Geriatric Considerations for Post Op

Question 1

What types of surgeries are huge risk factors for old pep

Answer 1

long
abdominal
thoracic

Question 2

How long is considered long

Answer 2

over 2 hrs

Question 3

Why do thoracic and abdominal surgeries increase post op comp risk

Answer 3

bec its harder to mobilise secretions through activity coughing and incentive spirometer bec they are weaker, have less alveoli, less cilia and less compliance

Question 4

What is a consideration for communication

Answer 4

check to see if they are hard of hearing yourself instead of asking them bec they will lie

Question 5

What can you do to increase the quality of your communication

Answer 5

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

Question 6

What percentage of surgical comps with old peps are resp

Answer 6

40

Question 7

What percentage of mortality in old peps comes form resp

Answer 7

20

Question 8

What are some common resp changes with normal aging

Answer 8

decreased vital capacity, tidal vol, and pulmonary reserve
increased residual vol
decreased compliance, ability to cough, and tissue

Question 9

What are the interventions for making sure old pep doesnt get pneumonia and atelectasis

Answer 9

get them up and moving
incentive spirometry
cough and deep breath
meticulous oral hygeine

Question 10

What should you do before having them deep breath and cough

Answer 10

give pain meds

Question 11

What situation makes orla hygeine even more important

Answer 11

if they use a ventilator

Question 12

Should you show them how to do your interventions before or after surgery

Answer 12

before

Question 13

What are some considerations for circulatory normal aging

Answer 13

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

Question 14

What should you do for pt who show signs of orthostatic hypoT

Answer 14

react quickly, help them sit or lie down

Question 15

If they have a heart block what should you do for the surgery

Answer 15

try to postpone if it is elective and find out why they have a H block

Question 16

What should they do if they have had an MI and are within 6 months of it and why

Answer 16

postpone bec their is a 37 percent chance of having another MI during surg within 6 mo of the last one happening

Question 17

What should you assess if they have HF

Answer 17

assess lungs for abnormal sounds, SOB, JVD, DOE and edema

Question 18

What are some considerations for renal and liver in normal aging

Answer 18

they have less efficient fluid balance, electrolyte bal, vit D bal, erythropoeitin prod, detox speed

Question 19

Bec of the natural process of aging on the kids and liver what are old peps more suseptable to

Answer 19

incontinence, retention UTI’s, and dehydration from decreased thirst preception

Question 20

What is a common neurological complication after surg

Answer 20

delirium

Question 21

What should you do wiht delirium

Answer 21

be patient

assess vitals to make sure its not from a prob

Question 22

What is a consideration if they have Diabetes

Answer 22

decreased wound healing so check for skin breakdown