CHAPTER I

INTRODUCTION

A. Background
Surgery are all acts of treatment use invasive methods by opening or
displaying body parts will be handled. The opening of this body part is
generally done with making an incision, after which parts to be handled are
displayed, done. Acts of repairs ending with the closing and suturing of the
wound. The surgery is performed by a surgeon. There are various kinds of
specialists who perform surgery.
Generally the same division of specialization in almost all parts of the
world. Usually that includes surgeons is doctors, dentists, and veterinarians
who have specialists in the field of surgery. Surgical science is a side of
medical sciences which return the normal anatomy function with surgical
doing. The surgeon should know why are needs to be significant actions,
about known the patients will be surgery, and many experiences have decided
to determine the attitude to surgical will be done. Patients should know that he
will be dissected and treated, the patient is also entitled to a clear illumination
about the course of surgery that will be undergoing, in conducting surgery is
necessary openness surgeon, personality and sufferer background is also
known.

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 CHAPTER II

DISCUSSION

A. Definition and Part of Basic Surgical

Medical-surgical nursing is the single largest nursing specialty in the
United States. Registered nurses in this specialty practice primarily on
hospital units and care for adult patients who are acutely ill with a wide
variety of medical problems and diseases or are recovering from surgery.
Basic surgical skills is defined as cornerstone corse for all tarines. In
this lesson the students will learn a range of essential basic surgical skills and
technique in a contrelled workshop environment. In rutes of AIV transmission
injury with needles are contaminated with blood, body fluids. In preventing
transmision of infektion,we are not allowed to recap nidles. It is important to
set up sharps containers where sharps are used. Every hospital needs to give
clear guidelines for manegement of injury. There are some steps which need
to do in preventing infections universal precautions.
The first is to protect areas of broken skin,open wounds with
watertight dressings.it is important to treat all body substances. Nursis need to
wear protektive glasses where blood splashes may occur.infection is defined
as the most important and preventable causes of impaired wound healing.
Tissues can be reached by microoganism during surgery or manipulation. It
can be transmitted by air around wounds which can be contaminated by
dust.aseptic treatment wound functions to privent bacteria contamination from
thest sources,during surgery,and phase of healing.
In operating theatre,the doors must biklosed accept as needed for
passag equipment,personnal,patiens. Staffs need to minimize people who
want to enter operating theatre. In preventing infection the most imfortant
measure is to do hand washing plain soap and water can be used. To remove

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 visible contaminations. The greates contaminations areas is nails. Surgical
loves fungtion to preven transsmition of other infections through contact with
blood. There are many types of instruments such as forceps used for holding
tissue,needle horders,scissors,and retractors. In, wound management,we Are
not allowed to leave the infected wounds open. A contaminated wound delays
healing. Patients need to close wounds with sutures at 2 days. The factors that
prevent wound healing is the age,and underlying illness.

B. Preventuring Maintenance Procedures

How to treat the wound should be Right and Right, so that the impact
is not more severe or even cause infection that would be dangerous. The
wound is the disruption of normal integrity to the skin and underlying tissues
that occur for any intentional or intentional, closed or open, clean or
contaminated cause
1. The mechanism of the occurrence of injuries that often occur because:
 An incision injury, caused by a sharp instrument (surgery or
exposure to other sharp objects due to intentional or unintentional).
 Bruises, caused by impact or pressure and characterized by injury to
soft tissue, bleeding and swelling of the skin tissue and underlying
tissue.
 The blisters, which occur because the skin rubs against other objects
that are usually visible and objects that are not sharp.
 Stab wounds, caused by the presence of taper objects (bullets,
knives, etc.) that enter into the skin and usually with a small
diameter.
 Scratch, caused by sharp objects such as glass or wire ends.
 Injured wound, is a wound that penetrates the organs of the body,
usually at the beginning of the wound entering a small diameter but
the other end will be wider

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2. Aim
 Prevent, limit, or control infection
 Lifting necrotic tissue to improve wound healing
 Absorb drainage (exudate)
 Maintaining a humid wound environment
 Compressing the eyes
3. Indication
 Chronic wounds and many drainage / pussy
 Wounds that lose a lot of skin tissue
4. Tools preparation
 A sterile set as needed
 Plaster
 Sterile gauze in place, bandage if necessary
 Clean gloves
 Sterile gloves
 The normal solution of sterile saline (NaCl 0.9%)
 Infectious garbage bags
 Perlak and its base
 Storage of sterile goods, such as bent (kidney cup) and sterile bowl
(kopyes) above the trolley
5. Procedure
 Check doctor's instructions and treatment plan
 Prepare the tools, including sterile equipment on the table / trolley
 Identify the patient, explain the goals and procedures
 Provide privacy
 Elevate the bed and lower the bed barrier to work on the side of the
patient
 Place the bag to put a dirty bandage near the patient
 Wash hands

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 Spread perlak under the area to be replaced bandage
 Wear clean gloves (not sterile)
 Remove the plaster towards the wound or open the bandage bandage
 Pour saline normal solution in dressing
 Remove the gauze one by one, then throw it into a plastic bag
 Remove the gloves
 Open the sterile set while maintaining the sterility of the tool
 Pour the normal saline solution into kopyes and place a few pieces of
gauze in the sterile area
 Wear sterile gloves
 Clean the wound area using gauze, press gauze on the depression or
hole area
 Assess wounds, measure, type identification and determine if there are
any signs of infection
 Extend a damp and alkaline gauze in a single layer and place it at the
top covering the entire area
 Then cover with a dry gauze on a bandage to hold it
 Remove the gloves and insert them into infectious waste bags
 Plaster only at the ends of the bandages, montgomery plaster can be
used to prevent excessive skin irritation and damage caused by
frequent dressing changes. For certain areas, can be added bandage
rolls to strengthen the fixation
 Return the patient to its original position. Lower the bed and re-raise
the bed barrier
 Dispose of dirty material into the right container (infectious waste)
 Wash hands
 Clean up the tools
 Record in medical record

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C. Hecting
1. Definition
Wound dressing is an action to close the wound edge with the thread until
it is healed and sufficient to withstand physiological burden.
2. Indication
Any injury where for healing needs to close the wound edges.
3. Sharp trauma causes:
 Wound iris: vulnus scissum / incicivum
 Puncture wounds: vulnus ictum
 Bite wounds: vulnus morsum
Blunt trauma causes:
 Open wounds: vulnus apertum
 Closed wounds: vulnus occlusum (excoriation and hematoma)
 Shot wounds cause: vulnus sclopetorum.
Clashing wounds based on the presence or absence of germs:
 Sterile wound: wound made operation time
 Contamination wound: wound containing germs but less than 8
hours. (golden period)
 Wound infections that contain germs and have multiplied and
have arising local symptoms as well as common symptoms.
(rubor, dolor, calor, tumor, lechee function).
4. Tools and materials needed for wound suturing.
 Tools (Instruments)
 Tissue forceps (tweezers) consists of two forms of tissue forceps
scalloped tip (surgical forceps) and without teeth at the tip ie
atraumatic tissue forceps and dressing forceps.
 Scalpel handles and scalpel blades
 Dissecting scissors (Metzen baum)
 Suture scissors

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  Needleholders
 Suture needles (needles) of 2/3 circle shape, Vi circle, shape
triangle and round shape
 Sponge forceps (Cotton-swab forceps)
 Hemostatic forceps the toothless tip (Pean) and tip toothed
(Kocher)
 Retractors, double ended
 Towel clamps
5. Material
 Yarn (type and indication explained later)
 Desifectant Liquids: Povidon-iodidine 10% (Bethadine)
 0.9% Na Cl fluid and 5% per day to wash the wound.
 Local anesthesia lidocain 2%.
 Gloves.
 Sterile gauze.

D. Dialog Practice
A Visit To The Doctor's Office

Laura : Good morning, I have an appointment with Doctor Clark at 8:30.

Clerk : Let me pull your record. In the meantime, please sign-in and have a
seat.
Nurse : Laura Nicholson.
Laura : Here.
Nurse : Follow me to Room A please.
Nurse : Here we are. What are your reasons for seeing Doctor Clark today?
Laura : Well, lately I have been feeling tired, and occasionally I have had
really bad headaches and an upset stomach. On top of that, I have

7
 had this persistent cough for the last two weeks.
Nurse : When did you start having these symptoms?
Laura : I started feeling tired about two months ago; then, a little bit after that
the headaches came. I got the upset stomach long before feeling tired.
Nurse : Are you taking any medications?
Laura : Only my vitamins.
Nurse : What vitamins are you taking?
Laura : I am taking a multi-vitamin tablet and extra Vitamin C every day.
Nurse : OK, let me take your vital signs.
Laura : How am I doing?
Nurse : Everything is good—normal blood pressure and no high temperature.
Please wait here for a minute. Doctor Clark will be with you in a
moment.
Laura : Thank you.
Doctor : Good morning, Laura.
Laura : Good morning, Doctor.
Doctor : I see here that you started feeling tired two months ago, and then you
started having bad headaches. You also have had an upset stomach
and a persistent cough. Did you run a fever too?
Laura : No, doctor.
Doctor : Let me do a quick physical check up.
Doctor : Please take a deep breath, hold your breath, and exhale. Do it again
please.
Doctor : Were there any changes in your diet or your weight lately?
Laura : I ate the usual things, but I lost five pounds recently.
Doctor : Did you suffer from insomnia?
Laura : Well, it is pretty hard for me to fall asleep when I go to bed. I also
woke up many times during the night.
Doctor : Do you drink? Do you smoke?
Laura : No.

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Doctor : How are things at work?
Laura : There was a change of ownership three months ago, and I had to
work a lot of overtime, even during the weekend.
Doctor : It looks like you have pneumonia. Other than that, I do not see any
problems. You are probably under stress from changes at work, and
the stress causes headaches, upset stomach, and sleeplessness. For
now, try to relax and exercise. It may solve your problems. Come
back to see me again if the symptoms persist, and I will do further
tests. I am going to give you a prescription for your pneumonia. Are
you allergic to any medications?
Laura : Not to my knowledge.
Doctor : OK, take this medication three times a day after you eat. Also, I want
you to have some blood tests. Stop by the laboratory on your way out
and have the nurse draw your blood.
Laura : I am anxious to know my cholesterol level. When will I get the
results of the blood test?
Doctor :The results will be available in two weeks. Don't stress yourself. I
think everything will be OK.
Laura : Thank you, Doctor.
Doctor : You are welcome

Emergenc Room Visit

Angel : Don’t be panic, please. You just have a terrible accident. Now, youa
are in emergency room in Sanglah Hospital.
Anton : Sorry, but I don’t remember anything. Who are you ?
Angel : I am doctor Angel who is incharge now.
Anton : What’s happening to me ? Why I’am here?
Angel : You had an accident with your bike and crashed into tree and you

9
 broke your arm. But you don’t have to worry abaut it. I will take care
of you.
Anton : What are you doing now ?
Angel : You just need to relax. We will give some medicines to help you feel
better.
Anton : Pain? What pain ? But I don’t feel anything in my arm.
Angel : It does not sound good. We need to start operating immediately.
Please be quit and don’t move. You need to do fasting before
surgery. Before the surgery, please don’t take anydrink or food.
Anton : Thank you docter. I will do my best.

“ Three Hours Later”

Johan : Hello, Are you awake ?

Anton : Yes, I am. And I can see you. What’s happening? Where am I now ?
Johan : I’m an ortopaedic surgeon who did operation to you. Do you have
pain in your am ?
Anton : Yes, it hurts.
Johan : Great, I did the operation well. We reattached the nerves which were
injured during your accident. You have to take a rest for three month
You are not allowed to play sports and use your mobile phone for
the next three months. You may leave now. Good bye.
Anton : Thanks you docter.
Johan : I just do my best. Take care Anton. Good bye.

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 Dialog Practice

Doctor : Well, Mr. Anton. What seems to be the problem ?

Patient : I can’t sleep last night, doctor.
Doctor : May I know, how long have you got this problem ?
Patient : Hmmmmmm, it’s about two weeks.
Doctor : Have you got headache ?
Patient : Sometimes
Doctor : Have you get fever ?
Patient : No I haven’t
Doctor : Do you have problem in your family ?
Patient : No, I don’t. my wife and I get well together.
Doctor : How about your works ?
Patient : Well, I usually work late 10 to 12 hours a day.
Doctor : Maybe you’d better have vacation for a while.
Patient : I am afraid I cannot do it now. I have some important businesses to
do.
Doctor : Is your business going well
Patient : It is not running so good at the momenut.
Doctor : Are you worried about your business ?
Patient : I guess so.
Doctor : Maybe, you should consider changing your job to be less stressful.
Patient : Well, it’s pretty had finding new jobat my age.
Patient : Thank you doctor

E. Grammar Focus
Present Continous
The present continuous tense is formed from the present tense of the
verb be and the present participle (-ing form) of a verb:

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a. Positif :
Subject + to be (is, am are) + verb-ing + object
Example: She is following the principles of antiseptic surgery

b. Negative
Subject + to be (is, am, are) + not + verb-ing + object
Example: He is not going to the surgery later

c. Intterogative
To be (is, am, are) + subject + verv-ing + object?
Example: Are you going to make a good recovery after surgery?

subject auxiliary verb main verb

+ I Am speaking to you.
+ You Are reading this.
- She Is not staying in London.
- We Are not playing football.
? Is He watching TV?
? Are They waiting for John?

1. Use
1) We use the present continuous tense to talk about the present:
 For something that is happening at the moment of speaking:
I’m just leaving work. I’ll be home in an hour.
Please be quiet. The children are sleeping.
 For something which is happening before and after a
given time:
At eight o’clock we are usually having breakfast.

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 When i get home the children are doing their homework.
 For something which we think is temporary:
Michael is at university. He’s studying history.
I’m working in london for the next two weeks.
 For something which is new and contrasts with a previous
state:
These days most people are using email instead of writing
letters.
What sort of clothes are teenagers wearing nowadays?
What sort of music are they listening to?
 To show that something is changing, growing or developing:
The children are growing quickly.
The climate is changing rapidly.
Your english is improving.
 For something which happens again and again:
It’s always raining in london.
They are always arguing.
George is great. He’s always laughing.
Note: We normally use always with this use.

2) We use the present continuous tense to talk about the future:

 For something which has been arranged or planned:
Mary is going to a new school next term.
What are you doing next week?
3) We can use the present continuous to talk about the past:
 When we are telling a story:
 When we are summarising the story from a book, film or play
etc.:

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14
 CHAPTER III

CONCLUSION

Medical-surgical nursing is the single largest nursing specialty in the United

States. Basic surgical skills is defined as cornerstone corse for all tarines, the students
will learn a range of essential basic surgical skills and technique in a contrelled
workshop environment. In rutes of AIV transmission injury with needles are
contaminated with blood, body fluids. In preventing transmision of infektion,we are
not allowed to recap nidles. It is important to set up sharps containers where sharps
are used. Every hospital needs to give clear guidelines for manegement of injury.
There are some steps which need to do in preventing infections universal precautions.
In the hospital, preventuring maintenance procedures and hecting is very
important it is how we can treat the wound should be right and right, so that the
impact is not more severe or even cause infection that would be dangerous.

15
 CHAPTER IV

BIBLIOGRAPHY

Juliarta, I Made.2017.Module Theory English for Nursing.Denpasar

http://fk.unsoed.ac.id/sites/default/files/img/modul%20labskill/genap%20I/Genap%2
0I%20-%20Hecting.pdf
http://www.esbase.com/grammar/present-continous

https://googleweblight.com/?lite.url=https://en.m.wikipedia.org/wiki/surgery&ei.goo
gle.co.id

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