peri-operative fluid management 46
Peri-operative temperature management 48
Immediate post-operative care 49
3 Post-operative Recovery Sylvia Prosser and Fiona J McArthur-Rouse 53
Introduction 53
The respiratory system 54
The cardiovascular system 57
Fluid and electrolyte balance 61
Nutrition 64
Elimination 65
Thermoregulation 66
Nervous system function 67
Tissue integrity 68
4 Post-operative Pain Management Jane McLean, Sandra Huntington, Fiona J McArthur-Rouse 75
Introduction 75
Types of pain 75
The physiology of pain 76
Psychosocial aspects of pain 80
Adverse effects of unrelieved pain 80
Assessment of pain 81
Non-pharmacological approaches to post-operative pain management 87
5 Psychosocial Aspects of Surgery Fiona J McArthur-Rouse and Tim Collins 91
Introduction 91
Anxiety and stress in the surgical patient 91
Body image 93
Sexuality 96
Caring for the dying patient in an acute surgical environment 97
Part 2 Surgical Specialities 103
6 Head and Neck Surgery Tracey Sharpe and Carma Harnett 105
Introduction 105
Tracheotomy and tracheostomy 105
Neoplastic disease of the head and neck 111
Laryngectomy 112
Surgery of the thyroid gland 113
Other endocrine conditions 117
7 Vascular Surgery Ann M Price 121
Introduction 121
Common vascular pathophysiological conditions 121
Investigations and assessment of vascular disease 124
Management of abdominal aortic aneurysms 126
Thoracic aneurysm 130
Varicose veins 130
Peripheral vascular disease in limbs 131
Arterial insufficiency leading to amputation 132
Carotid endarterectomy 133
Conclusion 134
8 Upper Gastrointestinal Surgery Ian Felstead 139
Introduction 139
Oesophageal disorders 139
Gastric disorders 147
Gallbladder disorders 149
Acute pancreatitis 151
Pancreatic cancer 154
9 Surgery of the Lower Gastrointestinal Tract Ian Felstead 159
Introduction 159
Applied pathophysiology of colorectal disorders 160
Investigations and diagnosis of colorectal disorders 162
Conservative management of GI obstruction 164
Pre-operative assessment, monitoring and preparation for bowel surgery 165
Major surgical procedures 166
Post-operative management and care 168
10 Urological Surgery Ian Felstead and Jane McLean 171
Introduction 171
Urological investigations and diagnosis 171
Urinary stone disease 176
Prostate obstruction 178
Carcinoma of the bladder 180
Renal cancer 188
11 Women's Health Fiona J McArthur-Rouse 191
Introduction 191
Endometriosis 191
Uterine fibroids (fibromyomata, leiomyomas) 192
Genital prolapse 194
Genuine stress incontinence 195
Ectopic pregnancy 195
Gynaecological malignancies 199
Invasive carcinoma of the uterine cervix 199
Ovarian cysts and neoplasms 202
Endometrial cancer 206
Vulval cancer 209
Breast cancer 210
12 Orthopaedic Surgery Ann Newman 215
Introduction 215
Osteoarthritis 215
Rheumatoid arthritis 218
Joint replacement surgery 222
Low back pain 224
Fractures 227
Other considerations 237
13 Identifying and Managing Life-threatening Situations Tim Collins and Catherine I Plowright 241
Introduction 241
Early warning signs and symptoms of critical illness 241
Critical care outreach 242
Systematic assessment of the acutely unwell patient 242
Clinical shock 243
The hypoxic patient 247
The hypotensive patient 250
The oliguric patient 251
Management of a patient with reduced consciousness 253
Cardiorespiratory arrest 254
Self-test Answers 262
Index 269

Rezensionen

"The book provides a clear overview of the patient's perioperative
experience which informs the reader of all pertinent issues and
would be of value as a departmental resource for use by all
perioperative staff." (Open Forum, December 2008)

"This book will be a welcome addition to library shelves, and it
provides a useful resource for nurses working in a range of
surgical areas." (Nursing Standard)

"Aimed at newly qualified staff, operating department
practitioners and adult nursing students." (Science Direct)

"This book will be a welcome addition to library shelves, and it
provides a useful resource for nurses working in a range of
surgical areas." Nursing Standard

"Aimed at newly qualified staff, operating department
practitioners and adult nursing students."

Science Direct

Produkt-Details

• Erscheint lt. Verlag: 15.4.2008
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Medizin / Pharmazie ► Pflege ► Pflegemanagement / Qualität / Recht
• Themenwelt: Studium ► 2. Studienabschnitt (Klinik) ► Anamnese / Körperliche Untersuchung
• Schlagworte: acutely • addresses • Clinical • Clinical Specialities • commonly • Conditions • Data • District • encountered • Findings • focuses • ill adult • importance • Krankenpflege • Major • necessary knowledge • nurses • nursing • Patient • Practice • Sense • Spezialaufgaben i. d. klinischen Krankenpflege • Surgery • surgical • surgical care • thorough
• ISBN-10: 0-470-69124-7 / 0470691247
• ISBN-13: 978-0-470-69124-3 / 9780470691243