Lecture 1 Flashcards
Half life of Heparin
90 minutes
Bowel Prep for colon surgery includes
Cathartic
Oral ABX: Flagyl 500 mg PO @ 1300, 1400, & 2300
or Neomycin 1 g PO
When should Coumadin be stopped prior to surgery?
4-5 days
can use FFP if needed
bridge with LMWH if needed
AMPLE
Age/Allergies Medications Past medical/surgical history Last meal, LMP, last tetanus Events leading pt to you
True or False: smoking compromises wound healing
TRUE
Admitting the Patient
'ABC VAAN DIML' Admit: location, attending physician Because: diagnosis Condition: stable, unstable Vitals: what and how often Activity: bed rest? bed to chair? Allergies Nursing Care: catheter? NGT? Diet: when in doubt, NPO IV Fluids Meds: pain, DVT prophylaxis, bowel prep etc Labs: what and when Call Parameters
Pre-Op Note
Surgeon Procedure Labs CXR Consent PT is NPO after midnight, IVF ordered
Operative Note
Pre-Op Diagnosis Post-Op Diagnosis Procedure Surgeon Assistant Anesthesia Fluid EBL (estimated blood loss) Drains Specimen Complication Condition Counts (surgical equipment)
When can you discharge a patient?
afebrile for >24 hrs stable vitals ambulating have resumed bowel/bladder function pain is controlled tolerating oral diet normal labs meds converted to oral form
Lasix IV push can cause
ototoxicity (transient or permanent)
How long should an ileus last?
1 day for every decade of life
How can you control post-op shivering?
Demerol 50 mg IV
A drop of systolic blood pressure by more than 20-30 mm Hg with the induction of anesthesia makes the patient at risk for what?
Myocardial Infarction
True or False: Celebrex needs to be stopped before surgery
False
What is the estimated dose of IV lasix to use?
Cr x 40
