Flashcards in MTB Surgery Deck (23):
If the patient is under the age of 35 and has no history of cardiac disease, EKG is the only test needed. A patient who has a history of cardiac disease, regardless of age, must have a(n):
• Stress testing to evaluate for ischemic coronary lesions
• Echocardiogram for structural disease and to assess ejection fraction
Have the patient quit smoking for xxx prior to surgery and use a nicotine patch in the meantime.
6 to 8 weeks
Systemic Inflammatory Response Syndrome
There are 4 SIRS criteria; the presence of at 2 or more indicates SIRS.
1. Body temperature 38°C
2. Heart rate >90 BPM
3. Tachypnea >20 breaths per minute, or PC02 12,000 cells/mm3
2 criteria of SIRS + source of infection=
2 criteria of SIRS + source
of infection + organ dysfunction =
2 criteria SIRS + source
of infection+ organ dysfunction + hypotension =
Four kinds of shocks
Pain in the left shoulder
A kidney, ureters, and bladder
Ischemic bowel disease The most common symptoms are:
• Abdominal pain after eating • Bloodydiarrhea
a full-thickness tear of the esophagus secondary to retching.
palpation of the left lower quadrant causes pain in the right lower quadrant
pain with extension of the hip
pain with internal rotation of the right thigh
• Adhesions from previous
• abdominal surgery
• Crohn disease
• Foreign bodies
• Intestinalatresia • Carcinoid
POD 1- 2
Atelectasis or postoperative
POD 3- 5
Urinary tract infection
Deep vein thrombosis or thrombophlebitis of
the IV access lines.
Must also consider pulmonary embolism for new-onset tachycardia and chest pain.
Wound infections and cellulitis
Drug fever or deep abscess
• An elevated white count is sensitive but not specific.
• An elevated lactate with marked acidosis is a hallmark sign.
Xray and CT
1. Make the patient NPO.
2. Place an NG tube to help decompress the bowel.
4. Transport to the operation room for emergent surgical resection.