종합실습 주요 시술/수술/침습적 검사 관련 간호활동

문서 내 토픽

• 1. Total knee replacement

  무릎치환술은 무릎의 한쪽 구획에 진행된 관절염, 염증성 관절염, 관절강직 또는 인대 손상 등의 적응증으로 시행됩니다. 합병증으로는 탈구, 감염, 출혈, 빈혈, 경골 골절, 신경 및 혈관 손상, 지속되는 관절통, 정맥혈전증, 폐색전 등이 있습니다. 간호사는 수술 전 대상자의 심리적 두려움과 불안을 해소하고, 관절가동범위운동, 기침 및 심호흡, 수술 후 이동 방법 등을 교육합니다. 또한 탈구 예방, 감염 예방, 출혈 및 빈혈 예방, 신경혈관계 관찰, 운동 등의 간호활동을 수행합니다.

• 2. Open reduction and internal fixation

  개방정복 내부고정술은 폐쇄골절 교정이 효과가 없거나 불가능한 경우, 대퇴골경부 골절, 무릎뼈의 횡선골절, 불유합 경향이 있는 골절, 복합골절, 병리적 골절 등의 적응증으로 시행됩니다. 합병증으로는 출혈, 감염, 신경손상, 구획증후군, 유합장애, 석고붕대 증후군 등이 있습니다. 간호사는 수술 전 운동, 기침, 심호흡을 교육하고, 환부 상승, 출혈 및 신경혈관 상태 관찰, 드레싱 관리, 등척성 운동 격려, 신체정렬 유지 등의 간호활동을 수행합니다.

• 3. Knee ligament reconstruction

  무릎인대 재건술은 인대 손상 및 파열, 특히 전·후방 십자인대, 내·외측 측부인대 등의 손상으로 무릎 관절이 외부 충격이나 손상으로 제 기능을 상실할 경우 새로운 인대를 이식하여 원래의 기능을 되찾아주는 수술입니다. 합병증으로는 출혈, 감염, 붓기, 열감, 요통, 방사통 등이 있습니다. 간호사는 수술 전 대상자의 심리적 두려움과 불안을 해소하고, 신경혈관 사정, 배액량과 활력징후 모니터링, 무균적 드레싱, 섭취량과 배설량 모니터링, 배액관 관리, 목발 사용법 교육 등의 간호활동을 수행합니다.

• 4. Spinal fusion

  척추융합술은 약물치료 및 주사치료에도 호전이 없는 재발성 추간판 탈출증, 요통이 심한 디스크 내장증이나 척추관협착증, 척추전방전위증, 척추분리증, 퇴행성척추증 등의 적응증으로 시행됩니다. 합병증으로는 출혈, 감염, 무기폐, 폐렴, 뇌척수액 누출, 통증, 감각장애, 운동장애, 배뇨장애 등이 있습니다. 간호사는 수술 과정 설명, 자료수집, 수술 전 교육, 활력징후 및 신경계 사정, 절개부위 관찰, 통증 관리, 합병증 예방 등의 간호활동을 수행합니다.

• 5. Arthroscopy

  관절경검사는 무릎, 어깨, 팔꿈치, 속목, 발목 관절의 연골, 인대 상황을 관찰하고 조직생검, 관절액 천자, 시진, 검사물 채취, 약물 주입 등을 시행할 수 있습니다. 합병증으로는 통증, 출혈, 신경 및 혈관 손상, 감염, 종창, 저체온증, 관절통, 혈전성정맥염 등이 있습니다. 간호사는 금식, 압박드레싱 적용, 신경혈관 상태와 합병증 증상 관찰, 관절운동 격려, 진통제 투여 등의 간호활동을 수행합니다.

• 6. Epidural block

  경막외 차단술은 허리 수술 후 통증 재발, 꼬리뼈, 천골뼈, 하부 요추주위 통증, 디스크, 협착증, 급성요부염좌, 하지수술 후 통증, 만성요통 등의 적응증으로 시행됩니다. 합병증으로는 시술 후 꼬리뼈 통증, 하지 방사통 증가, 경막내강 약물주입, 혈관내 약물주입, 감염 등이 있습니다. 간호사는 시술 전 혈액검사, 약물 상호작용 확인, 금식, 안전한 귀가 등을 교육하고 관찰합니다.

• 7. Microdiskectomy

  미세현미경 디스크절제술은 약물 및 운동 요법 등 보존적 치료에도 효과가 없는 추간판 탈출증의 경우 시행됩니다. 합병증으로는 상처부위 감염, 골수염, 패혈증 등이 있습니다. 간호사는 수술 전 금식, 검사 확인, 혈액 응고 저해제 복용 확인, 수술 후 보조기 착용, 운동 교육, 통증 관리 등의 간호활동을 수행합니다.

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• 1. Total knee replacement

  Total knee replacement is a common and effective surgical procedure used to treat severe arthritis or injury in the knee joint. The surgery involves removing the damaged or worn-out parts of the knee and replacing them with an artificial joint, called a prosthesis. This can significantly improve a patient's mobility, reduce pain, and enhance their quality of life. The procedure is generally safe and has a high success rate, with most patients experiencing significant improvements in their knee function and ability to perform daily activities. However, as with any major surgery, there are risks involved, such as infection, blood clots, and implant failure. Careful patient selection, meticulous surgical technique, and proper post-operative rehabilitation are crucial for achieving optimal outcomes. Overall, total knee replacement is a valuable treatment option for individuals with severe knee arthritis or injury who have exhausted conservative management options.

• 2. Open reduction and internal fixation

  Open reduction and internal fixation (ORIF) is a surgical procedure used to treat fractures by restoring the normal alignment and stability of the broken bone. This technique involves making an incision to expose the fracture site, reducing the fragments to their anatomical position, and then securing them in place using various internal fixation devices such as plates, screws, or intramedullary nails. ORIF is often used for complex or displaced fractures that cannot be adequately treated with closed reduction and immobilization alone. The primary goals of ORIF are to achieve anatomic reduction, stable fixation, and early mobilization of the affected limb, which can facilitate faster healing and better functional outcomes for the patient. However, ORIF is a more invasive procedure and carries a higher risk of complications, such as infection, bleeding, and damage to surrounding tissues. Careful patient selection, meticulous surgical technique, and appropriate post-operative management are crucial for successful outcomes. Overall, ORIF is an important surgical option for the treatment of complex fractures, but it should be considered in the context of the individual patient's needs and the surgeon's expertise.

• 3. Knee ligament reconstruction

  Knee ligament reconstruction is a surgical procedure used to repair or replace damaged ligaments in the knee joint, such as the anterior cruciate ligament (ACL) or the posterior cruciate ligament (PCL). This type of surgery is often performed to restore knee stability and function after a significant ligament injury, such as a complete tear or rupture. The goal of the procedure is to reconstruct the damaged ligament using a graft, which can be taken from the patient's own tissue (autograft) or from a donor (allograft). The graft is then secured in place using various fixation methods, such as screws or sutures. Knee ligament reconstruction can be an effective treatment option for individuals with persistent instability or functional limitations due to a ligament injury. However, the surgery is not without risks, including infection, graft failure, and the potential for long-term osteoarthritis development. Careful patient selection, meticulous surgical technique, and a comprehensive rehabilitation program are essential for achieving optimal outcomes. Overall, knee ligament reconstruction can be a valuable intervention for restoring knee stability and function, but it should be considered in the context of the individual patient's needs and the surgeon's expertise.

• 4. Spinal fusion

  Spinal fusion is a surgical procedure that involves permanently connecting two or more vertebrae in the spine, eliminating motion between them. This procedure is often used to treat a variety of spinal conditions, such as degenerative disc disease, spinal instability, scoliosis, or vertebral fractures. The goal of spinal fusion is to alleviate pain, improve spinal alignment, and restore stability to the affected segment of the spine. During the surgery, the surgeon removes the damaged disc or vertebra and replaces it with a bone graft, which can be taken from the patient's own body (autograft) or from a donor (allograft). The surgeon may also use additional hardware, such as screws, rods, or cages, to help stabilize the spine and promote fusion. While spinal fusion can be an effective treatment option for many patients, it is a major surgical procedure with potential risks, including infection, bleeding, nerve damage, and failure of the fusion to occur. Careful patient selection, meticulous surgical technique, and a comprehensive rehabilitation program are essential for achieving successful outcomes. Additionally, the long-term effects of spinal fusion, such as the development of adjacent segment disease, should be considered when evaluating this treatment option.

• 5. Arthroscopy

  Arthroscopy is a minimally invasive surgical procedure used to diagnose and treat various joint problems, particularly in the knee, shoulder, and other major joints. During an arthroscopic procedure, the surgeon makes small incisions and inserts a tiny camera (arthroscope) into the joint, allowing them to visualize the internal structures and identify any issues. Based on the findings, the surgeon can then use specialized instruments to repair or remove damaged tissue, such as torn ligaments, cartilage, or bone. Arthroscopy is often preferred over traditional open surgery because it is less invasive, has a shorter recovery time, and carries a lower risk of complications. However, it is still a surgical procedure and carries some risks, such as infection, bleeding, and nerve damage. Careful patient selection, meticulous surgical technique, and appropriate post-operative management are crucial for achieving successful outcomes. Overall, arthroscopy is a valuable tool in the diagnosis and treatment of joint problems, offering patients a minimally invasive option that can help alleviate pain, restore function, and improve their quality of life.

• 6. Epidural block

  An epidural block is a type of regional anesthesia that involves the injection of a local anesthetic and/or other medications into the epidural space, which is the area just outside the dura mater (the outermost layer of the spinal cord). Epidural blocks are commonly used for pain management during and after various medical procedures, such as childbirth, major surgery, and chronic pain conditions. The primary benefits of an epidural block include effective pain relief, reduced need for systemic pain medications, and the ability to maintain sensation and motor function in the affected area. However, epidural blocks are not without risks, which can include headache, hypotension, urinary retention, and in rare cases, more serious complications such as spinal cord injury or epidural hematoma. Careful patient selection, proper technique, and close monitoring by experienced healthcare providers are essential for the safe and effective use of epidural blocks. Overall, epidural blocks can be a valuable tool in the management of acute and chronic pain, but they should be considered in the context of the individual patient's needs and the provider's expertise.

• 7. Microdiskectomy

  Microdiskectomy is a minimally invasive surgical procedure used to treat a herniated or ruptured intervertebral disc in the spine, particularly in the lumbar (lower back) region. During the procedure, the surgeon makes a small incision and uses specialized instruments to remove a portion of the damaged disc that is pressing on the spinal nerve, causing pain, numbness, or weakness. Microdiskectomy is often preferred over traditional open discectomy because it is less invasive, has a shorter recovery time, and carries a lower risk of complications. The primary goals of microdiskectomy are to relieve the patient's symptoms, restore spinal function, and prevent further nerve damage or disability. While microdiskectomy can be an effective treatment option for many patients with a herniated disc, it is still a surgical procedure and carries some risks, such as infection, bleeding, and the potential for recurrence of the disc herniation. Careful patient selection, meticulous surgical technique, and appropriate post-operative management are crucial for achieving successful outcomes. Overall, microdiskectomy can be a valuable intervention for the treatment of a herniated disc, but it should be considered in the context of the individual patient's needs and the surgeon's expertise.