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EMS 2 > Post-op Complications > Flashcards

Post-op Complications Flashcards

1
Q

Hematoma- Eti

A
  • Blood or clot in wound
  • Aspirin and LMWH increases risk
  • D/t imperfect hemostasis
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2
Q

Hematoma- Timeline

A

Day 5-8 post-op

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3
Q

Hematoma- Sx

A
  • Elevation and discoloration of wound edges
  • May resorb
  • Discomfort, pressure and swelling at site
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4
Q

Hematoma- Tx

A
  • Evacuate clot

- Ligate bleeding vessels

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5
Q

Seroma- Eti

A

Fluid collection at wound site

  • Common in mastectomy
  • Lymph removal
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6
Q

Seroma- Timeline

A

Day 5-8 post-op

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7
Q

Seroma- Sx

A
  • Painless swelling below wound

- Yellow needle aspirate

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8
Q

Seroma- Tx

A
  • Needle aspriation
  • Compression
  • Allow small seromas to resorb
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9
Q

Dehiscence/ Evisceration- Eti

A

Dehiscence- partial to total disruption of wound layers

  • Evisceration- Rupture of all layers of abd wall, extrusion of viscera
  • Immunosuppression, steroids, cancer
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10
Q

Dehiscence/ Evisceration- Time

A

5-8 days postop

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11
Q

Dehiscence/ Evisceration- Sx

A
  • Serosanguineous discharge from wound

- Popping sensation

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12
Q

Dehiscence/ Evisceration- Tx

A

Dehiscense = reclosure

  • Keep stitches in at least 2 weeks
  • Corset and compression
  • Clean, return to abdomen and re-close
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13
Q

Atelectasis- Eti

A
  • Most common pulm complication

- Partial or total collapse of lung

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14
Q

Atelectasis- Time

A

Within 48 hrs post-op

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15
Q

Atelectasis- Sx

A
  • Ventilation perfusion mismatch
  • Decreased o2
  • Rales, elevated diaphragm
  • Decreased breath sounds
  • Tachypnea, cardia
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16
Q

Atelectasis- Tx

A
  • Commonly self limited
  • Clear airway though coughing, nasotrach suction
  • Bronchodilators or mucolytics
  • Suction
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17
Q

Atelectasis- Prevent

A
  • Early mobilization
  • Position changes
  • Incentive spirometer
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18
Q

Fat embolism- Eti

A
  • Fat particles in pulm vasc bed

- Fractures of long bones or joint replacements- risk

19
Q

Fat embolism- Time

A

12-72 hrs post op

20
Q

Fat embolism- Sx

A
  • Neuro dysfxn
  • Resp insufficiency
  • Petechiae to axillae, chest and proximal arms
21
Q

Fat embolism- Tx

A
  • Supportive O2 unti sx resolve

- positive end-expiratory pressure

22
Q

Air embolism- Eti

A
  • Insertion of catheter with air induction

- Lodges in rt atrium

23
Q

Air embolism- Time

A
  • Soon after IV insertion
24
Q

Air embolism- Sx

A

Hypotension

  • JVD
  • Tachycardia
25
Q

Air embolism- Tx

A

Aspirate air with syringe

- Place pt rt side up, head down to dislodge air

26
Q

Fecal impation- Eti

A
  • Common due to post-op illius and opioid use

- Common in elderly, toxic megacolon and paraplegia

27
Q

Fecal impation- Sx

A

Anorexia

  • Constipation or diarrhea
  • Marked dissension of abd
28
Q

Fecal impation- Tx

A

Manual removal of fecal impaction

- enemas and poly-ethelene glycol

29
Q

Urinary retention- Eti

A
  • Common under spinal anesthesia
  • Inhibition of bladder contraction
  • Pelvic and perineal operations
30
Q

Urinary retention- Sx

A

Severe urgency

  • Suprapubic pain
  • Distended, palpable bladder
31
Q

Urinary retention- Tx

A

Catheter

32
Q

Anemia- Eti

A
  • Gastric operations

- Intrinsic factor made by stomach

33
Q

Anemia- Sx

A
  • Fatigue, paresthesias
  • brittle nails
  • Chelosis
  • Pica
34
Q

Anemia- Tx

A

Supplement with B12 or folate

- Packed RBCs

35
Q

IV phlebitis- Eti

A

Inflammation at IV entry site

36
Q

IV phlebitis- Time

A

Day 3 post-op

37
Q

IV phlebitis- Sx

A
  • Induration
  • Edema
  • Tenderness
38
Q

IV phlebitis- Tx

A

Remove catheter, rotate insertion site

39
Q

Fever- Eti

A
  • 40% pts after surg
  • 48 hrs = catheter, pneumonia, UTI
  • > 5 days abscess, sepsis
40
Q

Fever- Sx

A
  • Febrile
  • Diaphoresis
  • Chills
  • Muscle and HA
  • Weak, confused
41
Q

Fever- Tx

A
  • Tx underlying cause

- CT abd/ pelvis

42
Q

DVT/ PE- Eti

A
  • 21 fold risk
  • Resp failure > 3 days post op
  • 20% surg pts
  • 50-60% hip or knee pts
43
Q

DVT/ PE- Sx

A
  • PE: Acute onset dyspnea
  • Chest pain
  • Hemoptysis
  • Tachy
  • AMS
  • DVT- unilateral, mid-calf pain
  • Low grade fever
44
Q

DVT/ PE- Tx

A

Anticoagulation

- Routine DVT prophylaxis if moderate or high risk

EMS 2 (14 decks)

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