6/7/24, 6:17 PM Medical Surgical Nursing- lecture
Medical Surgical Nursing
ADRENAL GLAND - Epinephrine increases cardiac rate because
patient is bleeding due to surgery > the
heart has to pump rapidly in order to give
more blood to the other systems of the body
(blood contains oxygen and nutrients)
Adrenal Medulla Adrenal Cortex - Norepinephrine causes vasoconstriction
(compensatory mechanism): Blood pressure
perform goes down (hypotension) due to bleeding
gluconeogenesis and ➡ decreasing blood supply to the brain ➡
glycogenolysis vasoconstriction ➡ arteries constricted ➡ no
perfused bleeding developed ➡ therefore
>Epinephrine >Aldosterone increasing blood pressure ➡ giving more
-> Increase HR -> orders renal tubules blood to the brain
to reabsorb SODIUM ;
where sodium goes MECHANISM OF INFLAMMATION
water follows. Undergoes surgery > incision > tissue injury > SNS
>Testosterone triggered > Adrenal Medulla release NE causing
->Sex hormone Vasoconstriction > injured tissue release chemical
mediators (Ex. Histamine, Bradikinin, Prostaglandin)
Adrenal cortex causing Vasodilation > more blood will go to the
- Cortisol will order the liver to peform injured site causing Redness and Warmth to touch
glycogenolysis and gluconeogenesis because of increase blood supply. > d/t release of
because patient is in NPO > when there is Histamine > increase capillary permeability >
increased stress > hypermetabolism occurs > albumin goes out intravascularly to interstitial space
more glucose is needed because cells will thus Swelling happens. > d/t increase blood suppy
become hungry. there is pressure on the nerve endings beneath the
- Glycogenolysis (glycogen-glucose) > skin causing Pain and there is Loss of Function.
glucose is released because patient is - You have to clean the site very well
undergoing surgery > under stress > because they are going to create an
increased metabolism > increasing activity incision, if it is not clean bacteria will go in.
of cells, needing more food > cortisol orders - Pain is localized
the liver to produce more glucose > if the - WBCs phagocytize (a process called
liver runs out of glycogen, it will convert fats endocytosis) > it will ingest bacteria in the
and proteins to glucose (gluconeogenesis), form of lysosomes
which is not good. - Albumin (maintains osmotic pressure) will be
- patient is receiving IV fluids because of this allowed to go out from the intravascular
to counteract loss of glucose space to the third space > accumulation of
- aldosterone is a glucocorticoid produced albumin in the 3rd space > osmosis
by the adrenal cortex. It will reabsorb more (movement of water from higher to lower
Na (sodium), where sodium goes water area of concentrations) > water will go out
follows. - Hypertonic solution due to the release of
- Patient will be bleeding > needing albumin to the 3rd space.
increased volume > aside from bleeding Blood vessel dysfunction
client is in NPO, client also loses fluids - The capillaries connect the arterioles and
through respiration > no fluids are coming in venules
to the client’s body > sodium attracts water o This is where exchange of gases
to keep fluid balance occurs
Difference of aldosterone from ADH (anti-diuretic Functions of the inflammatory
hormone) - Prevents spread of the damaging agents
- Anti-diuretic hormone is released by the - Disposes of cell debris and pathogen
posterior pituitary gland. This will order the - Sets the stage for repair
renal tubules to reabsorb water decreasing - Inflammation sets the stage for healing >
fluid output. vasodilation > good amount of blood will go
- Aldosterone will reabsorb sodium which will to the damaged area > good amount of
attract water. nutrients, oxygen, and WBCs will also go to
Adrenal Medulla the area > flow in the blood in the wound is
- Releases two catecholamines: already preparing the site for healing.
Norepinephrine and Epinephrine - WBCs are activated during inflammation
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,6/7/24, 6:17 PM Medical Surgical Nursing- lecture
about:blank 2/180
,6/7/24, 6:17 PM Medical Surgical Nursing- lecture
- There is increase in heat during inflammation not cure (Ex. Nerve blocks placement of feeding
because heat will make it hard for the tubes)
bacteria to survive. - Patient is healthy but there is a problem
o Prevent the spread of damaging
agents Surgery based on urgency
o Forms a barrier to prevent the CLASSIFICATIO INDICATIONS EXAMPLES
bacteria from metastasizing N
Histamine – produced by circulating basophils, Emergent – Px Preserved the -Severe
platelets and mast cells adjacent to vessels requires function of bleeding
- (vasodilation, increased vascular immediate body parts or -Gunshot
permeability, endothelial activation) attention. ; it life of the -Fracture
Serotonin – produced mainly within platelets dense may be life patient. skull
body granules (vasodilation, increased vascular threatening c/o within 1-2
permeability) hours ; w/o
delay
Blood vessel dysfunction Urgent – px c/o within 24- -Repair of
- Capillaries leak out their walls requires prompt 48 hours. incision
- Caused by severe infection (sepsis) and attention -drainage of
certain diseases wound
infection
Capillary permeability Required – px Planned -cataracts
- Due to release of histamine of the injured needs to have
tissue it will alter capillary permeability and surgery
enlarge the pores of the blood vessels. Elective – px The patient is -repair of
Because of the enlargement of pores this should have in optimal scar
will cause the protein albumin to go out surgery. health, -vaginal
(albumin is the protein that controls the something repair
oncotic pressure inside the vessel) this will wrong but
cause the water to go out as well, from the can wait,
intravascular space to the third space done before
causing swelling. the disease
o Hypotonic: albumin inside the affects of
capillary threatens the
o Hypertonic: albumin outside the
quality of life.
capillary (inguinal
o Oncotic: fluid retained in blood hernia)
vessels because of pressure -satisfies
patient’s
GENERAL MANIFESTATION OF INFLAMMATION desires but
>Body weakness not needed
>Loss of Appetite to preserve
>Fever
life or
function.
Purposes of surgery (cosmetic
Diagnostics – confirmation of the suspected surgery)
diagnosis (ex. Biopsy, Endoscopy, Culture)
- To determine whether disease is benign or SURGICAL PROCEDURES CAN BE BROADLY
malignant. CATEGORIZED AS:
- Determines the cause
- ELECTIVE that which is planned
Explorative – confirms the type of and extent of the
- EMERGENCY that which is unplanned
disease (ex. Laboratory) Who is the most important part of the health care
Reconstructive – repair of physical deformities, team?
improves appearance. (Ex. Rhinoplasty, - The patient is the most important part of the
Mammoplasty, skin grafting)
health care team.
Currative – diseased or damaged body organ or - With the patient, nothing will be done or
structure is removed or repaired. (Ex. procedure will not push through
Appendectomy, Amputation, hysterectomy,
fixation of fractures)
Perioperative nursing
Palliative – alleviates pain or other disease
symptoms; slows progression of disease but does
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, 6/7/24, 6:17 PM Medical Surgical Nursing- lecture
about:blank 4/180
Medical Surgical Nursing
ADRENAL GLAND - Epinephrine increases cardiac rate because
patient is bleeding due to surgery > the
heart has to pump rapidly in order to give
more blood to the other systems of the body
(blood contains oxygen and nutrients)
Adrenal Medulla Adrenal Cortex - Norepinephrine causes vasoconstriction
(compensatory mechanism): Blood pressure
perform goes down (hypotension) due to bleeding
gluconeogenesis and ➡ decreasing blood supply to the brain ➡
glycogenolysis vasoconstriction ➡ arteries constricted ➡ no
perfused bleeding developed ➡ therefore
>Epinephrine >Aldosterone increasing blood pressure ➡ giving more
-> Increase HR -> orders renal tubules blood to the brain
to reabsorb SODIUM ;
where sodium goes MECHANISM OF INFLAMMATION
water follows. Undergoes surgery > incision > tissue injury > SNS
>Testosterone triggered > Adrenal Medulla release NE causing
->Sex hormone Vasoconstriction > injured tissue release chemical
mediators (Ex. Histamine, Bradikinin, Prostaglandin)
Adrenal cortex causing Vasodilation > more blood will go to the
- Cortisol will order the liver to peform injured site causing Redness and Warmth to touch
glycogenolysis and gluconeogenesis because of increase blood supply. > d/t release of
because patient is in NPO > when there is Histamine > increase capillary permeability >
increased stress > hypermetabolism occurs > albumin goes out intravascularly to interstitial space
more glucose is needed because cells will thus Swelling happens. > d/t increase blood suppy
become hungry. there is pressure on the nerve endings beneath the
- Glycogenolysis (glycogen-glucose) > skin causing Pain and there is Loss of Function.
glucose is released because patient is - You have to clean the site very well
undergoing surgery > under stress > because they are going to create an
increased metabolism > increasing activity incision, if it is not clean bacteria will go in.
of cells, needing more food > cortisol orders - Pain is localized
the liver to produce more glucose > if the - WBCs phagocytize (a process called
liver runs out of glycogen, it will convert fats endocytosis) > it will ingest bacteria in the
and proteins to glucose (gluconeogenesis), form of lysosomes
which is not good. - Albumin (maintains osmotic pressure) will be
- patient is receiving IV fluids because of this allowed to go out from the intravascular
to counteract loss of glucose space to the third space > accumulation of
- aldosterone is a glucocorticoid produced albumin in the 3rd space > osmosis
by the adrenal cortex. It will reabsorb more (movement of water from higher to lower
Na (sodium), where sodium goes water area of concentrations) > water will go out
follows. - Hypertonic solution due to the release of
- Patient will be bleeding > needing albumin to the 3rd space.
increased volume > aside from bleeding Blood vessel dysfunction
client is in NPO, client also loses fluids - The capillaries connect the arterioles and
through respiration > no fluids are coming in venules
to the client’s body > sodium attracts water o This is where exchange of gases
to keep fluid balance occurs
Difference of aldosterone from ADH (anti-diuretic Functions of the inflammatory
hormone) - Prevents spread of the damaging agents
- Anti-diuretic hormone is released by the - Disposes of cell debris and pathogen
posterior pituitary gland. This will order the - Sets the stage for repair
renal tubules to reabsorb water decreasing - Inflammation sets the stage for healing >
fluid output. vasodilation > good amount of blood will go
- Aldosterone will reabsorb sodium which will to the damaged area > good amount of
attract water. nutrients, oxygen, and WBCs will also go to
Adrenal Medulla the area > flow in the blood in the wound is
- Releases two catecholamines: already preparing the site for healing.
Norepinephrine and Epinephrine - WBCs are activated during inflammation
about:blank 1/180
,6/7/24, 6:17 PM Medical Surgical Nursing- lecture
about:blank 2/180
,6/7/24, 6:17 PM Medical Surgical Nursing- lecture
- There is increase in heat during inflammation not cure (Ex. Nerve blocks placement of feeding
because heat will make it hard for the tubes)
bacteria to survive. - Patient is healthy but there is a problem
o Prevent the spread of damaging
agents Surgery based on urgency
o Forms a barrier to prevent the CLASSIFICATIO INDICATIONS EXAMPLES
bacteria from metastasizing N
Histamine – produced by circulating basophils, Emergent – Px Preserved the -Severe
platelets and mast cells adjacent to vessels requires function of bleeding
- (vasodilation, increased vascular immediate body parts or -Gunshot
permeability, endothelial activation) attention. ; it life of the -Fracture
Serotonin – produced mainly within platelets dense may be life patient. skull
body granules (vasodilation, increased vascular threatening c/o within 1-2
permeability) hours ; w/o
delay
Blood vessel dysfunction Urgent – px c/o within 24- -Repair of
- Capillaries leak out their walls requires prompt 48 hours. incision
- Caused by severe infection (sepsis) and attention -drainage of
certain diseases wound
infection
Capillary permeability Required – px Planned -cataracts
- Due to release of histamine of the injured needs to have
tissue it will alter capillary permeability and surgery
enlarge the pores of the blood vessels. Elective – px The patient is -repair of
Because of the enlargement of pores this should have in optimal scar
will cause the protein albumin to go out surgery. health, -vaginal
(albumin is the protein that controls the something repair
oncotic pressure inside the vessel) this will wrong but
cause the water to go out as well, from the can wait,
intravascular space to the third space done before
causing swelling. the disease
o Hypotonic: albumin inside the affects of
capillary threatens the
o Hypertonic: albumin outside the
quality of life.
capillary (inguinal
o Oncotic: fluid retained in blood hernia)
vessels because of pressure -satisfies
patient’s
GENERAL MANIFESTATION OF INFLAMMATION desires but
>Body weakness not needed
>Loss of Appetite to preserve
>Fever
life or
function.
Purposes of surgery (cosmetic
Diagnostics – confirmation of the suspected surgery)
diagnosis (ex. Biopsy, Endoscopy, Culture)
- To determine whether disease is benign or SURGICAL PROCEDURES CAN BE BROADLY
malignant. CATEGORIZED AS:
- Determines the cause
- ELECTIVE that which is planned
Explorative – confirms the type of and extent of the
- EMERGENCY that which is unplanned
disease (ex. Laboratory) Who is the most important part of the health care
Reconstructive – repair of physical deformities, team?
improves appearance. (Ex. Rhinoplasty, - The patient is the most important part of the
Mammoplasty, skin grafting)
health care team.
Currative – diseased or damaged body organ or - With the patient, nothing will be done or
structure is removed or repaired. (Ex. procedure will not push through
Appendectomy, Amputation, hysterectomy,
fixation of fractures)
Perioperative nursing
Palliative – alleviates pain or other disease
symptoms; slows progression of disease but does
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, 6/7/24, 6:17 PM Medical Surgical Nursing- lecture
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