Post Op Flashcards

1
Q

If a pt spikes a fever during surgery, what would be the cause? Tx?

A

Wonder Drugs
Malignant Hyperthermia
Tx = O2 & dantrolene

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2
Q

If a pt spikes a fever RIGHT after surgery, what would be cause

A

Bacteremia

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3
Q

What’s the MC cause of fever POD 1? Tx?

A
WIND = Atelectasis
Tx = Spirometry & Get Pt out of bed (OOB)
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4
Q

What’s the MC cause of fever POD 3? Tx?

A

WATER = UTI

Take foley out! Abx

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5
Q

What’s the MC cause of fever POD 5? Tx?

A

WALKING = DVT/PE

Tx: OOB & LMWH

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6
Q

What’s the MC cause of fever POD 7? Tx?

A
WOUND = Cellulitis
Tx = clean wound & sterile
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7
Q

What’s the MC cause of fever POD 10-14?

A

WOUND = Abscess

Tx = I&D

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8
Q

If a pt has chest pain after surgery & you suspect and MI – what do you do?

A

EKG’s & troponins
If STEMI = cath
If NSTEMI = Heparin

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9
Q

If a pt is post-op and having pleuritic chest pain – what do you do?

A

DON’T GET A D-DIMER (it will be positive)

Go straight for a spiral CT

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10
Q

If a pt is hypoxemic – what 3 things should we think of?

A

PE, Atelectasis, or ARDS

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11
Q

What must have occurred to the pt to make you think of ARDS?

A

prolonged intubation, lots of fluids, lots of transfusions

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12
Q

If a pt is hypertensive, sweaty, and tachycardic POD 1 or 2 – what should you think of?

A

DT’s! (alcohol withdrawal, it’s not their pain)

If ataxia, opthalmoplegia, & confusion think Wernicke-Korsakoff

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13
Q

How do we treat DT’s?

A

Benzo’s & thiamine (possible folate, K, and Mg)

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14
Q

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?

A

Intrinsic renal disease

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15
Q

A pt is experiencing ileus, POD ½ with no stools or flatus – Tx?

A

Fluids, K, and OOB to move!

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16
Q

If a pt is still experiencing ileus POD 5 – what do you do?

A

NG tube, surgery again

17
Q

What is the difference between wound dehiscence & evisceration?

A

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!!

18
Q

What would cause a fistula to fail?

A

HIS FRIEND

19
Q

What are the 3 phases of wound healing?

A

Inflammatory – proliferative (begins once covered by epithelium) – Maturation

20
Q

What needs to be included in a discharge summary? (10)

A

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