Surgical Conditions Flashcards
what does SOCRATES stand for?
site onset character radiate associations time course exacerbate/relieving severity
how to determine pain levels?
0-10
wong baker faces scale
WHO analgesic ladder
what is a weak opiate?
codeine/dihydrocodeine/co codamol
what is a moderate opiate?
tramadol
what is a strong opiate?
morphine
oxycodene
what is diclofenac and what can it cause?
NSAID
contra indicated in cardiovascular disease
what might opiates cause?
respiratory destruction
induce toxicity/reduced consciousness/hypotensive/muscle spasm/seizure
have caution of NSAIDs and?
hepatic impairement/may cause renal failure
avoid NSAIDs and?
pregnancy/ GI ulceration/GORD
NSAIDs may worsen symptoms of?
asthma
when might haemorrhages happen post operatively?
0-48 hours = reactionary haemorrhage - slipped ligature/clot disoldged/BP rise - commonest at 4-6 hours post op
secondary haemorrhage - 7-14 days post op - infection or eroded vessel
what is post op hypotension?
bleeding/dehydration/sepsis/opiate overload/spinal anaesthesia
what is pyrexia?
temp over 37.5 degrees - check bloods/urine/swabs/echo
what kind of superficial dehisences can happen?
superficial - burst sutute
deep - same with haematoma
infection
how to treat delirium?
sedation/halopenol 0.5-1mg 1-2 hours : not if pt has parkinsons/lewly body dementia/acute intoxication with alcohol
what might cause urinary retention?
after GA
enlarged prostate
UTI
constipation
when is nausea common and what can it cause?
post op
tx with anti emetics
may cause mallory weiss tears/dehydration/electrolyte disturbance
what is hypokalaemia?
direct effect of renal compensation for acid loss = can cause cardiac arhhythmia
what is a mallory weiss tear?
repeat or profuse vomitting causes a tear in the junction of the stomach and oseophagus
associated with hiatus hernia/NSAID
can present as haematemesis/maleana
what is immediate surgery?
life/limb/organ saving intervention
urgent surgery is?
intervention for acute onset/cinical deterioration of life threatning conditions
expedited surgery?
pt needs early tx where conditions are not an immediate threat to life
what is elective surgery?p
planned/booked surgery in advance
what is done at a pre assesment?
before a GA
for patients with co morbidities
review anaesthetics
how to prep for surgery?
IV fluids
diabetic pt management
anti emetics
DVT risk?
what do fasted pts need?
what might they cause?
fluids
electrolyte imbalance
affects coagulation
what is a DVT?
common in over 60 years
active cancer/lower limb surgery/significant inflammatory condition
prophylaxis with low molecular weight heparin
tx with enxaporin
what does SBAR stand for?
situation
background
assesment
recommendation
