*Postop complications

Question 1

Post op fever shortly after anaesthetic (halothane/succinylcholine)

Answer 1

Malignant hyperthermia
1. >104deg F
2. Metabolic acidosis
3. ↑Ca, ↑K
4. Family h/o+
5. Mx - dantrolene, 100% o2, correct acidosis, cooling blankets
6. Complications - post op myoglobinuria

Question 2

*Post op atelectasis

Answer 2

POD 1
fever
Crepitation, low breath sounds
No antibiotic req
White lung on CXR

Question 3

**Mc complications on POD 1, 3, 4-5, 5-7

Answer 3

POD 1: Atelectasis
POD 3: Pneumonia, UTI
POD 3-5: DVT, PE
POD 5-7: Wound infection, septic thrombophlebitis
POD 10-14: Deep abscess

Question 4

Post op Urinary complications

Answer 4

Anuria - MECHANICAL - check catheter

Oliguria (<0.5ml/kg/hr) - renal/prerenal (dehydration)
●FLUID CHALLENGE TEST
500ml IV fluid over 10-20 mins, improves in dehydrated pts, no change in renal failure
●URINARY Na:
Dehydrated - <10-20mEq/L
Renal failure - >40mEq/L

Question 5

When is post op foleys placed?

Answer 5

No spontaneous urination with in 6-8hrs of Sx
Check for urethral problems
or enlarged prostrate

Question 6

Abdominal distention

Answer 6

Paralytic ileus
No passing of motion, no flatus but no pain

If not resolved after 7 days, pain, vomit -
MECHANICAL OBSTRUCTION
Xray abd done