Day 5 - ICU & Surgery Quiz Flashcards Preview

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Flashcards in Day 5 - ICU & Surgery Quiz Deck (27):
1

Causes of fever in postop period

Wind (Atelectasis possibly PNA), Water (UTI), Walking (DVT), Wound (Infection, POD 5-8), Wayne ("vein" thrombophlebitis), & Wonder Drugs (antibx); Sinusitis (especially if NG tube)

2

Usual lab panel in pt p/w generalized ab pain

CBC w/ diff, Chem 14 (lytes, BUN/Cr, & LFTs), B-HCG in females, U/A, Amylase, Lipase, Stool guaiac; If over age 45, may be atypical CP - EKG & cardiac enzymes

3

Usual time frame for stopping Warfarin prior to surgery

3-4 days; Coagulation factors have shorter half life

4

Normal time frame for stopping ASA prior to surgery

5-7 days; Platelets have longer half-life than coagulation factors (e.g., 3-4 days for warfarin)

5

Interventions helpful in optimizing lung fxn in postop pts w/ pre-existing lung disease

Normally - IS, Pain control, Deep breathing, PT; Pre-existing lung disease - also add bronchodilators (Albuterol or Levalbuterol), inhaled steroids

6

When greatest risk for postop MI

Within 48 hrs postop

7

Recommended periop regimen for pt w/ known CAD

Beta blockers, Telemetry monitoring

8

Vasopressors: theoretically causes renal vasodilation

Dopamine

9

Vasopressors: High dose optimize alpha1 vasoconstriction

Epinephrine

10

Vasopressors: ADH analog

Vasopressin

11

Vasopressors: Best choice for anaphylatic shock

Epinephrine

12

Vasopressors: Best choice for septic shock

NE

13

Vasopressors: Best choice for cardiogenic shock

Dobutamine

14

Vasopressors: Causes vasoconstriction but with bradycardia

Phenylephrine

15

Immunodef increases risk for transfusion reaction

IgA deficiency

16

Blood products most appropriate: Severe anemia 2/2 autoimmune hemolytic anemia

Packed RBCs

17

Blood products most appropriate: Hemophilia

Specific clotting factor (e.g., VIII in A, IX in B)

18

Blood products most appropriate: DIC

FFP; If platelets severely low, may need to replace them as well

19

Blood products most appropriate: Shock due to trauma or postpartum hemorrhage

Whole blood or Packed RBCs

20

Blood products most appropriate: Maintain bp during large volume pericentesis

Albumin

21

Blood products most appropriate: Hemorrhage due to warfarin overdose

FFP (while Vitamin K is starting to exert its effect)

22

Blood products most appropriate: Need for vWF rich product

Cryoprecipitate

23

Blood products most appropriate: Thrombocytopenia

Platelets

24

Preferred vessels for placement of Swan-Ganz catheter

Right IJ or Left Subclavian

25

Lab findings suggest hepatic disease during preop w/u

Elevation of PT/PTT, Decreased platelets, Elevated bili, LFTs elevated or decreased (if cirrhotic), Decreased lipids, Decreased Albumin

26

Interventions to protect kidney s during times of anticipated insults

N-acetylcysteine for 24 h before & after; IV fluids; Sodium bicarbonate right before IV contrast & 6 h after

27

Typical post op fever w/u

Assess pts; CXR, CBC w/ diff, UA, urine & blood cultures; Risk of DVT or sinusitis

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