Perioperative Flashcards
Patient for surgery with acute hepatitis.
Next step?
Contraindicated till LFT’s improve
Metformin is discontinued ___days before surgery.
2 days (and after surgery as well)
Wrt surgery, Oral hypoglycemic discontinued __
On day of surgery and post op until no longer NPO
Wrt surgery, insulin is __
Discontinued on the day but administered IV intraoperatively
Antihypertensives to discontinue one day b4 surgery
- ACE inhibitors
- ARBs
- Diuretics
Wrt surgery discontinue antiplatelets__
One week before
Wrt surgery discontinue anticoagulant __
• 2 days before
Wrt surgery, Warfrin __
Discontinue 5 days before surgery
Wrt to surgery LMWH discontinued__
24 hrs before
Post OP patient with < 0.5 mL/ kg/ hr urine output > 6 hrs __
Check catheter patency
INR reference range
0.9 - 1.1
Increased INR in__
- Vitamin K deficiency
- Impaired Coag. Factor production (chirrosis)
- Factor VII deficiency
- DIC
WHO analgesic ladder
(Mild) Non opioids ONLY
(Moderate) Non opioids & Mild Opioids
(Severe) non opioids + Strong Opioids
A clean contaminated wound requires ___ Antibiotics
prophylactic
Temperature has to be Greater than 38 C
to be considered Postoperative Fever
An acute post-Op fever is likely
- Nosocomial UTI (catheter)
- Pneumonia
- Surgical site Infection caused by
Group A streptococcus Or
Clostridium Perfringens
- Acalculous cholecystitis and
* Anastomotic Leak are other acute causes of
…Post-Op fever
Febrile Drug reaction usually occurs…
Greater than a week but < 1month post-Op
Fever > 1 month after surgery is likely
…delayed Cellulitis Or Infective Endocarditis
