Surgery PA (Exam #4) Flashcards
What two groups of meds should always be considered pre-op?
- NSAIDs
- Anticoagulants
What group of disorders can indicate increased risk for infection post-op? What are two examples?
Metabolic disorders
- DM
- Adrenal insufficiency
What is the #1 goal when positioning the patient for surgery?
PROTECT THE PATIENT
When would Trendelenburg vs. Reverse Trendelenburg positioning be used?
- Trendelenburg = increase exposure to pelvis
- Reverse Trendelenburg = increase exposure to upper abdomen
Describe Laparotomy vs. Laparoscopy?
- Laparotomy = open, large incision
- Laparoscopy = small incisions with camera aid
If infection presents post-op, what pathogen is most common?
GAS
What constitutes a Post-Op Fever? What labs should be ordered (4)?
102+ F within 48 hours post-op
- CBC with diff
- UA
- Cultures
- CXR
What is the prophylaxis abx goal with Post-Op Infection?
Which class of abx does this typically involve?
Choose abx that will cover MOST probable intraoperative contaminants
- Often Cephalosporins (1st and 2nd Gen)
What is the MOST common cause of fever in first 48 hours after surgery?
Atelectasis (pulm)
What post-op condition presents with fever, chills, tachycardia, leukocytosis, hypotension?
What is the recommended tx (2)?
Bacteremia
- Tx = change IV lines every 3 days; abx
What post-op condition presents with decreased mental status, often a/w NG tube feedings?
Aspiration
What two pathogens are most often associated with Post-Op Wound Infections?
- Staph
- Strep
What type of wound debridement involves use body’s own enzymes to liquify necrotic debris?
Autolytic Debridement
What type of wound debridement involves use chemical enzymes to turn necrotic tissue → slough?
Enzymatic Debridement
What type of wound debridement involves wet-to-dry dressing; cheap but non-selective, traumatic and painful?
Mechanical Debridement
