surgical complications in diabetics

Question 1

pre-Op evaluation in elective operations on diabetics

Answer 1

review previous cardiac hx, renal comorbidities

Question 2

preOp eval in emergent operations in diabetics

Answer 2

1. establish baseline
2. EKG
3. blood work

Question 3

top postOp issues in diabetics (4

Answer 3

1. infxns
2. wound care
3. glu control
4. gastroparesis

Question 4

what puts diabetics at incr risk for infxns (4)

Answer 4

1. reduced capillary perfusion
2. reduced O2 & nutrient delivery
3. impaired circulation of antimicrobials
4. hyperglycemia

Question 5

blood sugar control recommended for sternal wound infxns

Answer 5

sugars under 180 in timeframe of 18-24 hrs after anesthesia is done

Question 6

incr insulin tx has what effect on mortality?

Answer 6

incr motality

Question 7

if patient admitted and sugars are >300, then?

Answer 7

start on insulin drip

Question 8

how to protect diabetics from contrast-induced nephropathy (2)

Answer 8

1. adequate hydration prep

2. N-acetylcysteine