Post Op Flashcards
If a pt spikes a fever during surgery, what would be the cause? Tx?
Wonder Drugs
Malignant Hyperthermia
Tx = O2 & dantrolene
If a pt spikes a fever RIGHT after surgery, what would be cause
Bacteremia
What’s the MC cause of fever POD 1? Tx?
WIND = Atelectasis Tx = Spirometry & Get Pt out of bed (OOB)
What’s the MC cause of fever POD 3? Tx?
WATER = UTI
Take foley out! Abx
What’s the MC cause of fever POD 5? Tx?
WALKING = DVT/PE
Tx: OOB & LMWH
What’s the MC cause of fever POD 7? Tx?
WOUND = Cellulitis Tx = clean wound & sterile
What’s the MC cause of fever POD 10-14?
WOUND = Abscess
Tx = I&D
If a pt has chest pain after surgery & you suspect and MI – what do you do?
EKG’s & troponins
If STEMI = cath
If NSTEMI = Heparin
If a pt is post-op and having pleuritic chest pain – what do you do?
DON’T GET A D-DIMER (it will be positive)
Go straight for a spiral CT
If a pt is hypoxemic – what 3 things should we think of?
PE, Atelectasis, or ARDS
What must have occurred to the pt to make you think of ARDS?
prolonged intubation, lots of fluids, lots of transfusions
If a pt is hypertensive, sweaty, and tachycardic POD 1 or 2 – what should you think of?
DT’s! (alcohol withdrawal, it’s not their pain)
If ataxia, opthalmoplegia, & confusion think Wernicke-Korsakoff
How do we treat DT’s?
Benzo’s & thiamine (possible folate, K, and Mg)
A pt has had low urine output, with no urge to go. The foley is not kinked, and you decide to give a fluid challenge. There is no change in urine output – Dx?
Intrinsic renal disease
A pt is experiencing ileus, POD ½ with no stools or flatus – Tx?
Fluids, K, and OOB to move!
If a pt is still experiencing ileus POD 5 – what do you do?
NG tube, surgery again
What is the difference between wound dehiscence & evisceration?
Dihiscence is failure of the fascia (salmon colored drainage)
Evisceration is failure of the entire wound often with deep structures protruding out (bowel is out) à this is an EMERGENCY!!
What would cause a fistula to fail?
HIS FRIEND
What are the 3 phases of wound healing?
Inflammatory – proliferative (begins once covered by epithelium) – Maturation
What needs to be included in a discharge summary? (10)
Name/Date/Dx/Procedure/Imaging
- Reasons for hospitalization
- Patient exam findings/labs
- Hospital course
- Condition on D/C
- D/C instructions
- D/C diet
- D/C meds
- Follow-up & plan
- Who copies were sent to
