Nursing Observation

Topics: Heart, Surgery, Artery Pages: 3 (728 words) Published: June 4, 2012
During the day, I observed parts of two different surgeries.

The first client was in surgery for a thoracotomy to perform a lung biopsy. The surgeon said that the chest x-ray showed infiltrates and that pulmonologist wanted a tissue sample. The patient was a male approximately 60 years old. He had a large barrel chest, which might indicate COPD.

The procedure involved making an incision in the chest between two ribs. The surgeon continued cutting and cauterizing the incision until he reach the right lung. He then isolated and excised a 1 inch by half inch piece of lung. It looked like a little lung sock. The sample was placed into a specimen container. The next step of the procedure was to place a chest tube in the patient. He then began suturing the original incision. As he sutured the wound at different levels he injected marcaine into the area around the suturing. I could not find any information on why this drug was used at this time. Since it is an anesthetic, I presume that it would help alleviate post operative pain.

The team included: a surgeon, a surgical technologist, an anesthesiologist, a recorder and a nurse. The nurse was not scrubbed in for this procedure and she floated around helping out. I am not sure what the recorder actually wrote down, but at one point she asked me for my name, so I know she recorded who was in the room. The surgical technologist was the assistant to the surgeon. She managed all the sterile equipment and provided each piece to the surgeon as he needed.

All the equipment was counted prior to the onset of the surgery and compared to a count done before the incision was closed. Used sponges were thrown onto a pad placed on the floor rather than into the trash can. This allowed for less error prone counting. In the moment before the surgery began, the team took a time out. They verified the patient and the procedure.

I saw the beginning of a coronary artery bypass graft (CABG) surgery....
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