Surg Skill January Test (Part 3)
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Created by:
clarkmackinnon on January 30, 2012
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41 terms
Terms | Definitions |
|---|---|
 D + C = | Dilation and Curettage |
| (Dilation and Curettage) Therapeutic usage | removal of polyps postpartum bleeding evacuate retained placenta retrieval of "lost" IUD place radioactive carriers (for uterine malignancies) treatment of incomplete abortion -dysmenorrhea, endometriosis |
| (Dilation and Curettage) Diagnosis | endometriosis dysmenorrhea |
| Endometriosis | ruled out by collection of abnormal cytology |
| Dysmenorrhea | unusual situations (such as excess bleeding) |
| (Dilation and Curettage) Relevant Anatomy | -urethra -vagina -anus |
| D & C Draping | 1) Legs (x2) 2) Buttocks (x1) 3) 1/2 sheet (x1) |
| D & C Instruments | Hank Dilators Sims endocervial curette Kevorkian Curette Holka #3 KH with a #10 Blade Allis clamp Uterine sound (measure depth) of fundus |
| (Dilation and Curettage) Supplies | basic vaginal pack -Telfa (for specimen samples) |
| endometrium = | lining of uterus |
| (Dilation and Curettage) Instruments | Auvard weighted vaginal speculum Sims uterine sound Kevorkian endocervial curette Randall Forceps |
| C - Section = | Cesarean Section |
| (Cesarean Section) Reason for one? | Failure of the normal birthing process |
| (Cesarean Section) Indications - Maternal | -eclampsia -severe pre-eclampsia -Cardiac disease -diabetes -cervical cancer** -herpes** **= more common, can spread to fetus through canal |
| (Cesarean Section) More Indications - Maternal | -carcinoma -prior surgery of the uterus -failure to progress -maternal demise (such as a car accident) |
| (Cesarean Section) Indications - Fetal | -Fetal distress (low heart rate) -Breech -prolapse of umbillical cord -malpresentation -transvers -brow multiples -fetal demise |
| (Cesarean Section) Indications -Maternal/Fetal | Dystocia (labor not planned, baby stuck) -cephalopelvic disproportion -failed induction of labor -abnormal uterine action |
| Dystocia = | labor not as planned |
| A common structural reason for c-section is??? | cephalopelvic disproportion (CPD) |
| Cephalopelvic disproportion (CPD) = | meaning that the head of fetus is too large to pass through the maternal birth canal |
| (Side note) What is the difference between a spinal and a epidural regional block? | Spinal - needle in spinal area one time Epidural - catheter placed into spine |
| (Cesarean Section) Indications - Placental | -Placenta previa -placental abruption |
| Placenta previa = | placenta detaches from the uterine wall -very serious |
| Placental abruption = | tear |
| (Cesarean Section) Instruments | -bladder retractor -cord clamp (x3) -bandage scissors (to cut umbilical cord) -DeLee suction (suck fluid out of baby's nose etc) -Richardson/Eastman Retractors -Kochers -Heaney needle holder -Goelet Retractor |
| (Cesarean Section) Supplies | Prep set c-section pack bulb syringe -cord blood container -blood gas containers basin gloves etc |
| (Cesarean Section) Anesthesia | epidural (because general anesthesia would affect the baby) |
| (Cesarean Section) Position? | supine position -with a roll placed under the Right hip to keep uterine pressure off of the vena cava |
| (Cesarean Section) Equipment | safety strap 2 inches above the knee warming blanket fetal monitory suction apparatus neonatal bed ESU |
| (Cesarean Section) Prep | -abdominal prep plus vagina and inner thighs -with betadine |
| (Cesarean Section) Draping | laparotomy (specialized c-section drape may be needed) -half sheet -towels (x4 to square off) |
| (Cesarean Section) Incision | Pfannestiel (midline or low transverse) |
| (Cesarean Section) Diagnostics | Ultrasound Bloodwork MRI/CT Scan H+P Pelvic exam (palpating) vaginal exam Scheller exam (to identify cancer) |
| Scheller exam = | to identify cancer |
| (Cesarean Section) Medications? | Oxytocin Methergine |
| Oxytocin can be used for what? | Hemostasis -can help cause contractions |
| Methergine can... | control hemorrhage |
| How many closing counts for a c-section? | 3! There are 4 counts total. |
| What suture material holds a drain in? | NYLON! |
| Blake drain is a... | active drain |
| Free tie suture size? -absorbable or non absorbable? instrument used with it | 2-0 or 3-0 absorbable schnidt clamp |
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