Geriatric Considerations for Post Op Flashcards
What types of surgeries are huge risk factors for old pep
long
abdominal
thoracic
How long is considered long
over 2 hrs
Why do thoracic and abdominal surgeries increase post op comp risk
bec its harder to mobilise secretions through activity coughing and incentive spirometer bec they are weaker, have less alveoli, less cilia and less compliance
What is a consideration for communication
check to see if they are hard of hearing yourself instead of asking them bec they will lie
What can you do to increase the quality of your communication
supp with written material make sure their aid is in be face to face dont cover your mouth speak slowly and clearly use non-verbal comm
What percentage of surgical comps with old peps are resp
40
What percentage of mortality in old peps comes form resp
20
What are some common resp changes with normal aging
decreased vital capacity, tidal vol, and pulmonary reserve
increased residual vol
decreased compliance, ability to cough, and tissue
What are the interventions for making sure old pep doesnt get pneumonia and atelectasis
get them up and moving
incentive spirometry
cough and deep breath
meticulous oral hygeine
What should you do before having them deep breath and cough
give pain meds
What situation makes orla hygeine even more important
if they use a ventilator
Should you show them how to do your interventions before or after surgery
before
What are some considerations for circulatory normal aging
Atheroscleosis
Decreased vessel elasticity- increased risk of hemorrhage, stroke, aneurisms
decreased CO
Compensatory mechanisms (like BP and blood volume) not as responsive
Hypertension increased risk
Less blood volume to begin with
What should you do for pt who show signs of orthostatic hypoT
react quickly, help them sit or lie down
If they have a heart block what should you do for the surgery
try to postpone if it is elective and find out why they have a H block
What should they do if they have had an MI and are within 6 months of it and why
postpone bec their is a 37 percent chance of having another MI during surg within 6 mo of the last one happening
What should you assess if they have HF
assess lungs for abnormal sounds, SOB, JVD, DOE and edema
What are some considerations for renal and liver in normal aging
they have less efficient fluid balance, electrolyte bal, vit D bal, erythropoeitin prod, detox speed
Bec of the natural process of aging on the kids and liver what are old peps more suseptable to
incontinence, retention UTI’s, and dehydration from decreased thirst preception
What is a common neurological complication after surg
delirium
What should you do wiht delirium
be patient
assess vitals to make sure its not from a prob
What is a consideration if they have Diabetes
decreased wound healing so check for skin breakdown
