Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peri-Operative Care [16] > Post-Op Nausea and Vomiting > Flashcards

Post-Op Nausea and Vomiting Flashcards

1
Q

What % of post-op patients are affected by N&v in the first 24-48 hours post surgery?

A

20-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the consequences of PONV?

A
  • Increased anxiety for future surgical procedures
  • Increased recovery time and hospital stay
  • Aspiration pneumonia
  • Incisional hernia or suture dehiscence
  • Bleeding
  • Oesophageal rupture
  • Metabolic alkalosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can the risk factors for PONV be divided into?

A
  • Patient factors
  • Surgical factors
  • Anaesthetic factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the patient risk factors for PONV?

A
  • Female
  • Younger age
  • Previous PONV or motion sickness
  • Use of opioid analgesics
  • Non-smoker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the surgical risk factors for PONV?

A
  • Intra-abdominal laparoscopic surgery
  • Intracranial or middle ear surgery
  • Squint surgery
  • Gynaecological surgery, especially ovarian
  • Prolonged operative times
  • Poor pain control post-op
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the anaesthetic risk factors for PONV?

A
  • Opiate analgesia or spinal anaesthesia
  • Inhalational agents
  • Prolonged anaesthetic time
  • Intraoperative dehydration or bleeding
  • Overuse of bag and mask ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the first priority when assessing a patient with PONV?

A

Ensuring they are safe and stable - if any doubt, ABCDE approach should be taken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is there a risk of with PONV when the patient is drowsy?

A

Aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can aspiration caused by PONV be avoided?

A
  • Careful airway assessment

- Protection with NG tube if required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What questions should be asked when assessing a patient with PONV?

A
  • What was the operation? Is it likely to cause PONV?
  • Which anaesthetic agents/post-op drugs have been used
  • Are there any other factors contributing to the nausea?
  • Which anti-emetic therapy would suit this patient best
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the alternative causes of N&V in post-op patient?

A
  • Infection
  • GI causes
  • Metabolic causes
  • Medication
  • CNS causes
  • Psychiatric causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the GI causes of post-op N&V?

A
  • Post-op ileus

- Bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the metabolic causes of post-op N&V?

A
  • Hypercalcaemia
  • Uraemia
  • DKA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What medications can cause post-op N&V?

A
  • Antibiotics

- Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the CNS causes of post-op N&V?

A
  • Raised ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the psychiatric causes of post-op N&V?

A

Anxiety

17
Q

What can the management of PONV be divided into?

A
  • Prophylactic
  • Conservative
  • Pharmacological
18
Q

What are the prophylactic measures for PONV?

A
  • Anaesthetic measures
  • Prophylactic anti-emetic therapy
  • Dexamethasone at induction of anaesthesia
19
Q

What anaesthetic measures can be taken to reduce PONV?

A
  • Reduce opiates
  • Reduce volatile gases
  • Avoid spinal anaesthetics
20
Q

What are the conservative management options for PONV?

A
  • Adequate fluid hydration
  • Adequate analgesia
  • Ensure no obstructive cause
21
Q

What is important to do when using drugs to manage PONV?

A

Ensure choice of anti-emetic is considered by the likely cause of nausea

22
Q

What is often more effective in the drug treatment of PONV?

A

Multi-modal therapy

23
Q

What anti-emetic should be used for patients with impaired gastric emptying or gastric stasis?

A

Prokinetic agent, such as metaclopramide or domperidone (unless bowel obstruction suspected)

24
Q

What anti-emetic can be given in patients with bowel obstruction?

A

Hyoscine (reduces secretions and subsequent N&V)

25
Q

What anti-emetic should be used for patients with a suspected metabolic or biochemical imbalance?

A

Metoclopramide

26
Q

What anti-emetic should be used for patients with opioid-induced N&V?

A
  • Ondansteron

- Cyclizine

Peri-Operative Care [16] (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions