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.
Author(s): Luke Ewart, Ian Felstead, Carma Harnett, Sandra Huntington, Jane Mclean, Ann Newman, Catherine Plowr
Edition: 1
Year: 2007
Language: English
Pages: 272
Assessing and Managing the Acutely Ill Adult Surgical Patient......Page 2
Contents......Page 6
Preface......Page 10
Contributors......Page 12
Acknowledgements......Page 14
Part 1 Principles of Caring for Acute Surgical Patients......Page 16
Pre-operative assessment......Page 18
Pre-operative preparation......Page 23
The peri-operative environment......Page 32
Physiological monitoring of the surgical patient......Page 35
The triad of anaesthesia......Page 36
Airway management of the anaesthetised patient......Page 42
Transfer and positioning of the patient......Page 44
Peri-operative fluid management......Page 47
Peri-operative temperature management......Page 49
Immediate post-operative care......Page 50
Introduction......Page 54
The respiratory system......Page 55
The cardiovascular system......Page 58
Fluid and electrolyte balance......Page 62
Nutrition......Page 65
Elimination......Page 66
Thermoregulation......Page 67
Nervous system function......Page 68
Tissue integrity......Page 69
Types of pain......Page 76
The physiology of pain......Page 77
Adverse effects of unrelieved pain......Page 81
Assessment of pain......Page 82
Non-pharmacological approaches to post-operative pain management......Page 88
Anxiety and stress in the surgical patient......Page 92
Body image......Page 94
Sexuality......Page 97
Caring for the dying patient in an acute surgical environment......Page 98
Part 2 Surgical Specialities......Page 104
Tracheotomy and tracheostomy......Page 106
Neoplastic disease of the head and neck......Page 112
Laryngectomy......Page 113
Surgery of the thyroid gland......Page 114
Other endocrine conditions......Page 118
Common vascular pathophysiological conditions......Page 122
Investigations and assessment of vascular disease......Page 125
Management of abdominal aortic aneurysms......Page 127
Varicose veins......Page 131
Peripheral vascular disease in limbs......Page 132
Arterial insufficiency leading to amputation......Page 133
Carotid endarterectomy......Page 134
Conclusion......Page 135
Oesophageal disorders......Page 140
Gastric disorders......Page 148
Gallbladder disorders......Page 150
Acute pancreatitis......Page 152
Pancreatic cancer......Page 155
Introduction......Page 160
Applied pathophysiology of colorectal disorders......Page 161
Investigations and diagnosis of colorectal disorders......Page 163
Conservative management of GI obstruction......Page 165
Pre-operative assessment, monitoring and preparation for bowel surgery......Page 166
Major surgical procedures......Page 167
Post-operative management and care......Page 169
Urological investigations and diagnosis......Page 172
Urinary stone disease......Page 177
Prostate obstruction......Page 179
Carcinoma of the bladder......Page 181
Renal cancer......Page 189
Endometriosis......Page 192
Uterine fibroids (fibromyomata, leiomyomas)......Page 193
Genital prolapse......Page 195
Ectopic pregnancy......Page 196
Invasive carcinoma of the uterine cervix......Page 200
Ovarian cysts and neoplasms......Page 203
Endometrial cancer......Page 207
Vulval cancer......Page 210
Breast cancer......Page 211
Osteoarthritis......Page 216
Rheumatoid arthritis......Page 219
Joint replacement surgery......Page 223
Low back pain......Page 225
Fractures......Page 228
Other considerations......Page 238
Early warning signs and symptoms of critical illness......Page 242
Systematic assessment of the acutely unwell patient......Page 243
Clinical shock......Page 244
The hypoxic patient......Page 248
The hypotensive patient......Page 251
The oliguric patient......Page 252
Management of a patient with reduced consciousness......Page 254
Cardiorespiratory arrest......Page 255
Self-test Answers......Page 263
Index......Page 270
