Post Op Probs

Question 1

Early

Eg in recovery

Answer 1

Airway comprom
Confus, delerium
NV
Pain
Hypothermia, shiver
Hypoxia, hypoventil
Bleeding

Question 2

Effects of pain

Answer 2

CVS- HR, BP, myocardial demand
Resp- low VC, FRC, TV. Basal atelectasis, chest infec.
GI- NV, ileus
Other- urin reten, DVT, PE

Question 3

Neuro

Answer 3

Not waking
Pain
Confus, agitat- CVA, TIA, opiates etc
Hypothermia, shiver

Question 4

Resp

Answer 4

Upper airway obstruc- LOC, FB
Hypoventil
Hypoxia

Question 5

Hypoxia causes

Answer 5

Inadeq supply-
Atelectasis- hypoventil, pain, too much O
V/Q mism- pneum, PE, HF
Inadeq deliv- shock, anaemia
Incr use-
Fever, shiver, hypermetabol
Abn tiss use-
Cyanide pois

Question 6

middle complics on ward

Answer 6

MI
PE- trauma, immob, dehyd, inadeq antithromb
VTE
Pneumonia- atelectasis, immob
Ileus

Question 7

CVS

Answer 7

Hypot- inhaled anaes, inadeq fluid, PK etc vasodilat, sedation, bleed, NV
HTN eg pain, stress resp
MI- us day 3
VTE

Question 8

GI

Answer 8

PONV-
RF- child, female, anx, motion sickness, hx, gynae/ENT/GI/breast surg, squint, surg durat, anaes gas, opioid, pain, dehyd
AE- dehyd, cant take meds, aspirat, distress, poo rsurgic outc, delay disch.
Mx- avoid NO2 if poss, pain mx, hydrat, ondansetron, cyclizine, dexamethasone
Ileus-
RF- intra abdo surg, drugs
Mx- NG decomp, fluids

Question 9

Late complics

Answer 9

Obstruc
Adhesions
Wound breakd
Dehiscence
Graft fail