Surgical Assessment and Post Operative Care Flashcards
What is perfomed as part of the pre op checklist and why?
Making sure you have the right patien, right operation, right conditions for the operation. Consesnt form is checked and site of operation is confirmed, allergies are checked. This is performed before the patient goes to sleep and ensure safety and makes sure nothing has been forgotten.
What is perfomed as part of the perioperative checklist and why?
Performed as patinet has been put under, at a time hwere if anything is wrong the operation can stop. Staff introduce theirselves and roll , any anticipated critical events are discussed, has antibiotics been given and has thromboprophylaxis been ordered?
Whati s performed as part of the post op checklist?
Confirmation of procedure that has been completed, full equipment count and any problems with equipment, and discussion of any concerns that may be important for the patient in post of recovery.
What is the stress response?
hormonal and metabolic changes that follow injury or trauma . The response is proportional to the trauma
What is the neiroendocrine response?
The neuroendocrine response is stimulated by painful afferent neural stimuli reaching the CNS. The response
What is the stress repsone?
The bodies rsonse to stress, in terms of surgery the nomal negative feedback loop does not occur so cortisol is overproduced casuing an exaggerated response. You might see prolonged increased BGL, HR, Body Temp.
What cardiac complications can occur post op?
Haemorage, Hypotension/shock. arrythmias, MI, Hypertension, CVA, DVT
Wat respiratry complications can occur post op?
Atelactasis/Pneuminia, Airway obstriction, pulmonary odema, pulmonary embolism
What renal complications can occur post op?
Urinary retention, Actute kidney injury
What cognitive complications can occur post op?
Deliruium, Hypoxia, Perioperati stroke, medication effects, electrolyte abnormalities
What complications can occur with surgical wounds?
haematoma, infection, dehiscence, hernia around incision
When would you start to be concerned about post op fever and why?
AFter 72 hours if fever has not reduced it could be a sign of infection ( wound, UTI) or non infection such as a DVT.
0-24 hours - normalresponse to surgical trauma
24-72 - pulmonary disorders
72 hours + - infection
How can oain be harmful to patients post op?
Enhances surgical stress response, causes tachycradia and HTN, O2 demand increases, reduced ability to mobilise, resp function compromised.
Why is oliguria/inability to urinate post op a common side effect?
rine output is low in first 24 hours after surgery due to ADH and Aldosterone which have been stimulated by stress response .