Post-operative Care Flashcards
What are the 5 freedoms?
- Freedome from thirst, hunger, and malnutrition
- Freedom from discomfort
- Freedom from pain, injury, and disease
- Freedom to express normal behavior
- Freedome from fear and distress
Explain the negative energy balance in the post-operative patient…
Increased metabolic demand + decreased caloric intake
What are the consequences of protein calorie malnutrition in the post-op patient?
- Impaired immunocompetence
- Decreased wound healing
- Decreased resistance to infection
- Anemia
- Hpoproteinemia
- Organ/muscle atrophy
- Death
What is enteral hyperalimentation?
Providing nutrients to a FUNCTIONAL GI tract via nasoesophageal, pharyngostomy, esophagostomy, or gastrotomy tubes
What is parenteral hyperalimentation?
Providing nutrients intravenously
Pain management is used to DECREASE 3 things.
What are they?
Peripheral sensitization
Central sensitization
Wind-up
What 2 things work against peripheral pain sensitization?
- NSAIDs
- Good surgical technique
When must analgesias be given?
BEFORE painful stimulus
Helps prevent central nervous system “wind-up”
What are the 3 types of pain?
Somatic
Visceral
Neuropathic
Damage to which types of tissue would cause SOMATIC pain?
Damage to BONES, JOINTS, MUSCLE, or SKIN
What description might one use to describe SOMATIC pain?
Localized
Constant
Sharp
What types of changes might cause VISCERAL pain?
Stretching, distention, or inflammation of viscera
How might one describe VISCERAL pain?
Deep
Aching
Without good localization
What types of injury might cause NEUROPATHIC pain?
Injury of the PNS or CNS
How might one describe NEUROPATHIC pain?
Burning
Shooting
+/- neurological deficits
What are the risks of having an “unarousable” patient?
Hypoventilation
Hypoxemia
Gastro-esophogeal regurgitation
Aspiration pneumonia
Which do you treat first, pain or stress?
Pain
What are 3 medications that can be used for anxiety, fear, or stress?
Acepromazine
Alpraxolam
Trazazone
What types of changes does a full bladder causes within a dog?
Increased sympathetic stimulation
Tachycardia
Panting
Vocalization
What should be your protocol for bladder expression during surgery?
Express ALL bladders at the end of surgery
THEN: assess bladder size every 6 hours post-op if not urinating
What effect does Dexmedetomidine have on urine production?
Increases it
What effect do opioids have on urine production?
Decrease it
Increase sphincter tone
What should you consider doing if an enlarged bladder CANNOT be expressed?
Opioid reversal!
