Perioperative Practice: Fundamentals of

Written by experienced nurse lecturers and a theatre nurse,Perioperative Practicehighlights and explains the biological processes which can be disrupted by a major surgical procedure. Using the concept of homeostasis as a framework, the authors look at issues common to all surgical procedures such as the influence of anaesthesia on the nervous system or perioperative pain management.

List of figures

ix

List of tables

xiii

List of boxes

xv

Foreword

xix

About this book

xxi

Acknowledgements

xxiii

The human body and principles of homeostasis

1

(27)

Introduction

1

(10)

The basic needs of the human body and activities of daily living

11

(2)

Levels of organization

13

(2)

Homeostasis: the link with health and ill-health

15

(7)

Homeostasis and ill-health

22

(4)

Summary

26

(1)

Bibliography

26

(1)

Answers to multiple choice questions

27

(1)

The surgical approach and endoscopic procedures

28

(29)

Introduction

28

(1)

'Open' surgery: gaining access

28

(17)

Minimal access surgery: endoscopy

45

(9)

Summary

54

(1)

Bibliography

55

(2)

Perioperative influences on body fluid homeostasis

57

(34)

Introduction

57

(2)

Body fluids and their distribution

59

(6)

Electrolyte composition of intracellular and extracellular fluids

65

(8)

Perioperative influences on water and electrolyte homeostasis

73

(12)

Infusates and the support of body fluid compartments

85

(4)

Summary

89

(1)

Bibliography

89

(2)

Perioperative influences on immunological homeostasis and wound healing

91

(46)

Introduction: immunological homeostasis

91

(8)

The specific immune response

99

(12)

An overview of the homeostatic responses involved in wound healing

111

(8)

Details of the stages involved in wound healing

119

(14)

Summary

133

(1)

Bibliography

133

(3)

Answers to multiple choice questions

136

(1)

Perioperative influences on cardiovascular homeostasis

137

(40)

Introduction: relation of the cardiovascular system to cellular homeostasis

137

(1)

Overview of the anatomy and physiology of the cardiovascular system

137

(15)

Cardiac output, peripheral resistance and blood pressure

152

(11)

Shock: a failure to maintain cardiovascular homeostasis

163

(11)

Summary

174

(1)

Bibliography

175

(1)

Answers to multiple choice questions

176

(1)

Perioperative influences on respiratory hameostasis

177

(35)

Introduction

177

(3)

Principles of blood gas homeostasis

180

(13)

The respiratory system in the perioperative period

193

(12)

Ventilation therapy as a homeostatic mechanism

205

(3)

Summary

208

(1)

Bibliography

209

(3)

Anaesthesia, stress and surgery

212

(25)

Introduction

212

(6)

Surgical stress I: anxiety

218

(1)

Surgical stress II: general anaesthesia

219

(7)

Surgical stress III: responses to trauma

226

(8)

Summary

234

(1)

Bibliography

235

(2)

Pain and pain relief in the perioperative patient

237

(34)

Introduction

237

(1)

Pain perception: an overview

238

(2)

Details of the neurophysiology associated with pain perception

240

(8)

The subjectivity of pain

248

(3)

Perioperative pain management

251

(1)

Pharmacological pain management

251

(10)

Non-pharmacological pain techniques

261

(5)

Summary

266

(1)

Bibliography

267

(2)

Answer to multiple choice question

269

(2)

Index

271

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Perioperative Practice: Fundamentals of Homeostasis

Summary

Table of Contents

Supplemental Materials