Abdominal Aortic Aneurysm Flashcards Preview

AP II Final Exam > Abdominal Aortic Aneurysm > Flashcards

Flashcards in Abdominal Aortic Aneurysm Deck (22):
1

How do you set up the OR for a AAA? (5)

Large ETT

Transducers (double or triple)- Art, Swann, Central lines

Fluid warmers

NG tube

Albumin available?

2

What drugs do you need during a AAA?

Uppers (3)
Downers (3)

Uppers: Norepi, Epi, Vasopressin

Downers: NTG, Nicardipine, Esmolol

3

What does high creatinine indicate?

Renal insufficiency

4

For patients with a pacemaker, what do you need to do?

Need magnet to place on the device.

5

What is the normal diameter of the abdominal aorta?

3 cm

6

What do you need to ensure regarding blood prior to surgery?

7

What lab value is important because end organ issues can become a major complication during surgery?

Creatinine!

8

What induction drugs do you use for renal/heart patients?

Etomidate 20mg

Fentanyl 250 mcg

Cisatracurium 8mg

9

What are the 3 phases of an AAA?

Dissection

Clamping/Surgical Repair

Unclamping

10

What hemodynamic effects does clamping present?

Increased BP!!

11

What hemodynamic changes does surgical repair present?

Decreased BP!

12

PEARL

How do you quickly calculate PaO2?

FiO2 * 5

13

What does clamping do to afterload?

Increases it.

14

During clamping phase, what do you need to do? (2)

Check urine output often to ensure renal perfusion!

Turn off lower body Bair hugger to decrease metabolism/O2 requirement!

15

What is normal urine output?

0.5 - 1.5 cc/kg/hr

16

When clamping, what 2 drugs should be in line?

NTG--reduces preload

Nicardipine

17

What lab value can you expect to change when giving albumin?

Calcium decreases.

Note: Also occurs with cell saver.

18

What does a (-) BE indicate?

Acidic state

19

When unclamping, what should you do? (3)

Take downers out of line!

Pressors in line.

Give fluids-- use pressurized bag.

20

What should you do if the pt becomes unstable during unclamping?

Reclamp and reassess.

21

During closing, what should we do? (5)

22

What are common post-op complications? (7)

MI, arrhythmia (50% of complications)

Renal failure/insufficiency

Ileus

Ventilation problems (TRALI related)

Pain

Bleeding

Multiorgan failure