normal stuff

Question 1

what do we assess for pre op?

Answer 1

• medical hx
• medication use
• psychosocial/emotional status
• consent and pt understanding
• post op support
• baseline observations- BP,P, RR, temp, weight,

Question 2

when do pts need to stop eating before surgery?

Answer 2

food= stop 6 hrs before 
water= stop 2 hrs before

Question 3

what is the most common form of post op analgesia?

Answer 3

PCA= patient controlled analgesia

Question 4

pre op care plan

Answer 4

must be checked by 2 people, important info, must be correct

Question 5

what are some common post op complications?

Answer 5

infection/inflammation
unrelieved pain
dehiscence wound 
bleeding/haemorrhage
DVT/PE
nausea and vomiting 
delirium 
atelectasis

Question 6

explain the surgical stress response. (NEUROENDOCRINE RESPONSE)

Answer 6

includes the neuroendocrine response and the cytokine response

NEUROENDOCRINE RESPONSE
=hypothalmic-pituitary-adrenal

hypothalamus releases CRH, this stimulates anterior pituitary to release ACTH, works on the adrenal gand to release cortisol

increased ADH —> urine retention

IN SURGERY THIS CYCLE KEEPS ON GOING INSTEAD OF BEING SHUT OFF (NORMAL FUNCTION)

therefore high cortisol levels after surgery (4-6 hrs post op)

• increased BGL
• decreased immune+inflammatory response
• increased risk of infection
• inhibits prostaglandins-better pain/less pain
• increases metabolism and temp

Question 7

Explain the surgical stress response (CYTOKINE RESPONSE)

Answer 7

CYTOKINE AND INFLAMMATORY MEDIATOR RELEASE

• increased interleukin
• increased prostaglandins
• increased neutrophils
• increased metabolic rate
• decreased lymphocytes

RESULTS IN:

• increased coagulability
• high BGL
• decreased urine output
• increased HR
• decreased depth and rate of breathing