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Cardioresp > Post-op Complications > Flashcards

Post-op Complications Flashcards

1
Q

Impaired airway clearance

  • Evidence
A
  • non-effective, non-productive cough
  • moist cough
  • inspiratory coarse crackles
  • impaired cough
  • on suction
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2
Q

Impaired airway clearance

  • Patho cause
A
  • resp depression
  • pain
  • resp inhibition
  • impaired cough due to anaesthesia
  • reduced cilial function (secondary to O2 therapy)
  • anaesthetic
  • resp infection
  • thick secretions
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3
Q

Impaired airway clearance

  • Treatment
A
  • Supported/assisted cough (remove)
  • ACT’s (FET – low volume for mob and then high volume for secretion)
  • P+V (mob)
  • PD (mob)
  • PEP devices (mob)
  • Suction (removal)
  • MHI (mob and remove)
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4
Q

Impaired airway clearance

  • OMs
A
  • Sputum volume
  • Cough effectiveness/productiveness
  • Suction (suction less = airway clearance mechanisms is working)
  • Auscultation
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5
Q

Impaired ventilation

  • Evidence
A
  • Wheeze on ausc
  • V/Q mismatch
  • SOB
  • Spirometry
  • increased WOB (nasal flaring, Ax muscle use, increased RR)
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6
Q

Impaired ventilation

  • Patho cause
A
  • Retained secretions
  • airway obstruction (bronchoconstriction, tumour)
  • weak resp muscles
  • airway closes early due to parenchymal damage
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7
Q

Impaired airway clearance

  • Treatment
A
  • Fix whatever is causing obstruction
  • Strengthen resp muscles
  • Position in high sitting to reduced WOB
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8
Q

Impaired ventilation

  • OMs
A
  • Ausc
  • CXR to check for obstruction
  • spirometry
  • observation of breathing
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9
Q

Reduced lung volume

  • Evidence
A
  • CXR
  • redued BS on Ausc
  • reduced BBE
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10
Q

Reduced lung volume

  • Patho cause
A
  • Atelectasis post surgically due to anaesthetic /pain meds causing resp depression
  • obstruction
  • restrictive
  • non-complaint lungs (ie ARDS)
  • resp depression
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11
Q

Reduced lung volume

  • Treatment
A
  • Position(high siting)
  • Pain Mx (ensure not to cause further resp depression if taking analgesics)
  • TEE’s
  • Incentive spirometry
  • Stretch facilitation
  • MHI
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12
Q

Reduced lung volume

  • OMs
A
  • Ausc
  • obs
  • palpation
  • CXR
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13
Q

Impaired gas exchange

  • Patho cause
A
  • Impaired vent
  • reduced volume
  • retained secretions
  • damage to gas exchange surface
  • hyperinflation and gas trapping due to early airway closure
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14
Q

Impaired gas exchange

  • Treatment
A
  • Fix the cause
  • O2 – ensure fit and flow of device, notify Dr if any adjustments need to be made/are recommended
  • Increased metabolic demand (i.e burns, deconditioning, increase WOB)
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15
Q

Impaired gas exchange

  • OMs
A
  • ABG’s
  • WOB
  • observation (colour etc)
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16
Q

Impaired gas exchange

  • Evidence
A
  • V/Q mismatch
  • hypoxemic
  • resp failure
  • ABG’s
17
Q

Dyspnoea

  • Evidence
A
  • Subjective complaint
  • increased RR
  • Ax muscle use
  • pause in middle of sentence/on activity that isn’t typically exhausting etc
18
Q

Dyspnoea

  • Patho cause
A
  • Reduced lung volume
  • weak resp muscles
  • impaired airflow
  • impaired gas exchange
  • fatigue/deconditioning
  • Increased vent demands sue to infection/severe trauma
19
Q

Dyspnoea

  • Treatment
A
  • Positioning - recovery position –> reverse O/I axiohumeral muscle action
  • BC
  • Resolve causative issues (i.e clear secretions as mentioned above)
20
Q

Dyspnoea

  • OMs
A
  • Observation (Breathing pattern, during speaking etc)
  • Subjective report
21
Q

Pain

  • Evidence
A
  • Complains it hurts
  • reduced deep breaths
  • cough isn’t effective etc
22
Q

Pain

  • Patho cause
A
  • Incision
  • surgery
  • trauma
23
Q

Pain

  • Treatment
A
  • Position
  • Support wound when mobilising/coughing
  • Time Rx with pain meds,
  • advise them to deliver dose (if PCA) prior to Pt session
24
Q

Pain

  • OMs
A
  • Ask them (subjective report)
  • need for PCA before Rx
  • Cough effectiveness
25
Q

Reduced exercise tolerance

  • Evidence
A
  • Will say
  • tired when walking small distance
  • increased WOB on mild exertion
  • fatigue, slow when walking
  • need to take breaks
26
Q

Reduced exercise tolerance

  • Patho cause
A
  • Prolonged immobility
  • reduced WB/exercise/ movement
  • lung problems (reduced volume/ventilation/Retained secretions)
27
Q

Reduced exercise tolerance

  • Treatment
A
  • Mobilise
  • Bed exercises (LL, UL, Circ)
28
Q

Reduced exercise tolerance

  • OMs
A
  • Distance walked
  • BORG when walking/mobilising
  • observe resp pattern when mobilising
29
Q

Risk of DVT

  • Evidence
A
  • Prolong immobility
  • CV risk factors
  • LL surgery
  • PVD
30
Q

Risk of DVT

  • Patho cause
A

Reduced venous return secondary to reduced LL muscle use as well as possible clot from surgery

31
Q

Risk of DVT

  • Treatment
A
  • Circ exercises + mobilisation to increased active pump of venous blood,
  • Ted stocking –> for external pressure on vessels
32
Q

Risk of DVT

  • OMs
A
  • DVT check regularly
  • ultrasound if necessary
33
Q

Risk of pressure sore

  • Evidence
A
  • Prolonged immobility
  • reduced bed mobility due to surgery
  • CV risk factors, especially PVD and diabetes
  • Age – fragile skin
34
Q

Risk of pressure sore

  • Patho cause
A
  • Impaired circulation in LL
  • impaired sensation
  • fragile skin
  • prolonged immobility
  • may develop pressure areas, but have reduced healing capacity /reduced ability to feel/notice it and therefore it may develop into a pressure sore
35
Q

Risk of pressure sore

  • Treatment
A
  • Regular position changes in bed to relieve pressure
  • Circ exercises to facilitate blood flow
  • Mobilisation to achieve the above 2 effects
36
Q

Risk of pressure sore

  • OMs
A

Regular observation and monitoring

Cardioresp (12 decks)

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