Methodical pointing to work of students on practical employment

Semantic module 1 Practical employment №7 Theme: Surgical operation. Preparation of patient to the operations. After operation period. Care of patients in after operation period.

Theoretical questions for the extra auditory independent study and discussion to practical employment № 7:

1. Determination of before operation period.

2. Classification of operative interferences depending on urgency of their implementation.

3. Features of preparation of patients to the planned and urgent operative interferences.

4. Transporting of patient in an operating-room and from an operating-room.

5. Operation, types of operative interferences.

6. Basic conclusions of patient with operating table.

7. The after operation period and phases of his motion.

8. Basic biochemical changes in an organism as a result of operating trauma.

9. Motion of after operation period, basic complications, their prophylaxis, medical treatment.

10. Methods of artificial feed of patients in a after operation period, basic dietary tables.

11. Complex prophylaxis of bedsores at lying patients, care of patient which bedsore is in.

12. Feeding of seriously sicking by means the spoon, feeding tube.

Literature:

The basic literature:

1. Butyrsky A. General surgery. – Simferopol. 2004.

2. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

1. Kushnir R. Lectures of General surgery. – 2005.

2. Lyapis M.A. Methods of examination of a surgical patients. – 2004.

3. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

Distributing of marks, that can get students:

At mastering of theme № 7 with to the module № 1 for educational activity to the student the estimation for 4th is proposed by a mark (traditional) scale which are after converted in marks as follows:

Estimation	Marks
“5”(fine)	6 marks
“4” (well)	4 marks
“3”(satisfactory)	2 marks
“2” (negative)	0 marks

Semantic module 1

Practical employment №7

Theme: Surgical operation. Preparation of patient to the operations. After operation period. Care of patients in after operation period.

1. Actuality of theme.

Quite often after surgical medical treatment there are complications which difficulty process of convalescence. Therefore preparation of patient to the operation includes at itself the row of prophylactic measures as common so local, directed on warning complications as during the operation so in a after operation period. The surgical operation and anesthesia cause definite changes in the organism of man, which carry a general character and are an answer for an operating trauma. Correct introduction of patient in a after operation period, organization of stay of him in the separation, implementation of necessary manipulations and procedures on examination have extraordinarily the important value for the prophylaxis of possible complications and favorable result of medical treatment. The favorable result of medical treatment of patient in a after operation period in a large measure relies not only on adequacy of the executed operation, but also from knowledge and professional abilities of middle and junior medical personnel. Consequently the capture by practical skills and professional abilities on the care of patients, that carried operative interference, is important for all workers of surgical separation.

ІІ. Whole employments:

1. To have imagination about a before operation period.

2 To know classification of operative interferences depending on urgency of their implementation.

3. To know the features of preparation of patients to the planned and urgent operative interferences.

4. To be able to conduct transporting of patient in an operating-room and from an operating-room.

5. Students must familiarize with notion the operation, by the types of operative interferences.

6. To master the basic conclusions of patient with operating table.

7. To know determination of after operation period and phase of his motion.

8. To learn the basic biochemical changes in an organism as a result of operating trauma.

9. To become acquainted with motion of after operation period, basic complications, their prophylaxis, medical treatment.

10. To master the methods of artificial feed of patients in a after operation period, to familiarize with basic dietary tables.

To be able to conduct the complex prophylaxis of bedsores at lying patients, to look after a patient which bedsore is in.

ІІІ. Providing of initial level of knowledge-abilities

Literature:

The basic literature:

3. Butyrsky A. General surgery. – Simferopol. 2004.

4. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

4. Kushnir R. Lectures of General surgery. – 2005.

5. Lyapis M.A. Methods of examination of a surgical patients. – 2004.

6. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

ІІІ. Providing of initial level of knowledge-abilities

Tests and tasks for verification of initial level of knowledge

1. When it is necessary to conduct shaving of skin before the planned operation?

A. At the day.

B. In the evening before the operation.

C. In the morning in the day of operation.

D. Shave is not conducted.

E. Not earlier, as for 6 hours before the operation (+).

2. Source endogenous infection there can be all, except for:

A. Chronic tonsillitis.

B. There are carious teeth.

C. Purulent disease of skin.

D. Chronic osteomielitis.

E. Obliterate endarteritis (+).

3. To diagnostic operations belong:

A. Appendectomy.

B. Herniotomy.

C. Biopsy lymphatic knots (+).

D. Setting dislocation of shoulder.

E. Inersion whitlow (panaritium).

4. After urgency of conducting of operation divide on:

A. Urgent, emergency, palliative.

B. Planned, emergency, multistage.

C. Urgent, emergency, planned (+).

D. Radical, planned, palliative.

E. Diagnostic, unurgent, one stage.

5. Planned the operations are executed at:

A. Acute appendicitis.

B. Strangulated hernia.

C. Bleeding from the damaged vessel.

D. Asphyxia.

E. Calculus cholecystitis (+).

6. Operation on by a vital testimony is executed at:

A. Bleeding which proceeds (+).

B. Benign tumors.

C. Maligned tumors.

D. Obliterate endarteritis.

E. Varicose expansion of veins of lower extremities.

7. Prophylaxis trombembolism complications after the operation includes:

A. Apply bandage lower extremities by an elastic bandage.

B. Apply anticoagulants.

C. Apply disaggregates.

D. Early get up from a bed.

E. All higher transferred (+).

8. Call measures which are directed on the prophylaxis of pulmonary complications after the operation:

A. Prescribe preparations of iron.

B. Inhalation of nitric oxide.

C. Do washing stomach.

D. Breathing gymnastics (+).

E. Cold on a belly.

9. Prophylaxis suppuration of operating wound.

A. A lot of stitches on a wound.

B. Resorption stitches on a wound.

C. Drainage of wounds (+).

D. Remedial gymnastics.

E. Hermetic bandage.

10. To complications from the side of operating wound all belongs except for:

A. Bleeding.

B. Hematoma.

C. Infiltration.

D. Pain in a wound (+).

E. Eventration.

11. At presence of bedsores it is necessary all, except for:

A. Position the patient with a hard mattress (+).

B. Use inflatable circles.

C. Wipe skins by a camphoric alcohol.

D. Change position of patient abed.

E. Wipe soft what fabrics in the region of bedsores, remaking of bed of sick.

12. Patient, 38 years, operated concerning ulcerous illness of stomach. The executed resection of stomach for Bilrot - 1. During the operation a probe is set for the feed. When it is possible to feed a patient through a probe?

A. At once after the operation.

B. During 6 hours after the operation.

C. During 2-3 days after the operation.

D. During 24 hours after the operation.

E. After renewal of peristalsis (+).

13. Patient purchased scarce medications. Them a patient can enter:

A. On insistency of patient.

B. After consultations with the trained nurse.

C. According recommendations of manager by the separation.

D. After setting by their treating doctor (+).

E. After concordance with a main doctor.

14. Sick with a diagnosis sharp appendicitis acted in the surgical separation, two hours backwards the sick had dinner . How to prepare a patient to operative interference ?

A. Make cleansing enema

B. Make noose-gastric probe

C. to washing stomach (+)

D. Introduction of atropine during premedication

E. Special preparation is not needed

15. By radical operations take :

A. Cholecystistectomy (+).

B. Gastrostomy

C. Gastroenteroanastomosis

D. Biopsy

E. Punction joint

16 What preparation to the planned operation in the day of operation consists:

A. Shave operating field (+).

B. Take bath or shower

C. Transfusion of blood

D. Washing of stomach

E. Cleaning enema

17. What moment a before operation period begins

A. From the beginning of disease

B. From the moment of raising of diagnosis

C. From the moment of hospitalization of patient

D. From the moment of consent of patient with the operation (+)

E. From the moment of beginning of preparation to the operation

18. What the diseases need emergency operative interference

A. Cancer

B. Perforation ulcer of gastric (+)

C. Strangulates hernia (+)

D. Lipoma

E. Tonsillectomy

19.За the term of implementation operative interferences is:

A. urgent (+)

B. timely

C. emergency (+)

D. palliative

E. radical

20. Before operation by measures, that diminish the risk of infection of after operation wound is:

A. bed mode

B. shaving of hair in the area of the future operating field 2 hours prior to the operation (+)

C. application of alcoholic compress on the area of the future operating field

D. setting of sleeping-pills in eve the operation

E. sanation of mouth cavity (+)

21. By what purpose do not allow a patient to eat before the operation?

A. meal of the difficulty conducting in a stomach to the probe

B. meal of difficulty management by breathing during the operation

C. the reception of meal before the operation can entail vomit during general anesthesia (+)

D. the reception of meal before the operation can entail development of acidosis

E. the presence of maintenance in a stomach during intubation of trachea can entail regurgitation (+)

22. For the prophylaxis of allergic reactions during implementation of operative interference and in a after operation period to all patients conduct:

A. internal-skin test on novocaine (+)

B. internal-skin test on an antibiotic, that will be applied at medical treatment (+)

C. internal-skin test on an analgin

D. internal-skin test on chemical facilities antiseptic

E. internal-skin test on antihistaminic preparations

23. What appearance, transporting of patient in an operating-room must be conducted by?

A. to the operating-room a patient goes independently, if allows his state him

B. on wheel-stretcher in recumbence (+)

C. on loads in recumbence (+)

D. on handset

E. on wheel-stretcher in sit position

24. After operation period this:

A. period from the moment of ending of operation to convalescence of sick (+)

B. period from the moment of hospitalization of patient to his excerption from the separation

C. period from the moment of operation to excerption of patient from the separation

D. period from the moment of operation to transition of patient with ambulatory medical treatment

E. period from the moment of ending of operation to transference a patient with disability (+)

25. After operation divide a period on:

A. middle

B. early (+)

C. small

D. it is remote (+)

E. prolonged

26. Course after operation period can be:

A. it is balanced

B. functional

C. normal (it is uncomplicated) (+)

D. physiology

E. it is complicated (+)

27. In after operation period the following phases distinguish:

A. anabolic (+)

B. reverse development (+)

C. pathological

D. physiological

E. decompensations

28. To measures it is possible to take on the prophylaxis of bedsores:

A. wiping of “dangerous areas” of body of patient out by a 5% alcoholic solution of iodine

B. application of the sacs filled by the seed of millet or flax (+)

C. wiping of “dangerous areas” of body of patient out by a 10% solution of camphoric alcohol (+)

D. appendix to the places of possible defeat of alcohol compress

E. providing to the patient of permanent position on the back

29. The feed of patient after the operation can be:

A. interstitial

B. enteral (+)

C. internal

D. parenteral (+)

E. parenchimatosis

30. Replacement of bed linen is conducted:

A. at once after contamination by biological liquids (+)

B. in 2 hours after contamination by biological liquids

C. one time on a day

D. one time on 15 days

E. one time on 7-10 days (+)