complications

Question 1

complications

Answer 1

-human error- emission, commission, system
-independent of experience of procedure type
-planning, communication, and culture of safety are key to controlling level of complication

Question 2

types of complications

Answer 2

-Procedural complications:
-Central Lines
-Swan Ganz Catheters
-Arterial lines

-Endoscopy
-Bronchoscopy
-Tracheostomy
-Tube thoracostomy
-Angiography
-Biopsies
-Neurologic- AMS = stroke code
-ENT
-Carotid vascular problems- TIA, occlusion, graft bleed
-Thyroid/parathyroid- thyrotoxicosis
-Pulmonary
-Cardiac- EKGs post op- polymorphic PVCs?
-GI
-Hepatobiliary- meds can cause jaundice (antibx)
-Pancreas- meds can cause pancreatitis
-Renal
-MSK
-Hematologic
-Abdominal Compartment Syndrome- too much fluids or burn pt, crush IVC, bp drops -> check bladder pressure if sus
-Wounds/Drains/Infections
-Abdominal abscess
-Necrotizing fasciitis- DM
-SIRS/MODS
-Nutritional
-Glycemic
-Metabolic
-Temperature regulation

Question 3

5 Ws

Answer 3

-wind- PNA, aspiration, PE, atelectasis* -> cytokine storm interleukins cause fever
-water- urinary -> foley?
-wound- incisions
-walking- DVT of PE
-wonder drugs- drug fever or related to blood transfusion
-whopper- deep organ space infection, abscess
-wing/waterway- phlebitis or cellulitis from old IVs
-wave- EKG- MI

Question 4

post op fever workup

Answer 4

-directed approach
-tools:
-EKG, Troponins, ECHO
-CXR, ABG, Sputum Cultures (Labs)
-U/A wit Reflex Culture (Labs)- foley
-Cultures of Drainage (Labs in some cases)
-Venous Dopplers, CTA, D-Dimer- DVT
-CT Scan Affected Regions (Carful regarding renal function)
-Pharmacist Consultation
-Biomarkers: CRP, PCT, Lactic Acid -> infection
-U/S: POC Applications

Question 5

if you send for someone for imaging with dye you must check

Answer 5

creatinine
-can cause contrast induced nephropathy

Question 6

catheter, lines complications

Answer 6

-non-tunneled catheter
-tunneled catheter- chemo
-central line
-midline- 30 days, more popular
-swam-ganz catheter - CO, vascular resistance,
-arterial lines- get a + allen test
-bronchoscopy- atelectasis
-tracheostomy - blue rhino- scope from above so you dont puncture esophagus

Question 7

risk assessment

Answer 7

-to make sure we dont have:
-MI > Cardiac Arrest > -Cardiac Death
-HF
-Arrythmias
-Stroke
-Sudden Cardiac Death

Question 8

chronic use of steriods

Answer 8

-give vitamin A
-steroids prevent crossing of collagen and wounds are at risk of opening
-sugar is high

Question 9

up to date

Answer 9

Answer 10

50392/74475,

Question 11

up to date

Answer 11

Question 12

up to date

Answer 12

Question 13

up to date

Answer 13

Question 14

up to date

Answer 14

Question 15

up to date

Question 16

after surgery your in a

Answer 16

hypercoagulable state

Question 17

bronchial breathing

Answer 17

-subsegmental collapse
-atelectasis

Question 18

HTN + tachycardia is DVT PE unless proven otherwise

Answer 18

true

Question 19

MAP

Answer 19

-provides flow to critical organs
-60-65 MAP for sick pts
-too low- secondary injury to brain -> not enough O2
-too high- if someones bleeding it will cause more bleeding
-radial artery
-systolic pressure -> brain perfusion
-use norepinephrine (levofed), phenylephrine to increase BP

Question 20

CPP

Answer 20

MAP - ICP
- you want it >60
-increase the MAP or decrease the ICP