Postoperative Care

Question 1

Fever

Answer 1

• Causes (5 Ws)
  
  • Wind
    
    • Pneumonia
    • Atelectasis
  • Water
    
    • CAUTI (3-5 days)
  • Walking
    
    • DVT
    • PE
  • Wound
    
    • Infection (5-7 days)
  • Wonder Drugs
    
    • Prescribed drugs (7 days+)

Question 2

Malignant Hyperthermia

Answer 2

• Inherited
  
  • Ryanodine Receptor 1 Mutation
• Can be triggered by
  
  • Inhaled Anesthetics
  • Succinylcholine
• Symptoms
  
  • Autonomic Instability
    
    • HTN, Tachycardia, Fever, Diaphoresis
  • Muscle Rigidity
• Treatment
  
  • Dantrolene

Question 3

Drainage Types

Answer 3

• Types of drainage
  
  • Serous
    
    • watery, clear to yellow
    • seen in early stages of healing
  • Serosangeuineous
    
    • light pink, watery
  • Sanguineous
    
    • bright red
    • indicates active bleeding and poor wound healing
  • Purulent
    
    • green, yellow, brown pus
    • foul smelling
    • indicates infection

Question 4

Drainage devices

Answer 4

• T tube
  
  • bile duct
• Penrose
  
  • typically used in limbs when small amount of drainage is expected
• JP
  
  • Drains fluid around wound after surgery
  • negative pressure
• Hemovac
  
  • negative pressure
  • drains fluid around wound

Question 5

Chest Tubes

Answer 5

• Assessment
  
  • Crepitus (subcutaneous emphysema)
  • Kinking
  • Shortness of Breath
  • Infection
  • Excessive bubbling
    
    • in water seal chamber indicates a leak
    • gentle intermittent bubbling should be expected in pts with a pneumothorax
• Interventions
  
  • If tube dislodges from patient, petroleum gauze taped on 3 sides
  • If drainage system is damaged, place drainage tube in sterile water