effects of anaesthetics and surgery Flashcards
risk factors for cardiac surgery
elderly repeat surgery smoker substance abuse fat PMH lung/ kidney disease
specific risks for cardiac surgery
dec left ventricular function
female
coronary artery bypass graft
new routes around narrowed or blocked arteries
type of incision CABG
sternotomy
anaesthetic for CABG
general
post op anaesthetic for CABG
patient control
regularly
LOS for CABG
5-7 days
common complication for CABG
bleeding
infenction
valve repair/ replacement
mechanical ro biological replacement of valve in heart
operative aneasethic
post op aneasitc
LOS
all same as CABG
common complications for valve repealing
bleeding
infection
more likely mortality CABG or valve repair
valve
aortic dissection
blood filled channel in aortic wall
most common life threatening disorder affecting aorta
aortic dissection
risk factors for aortic dissection
HTN, preg, complication from previous medical treatment
clinical presentation of aortic dissection
sudden chest pain from back down
medical treatment aortic dissection
surgery
conqueneces if aortic dissection not treated
rupture extortion (into aortic valve)
lobectomy
excision of a lobe of the lung
post op aneasthic for lobectomy
thoracic epidural
complications lobectomy
wound infection
brachial plexus injruy
pneuomnectory
removal of lung
complications for pneonectomy
wound infection
brachial plexus injury
esophagectomy
removal of parts of esophagus
post operative anesthetics
epidural , oral pain medication
complication for esophagectomy
infection of chest and abdomen
LOS for esophagectomy
10-14
most common resitrctional sternal guidelines
no standrad
common is not lifter or pulling over 5lbs
pacemaker / ICD
control abnormal hear rhythm
what ICD
implantable cardioverter defibrillator
can pace maker and ICD be combined
yes
how long is pacemaker / ICD procedure
1-4 Horus
Pacemaker avoid these acitifivty
24hr moving shoulder
2 weeks lift
4 weeks life over 5kg
8 shovelling
what can you do pacemaker
24 bend elbow
2 weeks move shoulder
4 weeks regular acts
8 all accts
ECG purple
monster cardiac rhythm and rate
PCA
control dose of meds (self administered)
epidural
treat symptoms of surgery and labour
precautions of epidural
ensure line is aped
NG tube
in patient mouth or nose to give stomach function
precautions of NG tube
feeds are off or on pause before PT treatment
don’t lower head
maintain >30degs
contraindications NG tube
NG tube in same name as suctioning
chest tube
air
contradindiaciton chest tube
ensure collection chamber is kept away from insertion
urinary catheter
monster unitary output
conrradinciaton urinare catheter
back flow of urine
keep chamber below level of bladder
JP drain
remove fluid with constant suction
hemovac
drain indecision wound has suction (i.e breast)
embolus
moves in blood
thrombus
emboli composed of clotting blood
thrombosis embolism
a moving thrombus
deep vein thrombus
embolism formed in leg
pulmonary thromboembolism
embolism one artery of lung
phelbothrombrosis
thrombosis in vein
embolism epidemiology
30% of patients having major surgery
General risk factors embolism
bed ridden obese blood clotting disorder aneasethci HRT
3 DVT risk factors
hypercoagulabilty, vascular damage, circulatory stasis
blood, vessel, flow
signs n symptoms DV
selling in calf and ankle
leg pain
dorsi pain
red, warm leg
DVT treatment
blood thinners
prevent DVT
mobilty, bed exercises
DVT prophylaxis treatment
walk 30-45 minutes, 5-7 days.week
ankle pumps, knee extensions, seated march
effects of general aneasethic post op
dec: deep breathing tidal volume coughing mobilization funcitonal residual capacity
inc: need of approbate closing volume
RR,
Risk of blood clots
outcomes of aesethic
inc risk of: infection secretion rention atelectatsi immbolity LOS complications work of breathing
dec vital capacity
main goals physiotherapy aesthetic
breathing
moving
