PACU Care Complications Flashcards
At what temperature when patient is considered hypothermic (PACU care complications)?
Temp < 36 C
What are complications associated with hypothermia?
Shivering
Impaired wound healing/ surgical infection site
Myocardial ischemia
Coagulopathy
What is the treatment for hypothermia?
Warming measures checked Q15 minutes
What are the risk factors for PONV (PACU care complications)?
Female +1
Nonsmoker +1
PONV Hx +1
Postoperative opioids +1
What is the difference between Reglan and Zofran (PACU care complications)?
!Reglan - MOA is increasing gastric emptying
!Reglan contraindicated patient’s with Parkinsons because it blocks dopamine receptors
!Zofran - given after chemotherapy or surgery
Zofran - 5-HT3 receptor antagonists, MOA blocking the action of serotonin, a natural substance that may cause nausea and vomiting
What is emergence delirium (PACU care complications)?
Dissociative state of consciousness demonstrated by responsive/ non-responsive agitation that may last 10-45 minutes
Anxiety and Agitation
What is the treatment for emergence delirium (PACU care complications)?
Keep safe
!Always rule out hypoxemia
How does succinylcholine help in laryngospasm (PACU care complications)?
Relax laryngeal muscles
How does steroids/ lidocaine IV help in laryngospasm (PACU care complications)?
Decrease airway irritation - racenic epinephrine
What are the causes of dilutional hyponatremia in TURP syndrome (PACU care complications)?
Absorption of irrigating solutions
!Leads to water intoxication
What are the s/s of dilutional hyponatremia (PACU care complications)?
Confusion
Nausea
Bradycardia
Seizure
Coma
What are the characteristics of compartment syndrome (PACU care complications)?
5 P’s
Pallor
Paresthesia
Paralysis
Pulselessness
Pressure
What are the s/s of compartment syndrome (PACU care complications)?
Severe pain not relieved by analgesics
What is the late sign for MH (PACU care complications)?
Fever
What BP medication can not be given to MH (PACU care complications)?
!No calcium channel blockers for MH
What is citrate toxicity in blood transfusion (PACU care complications)?
Per NIH, citrate toxicity occurs when citrate in transfused blood begins to bind calcium in the patient’s body. However, clinically significant hypocalcemia does not usually occur unless the rate of transfusion exceeds one unit every five minutes or so.
What is the treatment for Disseminated Intravascular Coagulation (PACU care complications)?
Fresh frozen Plasma when bleeding is present or anticipated
What medication to treat Von Willebrand Disease (coagulation/ bleeding d/o)?
DDVAP - prevents breakdown of clotting factors
What are the side effects of scopolamine (PACU care complications)?
!Disorientation
!Hallucinations
Sedation
Dry mouth
Visual disturbance
Dysphoria
Confusion
What are signs and symptoms of epidural hematoma as complication of epidural anesthesia?
Lower back pain
Motor changes
Bowel/ bladder dysfunction (urine incontinence / NOT retention)
What are signs and symptoms of epidural hematoma as complication of epidural anesthesia?
Lower back pain
Motor changes
Bowel/ bladder dysfunction (urine incontinence / NOT retention)
