Question

CRITICALTHINKING:

Chris has come to the doctor’s office in a somewhat agitated state. Several months ago, his wife noticed a small, dark spot in the skin on his lower back. His wife is worried that the spot may indicate skin cancer. Initially, Chris chose to ignore it. But recently his wife has noticed the spot has grown. In addition, when she inspected it and squeezed it, a thick, white material was released from the spot. Now Chris is worried. The physician examines the spot and assures Chris that he doesn’t have skin cancer. The spot, which is a sebaceous cyst, is benign and will only require minor surgery to remove. What should you tell Chris to prepare him for the procedure? What can you do to assist the physician before and during the surgery?

Answer 1

Some of the things which has to be said to Chris to prepare him to surgery are

• Pre open preparation like doing basic blood investigation like HIV ,HCV ,HBsAg ,CBC ,Blood group, Blood glucose level. This will help to rule out any infection ,basic blood counts to prepare the patient for surgery
• Chest x ray to be done in order to know the lung status because the patient will be given anesthesia which can interact with these respiratory system if appropriate medication is not administered
• ECG to know the cardiovascular status
• Nil by mouth day before the surgery for about eight hours (This will prevent aspiration during intraoperative period)
• Skin preparation at back in order to maintain cleanliness and prevent any infection
• No OTC medications or blood thinners as per the advice of provider .

The work which has to be done to assist the physician before and during surgery are

Before surgery

• Pre operative preparation
• Vital signs monitoring
• Pre open medication if ordered
• Ensure informed consent is taken
• Providing psychological support to the patient

During surgery

• Assisting during surgery
• Administration of medication during surgery
• Monitoring of vital signs through out the procedure to know the general status of the patient .