Exam 3 Surgery Issues

Question 1

Ebb/Flow response to surgery:

Ebb is?

Goal?

Pathophys?

Regulated by?

Answer 1

Initial response to trauma

Goal to conserve circulating vol and energy for repairs

1st 24-72 hrs of non-stressed starvation
↓metabolic rate and CO
Uses glycogen stores from liver/mm
Hypothermia
Lactic acidosis

Catecholamines, cortisol, aldosterone

Question 2

Ebb/Flow response to surgery:

Flow is?

Goal?

Pathophys?

Regulated by?

Possible complication?

Answer 2

Response to trauma 3-5 days post

Goal is repair/rebuild

↑ metabolism/CO/Temp/O2 consumption/gluconeo
Uses up mm and fat = wgt loss/wasting
High nitrogen loss in urine

Catabolic: Catecholamines, cortisol, insulin, glucagon

Hypergylcemia -> leads to infection and death

Question 3

Caloric needs post surgery?

Answer 3

Normal =
25-30 cal/kg
Protein 1g/kg

Stressed =
50 cal/kg
Protein 2.5g/kg

Question 4

Enteral Nutrition advantages? (5)

Answer 4

(Uses GI tract)
↑ blood flow to gut
↑ gut immunity
↑ GB emptying
↓ infections
↓ mortality