Post-op management Flashcards
What is an ileus?
Peristalsis of the bowel stops, bowel expands and fills with fluid
what is cardiogenic shock?
inadequate tissue perfusion due to cardiac dysfunction
how is a fluid challenge conducted?
250ml bolus stat of usually 0.9% saline and check BP
What does improvement post fluid challenge indicate?
hypovolemic or septic shock
what does no improvement after fluid challenge suggest?
bleeding or very very severe hypovolemia
what does deterioration post fluid challenge indicate?
cardiogenic shock
What is the max onc of K you can infuse with fluid in 8h?
40mmol to 1l fluid
what fluids in what volume are given for fluid balance?
2000ml 5% glucose and 500ml 0.9% saline/Hartmanns over 24h
How to assess a patient’s fluid requirements
urine output BP pulse Resp rate/ spO2 cap refill JVP mucous membranes stool chart
4 options for blood transfusion
packed RBC
FFP
Platelets
factor concentrates
why do you usually give FFP alongside packed RBCs if giving a huge amount?
to prevent dilution of the patient’s own clotting factors
4 risks of blood transfusion
transmission of disease
transfusion reaction
bacterial contamination
pyrogenic reactions (antibodies to transfused WBCs)
risks of massive blood transfusion x5
hypothermia hyperK acidosis dilution of CFs fluid overload if not actively bleeding
3 ways to monitor nutrition
diet charts
weight
bloods
what is refeeding syndrome?
in starvatio: catabolic state leads to decreased intracellular stores of phosphate. When feeding resumes, insulin rises in response to carbohydrates, which leads to phosphate uptake into intracellular stores. This leads to hypophosphatemia.
