10. Post-operative care in obstetrics and gynaecology Flashcards
1
Q
Fluid depletion signs:
A
- Dry mucous membranes
- Reduced skin turgor
- Decreased urine output
2
Q
Worsened fluid depletion sings:
A
- Increased capillary refill time
- Tachycardia
- Low blood pressure
3
Q
Desired urine output
A
> 0.5 ml/ kg/ hr
4
Q
Fluid overload sings:
A
- Raised JVP
- Peripheral or sacral oedema
- Pulmonary oedema
5
Q
IV fluid types:
A
- Crystalloids (used widely; acute setting and theatres as maintenance fluid)
- Colloid – high colloid osmotic pressure, increase IV volume faster but no other benefits
6
Q
Active drain
A
Sealed system where vacuum removed fluid from a potential space created by the surgery
7
Q
Passive drain
A
Fluid flows into the collecting bag
8
Q
When can prophylactic drain be removed?
A
If draining is <100ml in 24h
9
Q
VTE risk factors
A
- Age
- Obesity
- Previous VTE
- Thrombophilia
- Hormone therapies (tamoxifen, COCP, HRT, pregnancy)
- Immobility (travel, hospitalisation)
- Surgery and blood loss
10
Q
VTE prophylaxis
A
- LMWH
- Hydration
- Mechanical – compression stocking
- Mobilisation and leg exercises
11
Q
Early surgical complications <36h
A
- 1* surgical haemorrhage
- Revealed or concealed haemorrhage
- Atelectasis
- Ureteric injury or obstruction
- Wound infection
- Fluid management
12
Q
Late surgical complications >36h
A
- UTI
- Bowel injury or obstruction
- 2* haemorrhage
- Thromboembolic event
- Chest infection
- Fistula
- Incisional hernia
- Paralytic ileus
13
Q
1* surgical haemorrhage
A
Inadequate haemostasis or slipped ligatures; tachycardia, tachypnoea, hypotension, cold and clammy, reduced GCS, shock
14
Q
2* surgical haemorrhage
A
Occurs after 7-14 days, might be secondary to retained products of conception or LLETZ large loop excision of the transformation zone
