Alexander's Care of the Patient in Surgery - E-Book

by Jane C. Rothrock

Overview

For more than 60 years, Alexander's Care of the Patient in Surgery has been an essential resource for perioperative nursing care. The detailed instruction in this thirteenth edition continues in the tradition of providing explanations of more than 400 contemporary and traditional specialty surgical interventions and numerous minimally invasive surgical procedures. In addition, a Special Considerations unit includes separate chapters for ambulatory, pediatric, geriatric, and trauma surgeries, as well as complementary and alternative therapies.

You'll find nearly 1000 full-color illustrations and photos to help you become familiar with surgical anatomy, procedures, methods, and equipment coupled with the latest trends and practices including patient and family education and safety-including the most recent JCAHO initiatives and updated OSHA guidelines regarding workplace safety. Alexander's Care of the Patient in Surgery provides you with all of the information you need to deliver safe, cost-effective, high-quality patient care.

Product Details

ISBN-13:	9780323532990
Publisher:	Elsevier Health Sciences
Publication date:	01/16/2018
Sold by:	Barnes & Noble
Format:	eBook
Pages:	1248
Sales rank:	359,826
File size:	82 MB
Note:	This product may take a few minutes to download.

Table of Contents

Foundations for Practice
Concepts Basic to Perioperative Nursing     1
Overview of Perioperative Nursing Practice     1
Perioperative Patient Focused Model     2
Standards of Clinical Nursing Practice     3
Nursing Process     3
Perioperative Nursing Practice Standards     11
Standards of Professional Performance     11
Institutional Standards of Care     12
Performance Measurement     12
Evolving Perioperative Nursing Roles     12
Registered Nurse First Assistant     13
Nursing Informatics Specialist     13
Advanced Practice     13
Patient and Environmental Safety     15
Safe Environment     15
Safety Design Features     15
Physical Plant Design Elements     16
Emergency Signals     17
Staff Safety     17
Emergency and Disaster Preparedness     18
Electrical and Fire Hazards     18
Radiation Safety     19
Latex Allergy     20
Patient Safety     21
Patient Safety Standards     21
Maintaining Fluid and Electrolyte Balance     31
Estimating Blood Loss     36
Handling Blood and Blood Products     36
Maintaining Normothermia in a Surgical Patient     38
Care and Handling of Specimens     38
Sponge, Sharp, and Instrument Counts     39
Cardiopulmonary Resuscitation     42
Malignant Hyperthermia     42
Infection Prevention and Control in the Perioperative Setting     44
Causes of Infection     44
Asepsis     44
Microorganisms That Cause Infection     45
Drug-Resistant Bacteria: Emerging and Resurging Organisms     48
Controlling Infection     52
Universal Standard and Transmission-Based Precautions     52
Engineering Practices to Control Infection     57
Practices to Prevent Infection     58
Aseptic Practices to Control Infection     75
Surgical Aseptic Principles     75
Traffic Control     77
Surgical Attire     78
Surgical Hand Antisepsis     79
Gowning     83
Gloving     84
Removing Soiled Gown Gloves and Mask     86
Patient Skin Disinfection and Preparation     86
Creating the Sterile Field with Surgical Drapes     90
Environmental Cleaning      93
Bioterrorism     94
Anthrax     94
Smallpox     95
Plague     95
Tularemia     96
Botulism     96
Viral Hemorrhagic Fevers     96
Emergency Preparedness     96
Progressive Knowledge     96
Anesthesia     100
History of Anesthesia     100
Anesthesia Providers     100
Patient Safety     102
Awareness During Anesthesia     102
Preoperative Preparation     103
Patient Evaluation     103
Choice of Anesthesia     103
Premedications     104
Types of Anesthesia Care     105
General Anesthesia     105
Regional Anesthesia     105
Monitored Anesthesia Care     105
Conscious Sedation/Analgesia     105
Local Anesthesia     105
Perioperative Monitoring     105
Pulse Oximetry     107
Capnography     108
Anesthesia Machines and Anesthetic Gases     108
General Anesthesia     110
Mechanism of Action     110
Levels of General Anesthesia      110
Phases of General Anesthesia     113
Types of General Anesthesia     113
Muscle Relaxants     114
Typical Sequence of General Anesthesia     114
Regional Anesthesia     119
Spinal Anesthesia     119
Epidural and Caudal Anesthesia     120
Peripheral Nerve Blocks     122
Intravenous Regional Anesthesia     122
Monitored Anesthesia Care     122
Conscious Sedation/Analgesia     122
Local Anesthesia     123
Pain Management     124
Temperature Control     125
Malignant Hyperthermia     125
Safety of Health Care Workers     126
Operating Room Pollution     127
Perioperative Nursing Considerations     128
Positioning the Patient for Surgery     130
Anatomic and Physiologic Considerations     130
Skin and Underlying Tissue     130
Musculoskeletal System     135
Nervous System     135
Vascular System     140
Respiratory System     141
Other Vulnerable Areas     141
Perioperative Nursing Considerations     142
Operating Room Beds      145
Operating Room Bed Parts and Accessories     145
Mattress Materials and Their Pressure-Reducing Properties     146
Pressure-Reduction Considerations     146
Standard Surgical Positions     147
Supine     148
Trendelenburg     149
Reverse Trendelenburg     150
Fracture Table Position     150
Lithotomy     150
Semi-Fowler     153
Fowler     153
Prone     154
Jackknife     154
Knee-Chest     155
Lateral     155
Sutures, Needles, and Instruments     158
Suture Materials     158
Characteristics of Suture Material     158
Types of Suture Material     160
Packaging, Storage, and Selection of Sutures     164
Types of Packaging     164
Selection of Suture     165
Hemostasis     165
Methods of Ligating Vessels     165
Ligating Clips     165
Skin Staples     166
Skin Tapes     166
Surgical Adhesives     167
Surgical Needles     167
Eye     167
Body      168
Suturing Methods     168
Closure of Wounds     168
Endoscopic Suturing     169
Holding a Drain In Place     170
Knot-Tying Technique     170
Endoscopic Knot Tying     170
Perioperative Nursing Considerations     171
General Considerations     171
Opening Primary Packets     171
Handling Suture Materials     171
Threading Surgical Needles     171
Counting Needles     172
Sharps No-Touch Technique     172
Instruments     173
Historical Perspective     173
Composition of Surgical Instruments     174
Instrument Categories     175
Endoscopic Instrumentation     178
Stapling Instruments     179
Selecting and Preparing Instruments for Patient Use     180
Basic Table Setups     180
Care and Handling of Instruments     181
Instrument Counts     181
Patient Safety     181
Storing Instruments     182
Surgical Modalities     183
Endoscopic Minimally Invasive Surgery     183
Endoscopes     183
Light Sources and Fiberoptic Cables     184
Endoscopic Instrumentation     186
Video Technology     195
Evolution of Video Technology     195
Visualization Systems     197
Robotics     201
Videoconferencing     202
Endoscopic Practices and Potential Risks     203
Insufflation     203
Complications and Anesthetic Considerations During Endoscopic Minimally Invasive Surgery     204
Energies Used During Surgery     205
Laser     205
Electrosurgery     219
Ultrasonic Device Surgery     225
Hydrodissection and Irrigation     226
Cryosurgery     227
Wound Healing, Dressings, and Drains     228
Anatomy     228
Etiology of Wounds     228
Types of Wound Closure     228
Primary Intention     228
Secondary Intention (Granulation)     229
Delayed Primary Closure or Tertiary Intention     229
Phases of Healing     229
Inflammatory Phase     229
Proliferative Phase     231
Remodeling Phase     232
Factors Affecting Wound Healing     232
Wound Classification      235
Clean Wounds (Class I)     236
Clean Contaminated Wounds (Class II)     236
Contaminated Wounds (Class III)     236
Dirty or Infected Wounds (Class IV)     236
Antimicrobial Prophylaxis     236
Wound Management     238
Debridement     238
Hyperbaric Oxygenation (HBO)     239
Negative Pressure Wound Therapy     239
Hydrotherapy     239
Skin Substitutes     239
Growth Factors     240
Dressings     240
Drains     243
Postoperative Patient Care and Pain Management     246
Perianesthesia Considerations     246
Discharge From the Postanesthesia Care Unit     264
Admission to the Surgical or Short Procedure Unit     264
Postoperative Nursing Considerations     264
Patient Education and Discharge Planning     271
Importance of Patient Education     271
Historical Development     271
Trends in Patient Education     273
Assessment     274
Assessment of Individual Patient Education Needs     274
Assessment of Individual Readiness to Learn     274
Discharge Planning      278
Planning     280
Models for Planning Patient Education     280
Plans of Care Specific to Each Diagnosis     283
Implementation     285
Nursing Activities: Case Studies     285
Selecting Content in Preoperative and Postoperative Teaching     287
Facilitating Learning     288
Documentation     295
Surgical Interventions
Gastrointestinal Surgery     297
Surgical Anatomy     297
Perioperative Nursing Considerations     301
Surgical Interventions     312
Abdominal Incisions     312
Vertical Midline Incisions     313
Oblique Incisions     314
Transverse Incisions     314
Laparotomy     315
Laparoscope     318
Endoscopic Procedures     319
Esophagogastroduodenoscopy (Upper Endoscopy)     320
Small Bowel Enteroscopy     320
Colonoscopy and Sigmoidoscopy (Lower Endoscopy)     320
Procedures for Gastroesophageal Reflux Disease     321
Procedures for Barrett's Esophagus     321
Self-Expanding Metal Stents     322
Surgery of the Esophagus      322
Esophagectomy     322
Transhiatal Esophagectomy     322
Transthoracic Esophagectomy     322
Video-Assisted Thoracotomy Surgery (VATS)     323
Excision of Esophageal Diverticulum     323
Esophageal Hiatal Hernia Repair and Antireflux Procedure     323
Laparascopic Nissen Fundoplication     324
Esophagomyotomy (Heller Procedure)     325
Esophageal Dilation     326
Surgery of the Stomach     326
Vagotomy     326
Pyloroplasty (Pyloromyotomy)     326
Gastrostomy     327
Percutaneous Endoscopic Gastrostomy (PEG)     328
Gastrotomy     329
Closure of Perforated Gastric or Duodenal Ulcer     329
Gastrojejunostomy     329
Partial Gastrectomy-Billroth I and Billroth II     331
Total Gastrectomy     332
Bariatric Surgery     335
Laparoscopic Roux-en-Y Gastric Bypass     336
Surgery of the Small Bowel     337
Meckel's Diverticulectomy     337
Appendectomy     340
Laparoscopic Appendectomy     340
Resection of the Small Intestine     340
Ileostomy      341
Intestinal Transplantation     341
Surgery of the Colon     342
Laparoscopic Colectomy     342
Colostomy     342
Closure of a Colostomy     344
Right Hemicolectomy and Ileocolostomy     345
Transverse Colectomy     345
Anterior Resection of the Sigmoid Colon and Rectosigmoidostomy     345
Abdominoperineal Resection     347
Ileoanal Endorectal Pull-Through     350
Surgery of the Rectum     350
Hemorrhoidectomy     350
Excision of Anal Fissure and Lateral Sphincterotomy     352
Excision of Pilonidal Cyst and Sinus     353
Surgery of the Liver, Biliary Tract, Pancreas, and Spleen     356
Surgical Anatomy     356
Perioperative Nursing Considerations     358
Surgical Interventions     369
Surgery of the Biliary Tract     369
Cholecystectomy (Open Approach)     369
Intraoperative Cholangiogram     370
Laparoscopic Cholecystectomy     372
Robotic-Assisted Laparoscopic Cholecystectomy     374
Cholecystostomy (Open Procedure)     375
Open Common Bile Duct Exploration     376
Cholecystoduodenostomy and Cholecystojejunostomy     376
Choledochoduodenostomy and Choledochojejunostomy     377
Transduodenal Sphincteroplasty     378
Surgery of the Pancreas     379
Drainage or Excision of Pancreatic Cysts (Open Method)     379
Laparoscopic Pancreatic Cyst-Gastrostomy     380
Robotic-Assisted Laparoscopic Pancreatic Procedures     381
Pancreaticoduodenectomy (Whipple Procedure)     381
Pancreatic Transplantation     382
Surgery of the Liver     384
Drainage of Abscess     384
Hepatic Resection     384
Robotic-Assisted Laparoscopic Hepatic Surgery     386
Radioimmunoguided Surgery     386
Liver Transplantation     386
Donor Hepatectomy     389
Living-Related Liver Transplantation     390
Surgery of the Spleen     390
Splenectomy (Open Approach)     390
Laparoscopic Splenectomy     391
Repair of Hernias     393
Surgical Anatomy     393
Inguinal Hernias     393
Femoral Hernias     395
Abdominal Hernias     395
Direct and Indirect Inguinal Hernias     396
Perioperative Nursing Considerations     396
Surgical Interventions     400
Surgery for Repair of Groin Hernias     400
Repair of Inguinal Hernias     400
Surgery for Repair of Hernias of the Anterior Abdominal Wall     408
Ventral or Incisional Hernias     408
Umbilical Hernias     409
Epigastric Hernias     409
Spigelian Hernias     409
Interparietal Hernias     409
Snythetic Mesh and Patch Repairs     409
Gynecologic and Obstetric Surgery     411
Surgical Anatomy     411
Female External Genital Organs (VULVA)     411
Pelvic Cavity     411
Uterus     411
Fallopian Tubes (Oviducts)     411
Ovaries     413
Ligaments of the Uterus     414
Vagina     414
Cervix     414
Bony Pelvis     414
Pelvic Floor     415
Vascular Nerve and Lymphatic Supply of the Reproductive System     415
Perioperative Nursing Considerations     415
Lasers in Gynecologic Surgery     426
Surgical Interventions     426
Vulvar Surgery     426
Excision of Condylomata Acuminata      426
Simple Vulvectomy     427
Skinning Vulvectomy     427
Radical Vulvectomy and Groin Lymphadenectomy     427
Vestibulectomy and Vestibuloplasty     428
Gynecologic Surgery Using Vaginal Approach     429
Plastic Reconstructive Repair of the Vagina (Anterior and Posterior Repair; Colporrhaphy)     429
Operations for Urinary Stress Incontinence     434
Construction of a Vagina     435
Trachelorrhaphy     435
Dilation of the Cervix and Curettage (D&C)     436
Suction Curettage     437
Removal of Pedunculated Cervical Myomas (Cervical Polyps)     438
Conization and Biopsy of the Cervix     438
Cesium Applicator Insertion for Cervical and Endometrial Malignancy     438
Posterior Colpotomy (Culdotomy)     439
Marsupialization of Bartholin Duct Cyst or Abscess     440
Hysteroscopy     440
Endometrial Ablation     441
Vaginal Hysterectomy     442
Gynecologic Surgery Using Abdominal Approach     442
Laparoscopy     442
Pelviscopy     444
Ectopic Tubal Pregnancy     444
Ovarian Cystectomy     445
Laparoscopic-Assisted Vaginal Hysterectomy     446
Total Abdominal Hysterectomy (TAH)     447
Abdominal Myomectomy     448
Uterine Fibroid Embolization     448
Radical Hysterectomy (Wertheim)     450
Pelvic Exenteration     452
Surgery for Conditions that Affect Fertility     454
Uterine Suspension     454
Oophorectomy and Oophorocystectomy     454
Salpingo-Oophorectomy     455
Microscopic Reconstructive Surgery of the Fallopian Tube     456
Tubal Ligation     456
Assisted Reproductive Therapies for Infertility     459
Obstetric Surgery     459
Cervical Cerclage     460
Abdominal Surgery During Pregnancy     462
Fetal Surgery     462
Cesarean Birth     463
Genitourinary Surgery     467
Surgical Anatomy     467
Kidneys     467
Adrenal Glands     467
Ureters     467
Urinary Bladder     468
Urethra     469
Prostate Gland     470
Male Reproductive Organs     470
Perioperative Nursing Considerations     472
Surgical Interventions      482
Interventional Uroradiology     482
Diagnostic and Endoscopic Procedures     482
Cystoscopy     482
Periurethral-Transurethral Injection of Bulking Agents     485
Transurethral Ureteropyeloscopy     485
Surgery of the Penis and the Urethra     486
Laser Ablation of Condylomas and Penile Carcinoma     486
Circumcision     486
Excision of Urethral Caruncle     487
Urethral Meatotomy     487
Urethral Dilation and Internal Urethrotomy     487
Urethroplasty     488
Penectomy     489
Penile Implant     490
Deep Dorsal and Emissary Vein Ligation     494
Revascularization of the Penile Arteries     494
Surgery of the Scrotum and Testicles     494
Hydrocelectomy     494
Vasectomy     495
Vasovasostomy     495
Microscopic Epididymal Sperm Aspiration     496
Epididymectomy     496
Spermatocelectomy     496
Varicocelectomy     496
Testicular Biopsy     497
Orchiectomy     497
Radical Lymphadenectomy (Retroperitoneal Lymph Node Dissection)     498
Surgery of the Prostate Gland     498
Prostatic Core Needle Biopsy     499
Transurethral Resection of the Prostate Gland     501
Transurethral Incision of the Prostate     502
Transurethral Incision of the Ejaculatory Ducts     504
Photoselective Vaporization of the Prostate     504
Interstitial Laser Coagulation of the Prostate (Indigo)     504
Transurethral Microwave Therapy/Transurethral Needle Ablation     505
Simple Retropubic Prostatectomy     505
Suprapubic Prostatectomy     507
Simple Perineal Prostatectomy     508
Transrectal Seed Implantation (Interstitial Radiotherapy with Brachytherapy)     510
Transrectal Cryosurgical Ablation of the Prostate Gland     513
Nerve-Sparing Radical Retropubic Prostatectomy with Pelvic Lymphadenectomy     514
Radical (Total) Perineal Prostatectomy     517
Laparoscopic Radical Prostatectomy     520
Surgery of the Bladder     521
Suprapubic Cystostomy     522
Transurethral Resection of Bladder Tumors     522
Transurethral Laser Ablation of Bladder Tumors     522
Alternatives to Surgery for Superficial Bladder Cancer     523
Trocar Cystostomy     523
Suprapubic Cystolithotomy     524
Repair of Vesical Fistulas     524
Vesicourethral (Marshall-Marchetti-Krantz) Suspension     526
TVT Sling (Tension-Free Vaginal Tape)     526
Transvaginal Sling with Bone Anchor     528
Implantation of InterStim Sacral Nerve Stimulator (Neuromodulator)     529
Male Sling     530
Bladder Augmentation     530
Implantation of Prosthetic Urethral Sphincter     532
Radical Cystectomy with Pelvic Lymphadenectomy     533
Bladder Substitution (Substitution Cystoplasty)     535
Cutaneous Urinary Diversions     535
Continent Urinary Diversions     536
Surgery of the Ureters and Kidneys     537
Surgery of the Ureter     538
Surgery of the Kidney     539
Kidney Transplant     545
Adrenalectomy     549
Thyroid and Parathyroid Surgery     553
Surgical Anatomy     553
Thyroid Gland     553
Parathyroid Gland     553
Perioperative Nursing Considerations     554
Surgical Interventions     560
Unilateral Thyroid Lobectomy, Subtotal Lobectomy, Bilateral Subtotal Lobectomy, Near-Total Thyroidectomy, and Total Thyroidectomy      560
Substernal or Intrathoracic Thyroidectomy     563
Thyroglossal Duct Cystectomy     563
Parathyroidectomy     564
Breast Surgery     566
Surgical Anatomy     566
Benign Lesions of the Breast     566
Breast Cancer     567
Screening Technologies     569
Diagnostic Techniques     571
Surgical Treatment Options     571
Perioperative Nursing Considerations     573
Surgical Interventions     576
Biopsy of Breast Tissue     576
Open Breast Biopsy     576
Open Breast Biopsy with Needle (Wire) Localization     578
Incision and Drainage for Abscess     578
Lumpectomy (Segmental Resection)     579
Sentinel Lymph Node Biopsy     579
Using Isosulfan Blue Dye     580
Using Technetium     581
Axillary Node Dissection     581
Subcutaneous Mastectomy (Adenomammectomy)     582
Simple Mastectomy     582
Modified Radical Mastectomy     582
Ophthalmic Surgery     585
Surgical Anatomy     585
Bony Orbit     585
Lacrimal Apparatus      585
Conjunctiva and Eyelids     585
Muscles     586
Globe     587
Refractive Apparatus     590
Nerve and Blood Supply     590
Perioperative Nursing Considerations     591
Surgical Interventions     603
Surgery of the Eyelids     603
Removal of Chalazion     603
Repair of Entropion     604
Repair of Ectropion     604
Plastic Repair for Dermatochalasis     604
Surgery for Unilateral or Bilateral Ptosis     605
Excisional Biopsy     608
Plastic Repair for Traumatic Injuries     608
Surgery of the Lacrimal Gland and Apparatus     608
Surgery of the Lacrimal Fossa     608
Dacryocystorhinostomy     608
Surgery of the Globe and Orbit     609
Enucleation     609
Evisceration     610
Repair of Fracture of the Orbit (Blowout)     610
Exenteration     611
Myectomy     611
Tuck     611
Surgery of the Conjunctiva     611
Pterygium Excision     611
Excisional Biopsy     611
Surgery of the Cornea      612
Repair of Lacerations     612
Corneal Transplantation (Keratoplasty)     612
Keratorefractive Procedures     614
Surgery of the Lens     615
Cataract Extraction     615
Surgery for Glaucoma     618
Iridectomy     618
Trabeculectomy     618
Glaucoma Drainage Devices     620
Goniotomy     620
Laser Therapy and Photocoagulation     620
Laser Trabeculoplasty     620
Laser Iridotomy     621
Laser Cyclophotocoagulation     621
Laser Photocoagulation     621
Photodynamic Therapy     622
Surgery for Retinal Detachment     622
Scleral Buckling     622
Retinopexy     623
Vitrectomy     624
Anterior Segment Vitrectomy     624
Posterior Segment Vitrectomy     625
Otologic Surgery     630
Surgical Anatomy     630
External Middle and Inner Ear     630
Cochlea     631
Vestibular Labyrinth     631
Hearing     632
Equilibrium     633
Facial Nerve     633
Perioperative Nursing Considerations     633
Surgical Interventions     643
Incisional Approaches     643
Endaural Approach     643
Transcanal Approach     643
Postauricular Approach     644
Otologic Procedures     644
Myringotomy     644
Tympanoplasty     646
Mastoidectomy     647
Stapedectomy     648
Ossicular Chain Reconstruction     650
Endolymphatic Sac Decompression or Shunt     650
Labyrinthectomy     651
Vestibular Neurectomy     651
Facial Nerve Decompression     652
Removal of Acoustic Neuroma (Vestibular Schwannoma)     653
Assistive Hearing Devices     654
Cochlear Implantation     654
Implantable Hearing Aids     655
Rhinologic and Sinus Surgery     657
Surgical Anatomy     657
Perioperative Nursing Considerations     657
Surgical Interventions     666
Rhinologic Surgery     666
Nasoseptoplasty or Submucous Resection of the Septum (SMR)     666
Corrective Rhinoplasty     666
Repair of Nasal Fracture     667
Treatment of Epistaxis      667
Sinus Surgery     668
Endoscopic Sinus Surgery     668
Computer-Assisted Endoscopic Sinus Surgery     669
Microdebriders     670
Frontal Sinus Trephination     671
Frontal Sinus Operation (External Approach)-Trephination and Obliteration     671
Ethmoidectomy     672
Sphenoidotomy     672
Nasal Polypectomy     672
Turbinectomy and Outfracture Coagulation of Turbinates     672
Caldwell-Luc with Radical Antrostomy     672
Laryngologic and Head and Neck Surgery     674
Surgical Anatomy     674
Oral Cavity     674
Pharynx     674
Larynx and Associated Structures     675
General Structures of the Neck     676
Perioperative Nursing Considerations     677
Surgical Interventions     684
Surgery of the Oral Cavity and Pharynx     684
Salivary Gland Surgery     685
Excision of the Submandibular Gland     685
Parotidectomy     685
Uvulopalatopharyngoplasty     687
Laryngeal Surgery     688
Endoscopic Procedures     689
Adjunctive Procedures      691
Open Laryngeal Procedures     692
Neck Surgery     697
Tracheostomy     697
Radical Neck Dissection     700
Modified Neck Dissection     702
Reconstructive Procedures     703
Orthopedic Surgery     704
Surgical Anatomy     704
Anatomic Structures     704
Vertebrae     706
Shoulder and Upper Extremity     707
Wrist and Hand     708
Pelvis, Hip, and Femur     709
Knee, Tibia, and Fibula     710
Ankle and Foot     712
Perioperative Nursing Considerations     714
Surgical Interventions     728
Bone Grafting     728
Electrical Stimulation     728
Fractures and Dislocations     729
Types of Fractures     729
Principles of Treatment     730
Basic Treatment Techniques     731
Surgery of the Shoulder     734
Correction of Acromioclavicular Joint Separation     734
Correction of Sternoclavicular Dislocation     735
Clavicular Fracture     736
Correction of Rotator Cuff Tear     736
Correction of Recurrent Anterior Dislocation of the Shoulder     737
Correction of Humeral Head Fracture     738
Surgery of the Humerus, Radius, and Ulna     738
Fractures of the Humeral Shaft     738
Distal Humeral Fractures (Supracondylar, Epicondylar, and Intercondylar)     740
Olecranon Fracture     742
Transposition of the Ulnar Nerve     743
Excision of the Head of the Radius     743
Fractures of the Proximal Third of the Ulna with Radial Head Dislocation (Monteggia)     743
Correction of Colles Fracture with External Fixation     744
Surgery of the Hand     744
Carpal Tunnel Release     744
Excision of Ganglions     745
Fractures of Carpal Bones     745
Surgery of the Hip and Lower Extremity     745
Fractures of the Acetabulum     745
Hip Fractures     747
Surgery of the Lower Leg (Distal Femur, Tibia, and Fibula)     752
Femoral Condyle and Tibial Plateau Fractures     753
Supracondylar Fractures of the Femur     753
Patellectomy and Reduction of Fractures of the Patella     756
Correction of Recurrent Dislocation of the Patella     757
Repair of Collateral or Cruciate Ligament Tears     758
Popliteal (Baker's) Cyst Excision     759
Fractures of the Tibial Shaft     759
Surgery of the Ankle and Foot     760
Ankle Fractures     760
Triple Arthrodesis     762
Bunionectomy     763
Correction of Hammer Toe Deformity     763
Metatarsal Fractures     764
Metatarsal Head Resection     764
Pelvic Fracture and Disruption     765
Total Joint Arthroplasty     765
Total Hip Replacement     766
Total Knee Replacement     772
Total Shoulder Arthroplasty     779
Total Elbow Arthroplasty     781
Total Ankle Joint Replacement     783
Metacarpal Arthroplasty     784
Metatarsal Arthroplasty     784
Arthroscopy     784
Arthroscopy of the Knee     785
Arthroscopy of the Shoulder     788
Arthroscopy of the Elbow     790
Arthroscopy of the Ankle     791
Surgery of the Spinal Column     792
Treatment of Back Pain     792
Pedicle Fixation of the Spine     793
Treatment of Scoliosis     793
Artificial Disk Replacement     796
Neurosurgery      799
Surgical Anatomy     799
Brain and Adjacent Structures     799
Scalp     799
Skull     800
Meninges     801
Brain     803
Ventricular System and Cerebrospinal Fluid     809
Cerebral Blood Supply     810
Cranial Nerves     815
Spine, Spinal Cord, and Adjacent Structures     817
Vertebral Column     817
Spinal Cord     818
Spinal Nerves     818
Spinal Vasculature     820
Pathologic Lesions of the Spinal Cord and Adjacent Structures     822
Peripheral Nerves     825
Perioperative Nursing Considerations     826
Surgical Interventions     841
Minimally Invasive and Specialized Neurosurgery Techniques     841
Microneurosurgery     841
Neuroendoscopy     841
Endovascular Procedures     842
Stereotactic Radiosurgery     842
Stereotactic Procedures     842
Surgical Approaches to the Brain     843
Burr Holes     843
Craniotomy     843
Craniectomy     843
Transsphenoidal Approach      843
Surgery of the Brain and Cranium     844
Evacuation of Epidural or Subdural Hematoma     844
Cranioplasty     844
Ventricular Catheter and Shunt Placement for Hydrocephalus     844
Craniotomy     845
Surgery for Intracranial Aneurysm     848
Surgery for Arteriovenous Malformation     851
Craniotomy for Suprasellar and Parasellar Tumors (Pituitary Tumor, Craniopharyngioma, Meningioma, Optic Glioma)     851
Suboccipital Craniectomy for Posterior Fossa Exploration     852
Retromastoid Craniectomy for Microvascular Decompression of the Trigeminal Nerve     853
Transsphenoidal Hypophysectomy     854
Surgery of the Spine     855
Anterior Cervical Decompression and Fusion     855
Posterior Cervical Approach     856
Anterior Thoracic Approach     856
Laminectomy     856
Laminotomy     858
Carotid Artery Surgery     859
Carotid Artery Ligation     859
Carotid Surgery for Carotid-Cavernous Fistula     859
Peripheral Nerve Surgery     859
Sympathectomy     859
Nerve Repairs     860
Carpal Tunnel Syndrome     860
Ulnar Nerve Transposition at the Elbow     860
Plastic and Reconstructive Surgery     863
Surgical Anatomy     863
Perioperative Nursing Considerations     863
Surgical Interventions     872
Reconstructive Plastic Surgery     872
Removal of Skin Cancers     872
Simple Excision     874
Mohs' Surgery     874
Burn Surgery     874
Cultured Epithelial Autografting (CEA) and Artificial Skin     877
Debridement     877
Treatment of Pressure Ulcers     877
Skin and Tissue Grafting     878
Split-Thickness and Full-Thickness Skin Grafts     878
Preservation of Skin Grafts     880
Composite Graft     881
Replacement of Lost or Absent Tissue     881
Flaps     881
Reconstructive Breast Surgery     883
Breast Reconstruction Using Tissue Expanders     883
Second-Stage Tissue Expander Breast Reconstruction     884
Breast Reconstruction Using Myocutaneous Flaps     884
Transverse Rectus Abdominis Myocutaneous Flap     884
Free Transverse Rectus Abdominis Myocutaneous Flap     885
Nipple Reconstruction     885
Microsurgery      885
Replantation of Amputated Body Part     886
Toe-to-Hand Transfer     888
Reconstructive Maxillofacial Surgery     889
Procedural Considerations for Maxillofacial Surgery     889
Reduction of Nasal Fracture     889
Reduction of Orbital Floor Fractures     890
Reduction of Zygomatic Fractures     890
Reduction of Maxillary Fractures     890
Reduction of Mandibular Fractures     891
Elective Orthognathic Surgery     892
Gender Reassignment     892
Aesthetic Surgery     892
Scar Revision     892
Endoscopic Brow Lift     893
Rhytidectomy (Facelift)     894
Blepharoplasty     895
Rhinoplasty     896
Laser Surgery     896
Liposuction     896
Abdominoplasty     898
Post-Bariatric Surgery Body Contouring     898
Breast Surgeries     899
Thoracic Surgery     906
Surgical Anatomy     906
Perioperative Nursing Considerations     909
Surgical Interventions     919
Endoscopy (Diagnostic or Therapeutic)     919
Standard Bronchoscopy Using Rigid Bronchoscope     919
Bronchoscopy Using the Flexible Bronchoscope     921
Mediastinoscopy     922
Thoracoscopy     922
Endoscopic Thoracic Sympathectomy     923
Lung Surgery     924
Thoracotomy     924
Pneumonectomy     924
Lobectomy     926
Segmental Resection     929
Wedge Resection     930
Lung Volume Reduction Surgery     930
Lung Biopsy     931
Decortication     932
Drainage of Empyema     933
Open Thoracostomy (Partial Rib Resection)     933
Closed Thoracostomy (Intercostal Drainage)     934
Decompression for Thoracic Outlet Syndrome     935
Excision of Mediastinal Lesion     935
Lung Transplantation     936
Vascular Surgery     938
Surgical Anatomy     938
Arterial Disease     938
Aneurysmal Disease     938
Acute Arterial Insufficiency     939
Chronic Arterial Insufficiency     939
Arterial Insufficiency: Cerebrovascular Disease and Stroke     939
Arterial Insufficiency: Peripheral Vascular Disease     939
Venous Disease     944
Acute Venous Insufficiency     944
Chronic Venous Insufficiency     944
Perioperative Nursing Considerations     944
Surgical Interventions     954
Abdominal Aortic Aneurysm Resection     954
Transperitoneal Approach     955
Endovascular Abdominal Aortic Aneurysm Repair     955
Percutaneous Transluminal Angioplasty     957
Femoral-Popliteal and Femoral-Tibial Bypass     958
Femoral-Popliteal Bypass in Situ     958
Femorofemoral Bypass     959
Arterial Embolectomy     960
Femoral Embolectomy     960
Amputation     960
Carotid Endarterectomy     962
Carotid Endarterectomy with Shunt     964
Arteriovenous Fistula     965
Vena Cava Filter Insertion     967
Varicose Vein Excision and Stripping     967
Cardiac Surgery     971
Surgical Anatomy     971
Perioperative Nursing Considerations     977
Surgical Interventions     1010
Extracorporeal Circulation Procedures     1010
Pericardectomy     1012
Surgery for Coronary Artery Disease      1013
Coronary Artery Bypass Grafts with Arterial and Venous Conduits     1013
Laser Transmyocardial Revascularization     1020
Ventricular Aneurysmectomy     1020
Postinfarction Ventricular Septal Defect     1021
Surgery for Congestive Heart Failure     1021
Surgery for the Mitral Valve     1021
Mitral Valve Repairs     1021
Mitral Valve Replacement     1024
Surgery for the Tricuspid Valve     1025
Tricuspid Valve Annuloplasty     1025
Surgery for the Aortic Valve     1027
Aortic Valve Replacement     1027
Combined Surgery     1028
Double Valve Replacement     1028
Surgery for the Thoracic Aorta     1028
Repair of Ascending Thoracic Aortic Aneurysm or Dissection     1030
Repair of Aortic Arch Aneurysm     1031
Repair of Descending Thoracic Aortic Aneurysm     1032
Mechanical and Biologic Circulatory Assistance     1032
Intraaortic Balloon Pump     1033
Ventricular Assist Device     1034
Total Artificial Heart     1037
Biologic Ventricular Support     1037
Heart and Heart-Lung Transplantation     1037
Heart Transplantation      1037
Heart-Lung Transplantation     1038
Surgery for Conduction Disturbances     1039
Insertion of Permanent Pacemaker     1039
Insertion of Transvenous (Endocardial) Pacing Electrodes     1040
Insertion of Myocardial (Epicardial) Pacing Electrodes     1040
Insertion of Implantable Cardioverter Defibrillator     1040
Special Considerations
Ambulatory Surgery     1047
Regulation and Accreditation     1047
Facilities     1047
Hospital-Based Self-Contained Facility     1049
Hospital-Integrated Facility     1049
Freestanding Facility     1049
Office-Based Facility     1049
Recovery Center     1049
Patient Selection     1050
Anesthesia     1050
Premedication     1050
General Anesthesia     1050
Regional Anesthesia     1051
Local Anesthesia     1053
Moderate Sedation/Analgesia     1053
Appeal of Ambulatory Surgery     1053
Nursing Care for the Ambulatory Patient     1055
Preoperative Phase     1055
Intraoperative Phase     1057
Postoperative Phase      1058
Discharge     1062
Continuing Education and Performance Measurement     1062
Documentation     1063
Policies and Procedures     1065
Future Trends     1065
Pediatric Surgery     1066
Pediatric Surgical Anatomy     1066
Airway/Pulmonary Status     1066
Cardiovascular Status     1066
Temperature Regulation     1067
Metabolism     1067
Fluid Management     1067
Psychologic Development     1067
Perioperative Nursing Considerations     1067
Surgical Interventions     1078
Vascular Access     1078
Central Venous Catheter Placement     1078
Minimally Invasive Surgery     1079
Bariatric Surgery     1079
Correction of Gastrointestinal Disorders     1080
Repair of Atresia of the Esophagus     1080
Repair of Congenital Diaphragmatic Hernia     1081
Nissen Fundoplication     1083
Fredet-Ramstedt Pyloromyotomy for Pyloric Stenosis     1083
Emergency Gastrointestinal Procedures     1084
Gastrostomy     1084
Omphalocele and Gastroschisis Repair     1084
Repair of Hernias     1086
Umbilical Hernia Repair     1086
Inguinal Hernia Repair     1087
Repair of Obstructive Disorders     1087
Repair of Intestinal Obstruction     1087
Reduction of Intussusception     1087
Colostomy     1088
Correction of Biliary Atresia     1092
Hepatic Portoenterostomy (Kasai Procedure)     1092
Resection of Tumors     1093
Wilms' Tumor     1093
Neuroblastoma     1093
Sacrococcygeal Teratoma     1093
Genitourinary Surgery     1094
Pediatric Cystoscopy     1094
Circumcision     1094
Hypospadias Repair     1095
Epispadias Repair     1098
Bladder Exstrophy Repair     1099
Hydrocelectomy     1100
Orchiopexy     1101
Vesicoureteral Reflux     1101
Otorhinolaryngologic Procedures     1104
Foreign Body Removal     1104
Myringotomy with Ear Tube Placement     1105
Tonsillectomy and Adenoidectomy     1106
Excision of Branchial Cleft Cyst/Remnant/Sinus Tract     1107
Neurosurgical Procedures      1107
Myelomeningocele/Meningocele     1107
Craniectomy for Craniosynostosis     1109
Ventriculoatrial and Ventriculoperitoneal Shunts     1109
Orthopedic Procedures     1109
Developmental Hip Dysplasia     1109
Plastic and Reconstructive Surgery     1110
Cleft Lip Repair     1110
Cleft Palate Repair     1111
Pharyngeal Flap     1112
Total Ear Reconstruction     1112
Otoplasty     1113
Repair of Syndactyly     1114
Orbital-Craniofacial Surgery     1114
Thoracic Procedures     1115
Correction of Pectus Excavatum     1115
Trauma     1117
Surgery for Congenital Heart Disea se     1120
Repair of Atrial Septal Defect     1121
Repair of Ventricular Septal Defect     1123
Repair of Common Atrioventricular Septal Defects     1124
Correction of Tetralogy of Fallot     1125
Operation for Tricuspid Atresia     1126
Operations for Transposition of the Great Arteries     1126
Repair of Truncus Arteriosus     1130
Repair of Pulmonary Stenosis: Open Valvulotomy and Infundibular Resection     1130
Closure of Patent Ductus Arteriosus     1131
Video-Assisted Thoracoscopic Surgery for Patent Ductus Arteriosus     1132
Repair of Coarctation of the Aorta     1133
Repair of Hypoplastic Left Heart Syndrome     1134
Repair of Severely Diseased Aortic Valves: Ross Procedure     1136
Pulmonary Artery Banding     1138
Shunt for Palliation     1138
Extracorporeal Membrane Oxygenation     1141
Geriatric Surgery     1143
Perioperative Nursinc Considerations     1145
Preliminary Evaluation     1145
Surgical Interventions     1161
Common Surgical Procedures in Geriatric Patients     1161
Thyroid Surgery     1161
Abdominal Surgery     1161
Hernia     1162
Genitourinary Surgery     1162
Ophthalmic Surgery     1162
Orthopedic Surgery     1163
Vascular and Cardiovascular Surgery     1163
Additional Considerations     1163
Trauma Surgery     1165
Perioperative Nursing Considerations     1166
Preliminary Evaluation: Mechanism of Injury     1166
Critical Incident-Stress Debriefing     1187
Surgical Interventions      1188
Damage Control Surgery     1188
Injuries of the Head and Spinal Column     1188
Injuries of the Face     1190
Injuries of the Eye     1191
Injuries of the Neck     1191
Injuries of the Chest and Heart     1191
Injuries of the Abdomen     1192
Injuries of the Genitourinary System     1194
Skeletal Injuries     1195
Hypothermia     1196
Thermal Injuries     1197
Organ and Tissue Procurement     1197
Integrated Health Practices: Complementary and Alternative Therapies     1198
History and Background     1198
Major Categories of Complementary and Alternative Medicine     1199
Alternative Medical Systems     1199
Mind-Body Interventions     1200
Biologically Based Therapies     1201
Manipulative and Body-Based Methods     1201
Energy Therapies     1202
Complementary and Alternative Medicine Use and Surgery     1202
Energy Therapies     1202
Perioperative Medical Hypnotherapy     1206
Guided Imagery     1207
Aromatherapy in Perioperative Services     1208
Music and Surgery      1209
Psychoneuroimmunology     1210
Herbs and Surgery     1211
Integrative Health Therapies in Cardiothoracic Surgery     1214
Integrative Health Therapies and Perioperative Nursing     1215