Flashcards in Boblin's Review PPT Deck (133)
A serious a potentially life-threatening condition that arises when a considerable mass of body tissue dies after an injury, infection or ischemia
a collection of pus within a naturally existing anatomical cavity, like the lung pleura
bacteria in the blood that often occurs with severe infections and may be life threatening
A collection of pus in a newly formed cavity in any part of the body that is accompanied by swelling and inflammation
the presence of viable bacteria in the circulating blood that may or may not have any clinical significance.
A diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin
a surgical complication in which a wound breaks open along the surgical suture. Risk factors are age, DM, obesity, poor suture technique, trauma to wound s/p sx.
What are the 3 most common primary sources of infection that result in sepsis?
1) lungs (50%)
You estimate your patient will need surgery for an ectopic pregnancy within 36 hours. This would be an example of ________________ surgery.
(elective, urgent, or emergency)
urgent (life-saving sx to be done within 24-48 hours)
Any unanticipated event in a healthcare setting resulting in death or serious physical/psych injury to a person which is not related to the natural course of the patient's illness. Ex: loss of limb, gross motor fxn, etc.
What are some of the most common Sentinel Events?
1) wrong pt/procedure/site
2) retention of medical equipment
3) medication error
5) delayed treatment
6) suicide (no "fault" example)
Most surgeries are performed in the _________ position. Ex: abdominal, chest
Spinal procedures are typically done in the _________ position
Orthopedic procedures of the extremities are typically done in the _________ position
OBGYN and urology procedures are typically done in the ___________position
Colorectal and anorectal procedures are typically done in the ___________position
Neurosurgery and some ortho sx of neck and shoulders are typically performed in the ___________position
What are the pre-op labs that are generally ordered?
CBC, BMP, LFT, PT/PTT, UA, blood type (not all of these are ordered for asymptomatic patients without comorbidities)
In addition to labs, what other screening tests are commonly ordered pre-op?
What is one of the most common causes of delay for surgery?
Get your consent signed!
Your 55 year old WM patient has a h/o CHF and DM. You are going to perform a periumbilical hernia repair. When discussing his medications, you advise him that he should __________ his Metoprolol and _________ his Lasix.
a) hold, hold
b) hold, continue
c) continue, hold
d) continue, continue
c) continue BP meds and hold diuretics
Your 55 year old WM patient has a h/o CHF and DM. You are going to perform a periumbilical hernia repair. When discussing his medications, you advise him that he should __________ his Levemir (Long acting insulin) and _________ his Metformin.
a) hold, hold
b) reduce, continue
c) continue, continue
d) reduce, hold
b) reduce long acting insulin by 1/2 dose and hold oral DM medications on day of surgery
How many days before surgery should you stop ASA?
What is your pre-op advise for a surgical patient who is taking Coumadin for afib?
Convert from Coumadin therapy to Lovenox injections 4-5 days prior to surgery. (No anticoagulation on the day of)
What 4 factors predict pulmonary complications s/p sx?
2) lengthy sx
3) sx near diaphragm
4) current infection
Which of the following patients has the least risk for developing a blood clot following sx?
a) a patient with a prolonged intubation
b) a patient who underwent excision of cancer
c) a patient with PVD
d) a patient who underwent orthopedic surgery
e) a patient who had a spinal cord injury
c) a patient with PVD (I just made that one up, the rest are on the list)
If you are worried about the risk of hypoglycemia in your diabetic patient during surgery, what is your target range for glucose during the procedure?
When can diabetic patients resume their home medication regimen?
As soon as they can eat normally.
Studies show that smoking cessation for ___(#) _____ (days/weeks/months) prior to sx reduces risk for post op pulmonary infections