Post-op care Flashcards
(37 cards)
What is included in a pan culture
urine
sputum
Blood x 2
What are the 2 most common causes of Low BP in the post op period
Hypovolemia or
sudden termination of drug infusion
What is the initial treatment of hypotension
Volume infusion
If there is no immediate response to a volume infusion, what is the next step in treating low BP and why
500mg IV calcium Chloride
*increasing intracellular calcium levels, leads to increased cardiac stroke volume and vascular resistance due to smooth muscle contraction
What is included in the initial exam of a patient in the ICU
-examine heart/lungs/peripheral perfusion
- Hemodynamic measurements (CVP, PA pressure, PCW pressure, CO)
- Portable CXR
- 12 lead EKG
What setting should be used on a pacemaker if there are no atrial leads present
VVI
What is the setting for atrial pacing
AOO
What are the 2 settings for AV pacing
DDD or DVI
What arrhythmia may develop during AV pacing
Afib
What are the typical vent settings when a patient comes out of the OR
Tidal Volume: 8-10
Rate: 8-10/min
FIO2: 1
Why can an ABG be more beneficial than measuring only SaO2
ABG can help determine metabolic and respiratory alkalosis/acidosis based on the patients respiratory drive
When is an arterial line placed in the brachial artery instead of radial or femoral
If there is severe iliofemoral disease/IABP and a radial line is not able to be placed
What helps arterial lines improve patency rates and minimize thrombus formation
Being connected to continuous saline flushes
*continuous heparin flushes do not improve patency and may increase development of HIT
What information does monitoring CVP provide
Tells us filling pressure in patients with preserved ventricular function undergoing coronary surgery
What other pressure correlates with CVP
PA pressure
What does measuring SvO2 tell us
The venous oxygen saturation balance between oxygen delivery and consumption by tissues
*also tends to be reflective of cardiac output
What does ERAS mean
Enhanced recovery after surgery (CABG patients)
What do Swan-Ganz catheters measure
CVP, PCW, PA pressure
*PCW = pulmonary capillary wedge
Which port on the Swan catheter is used for the CVP
Proximal (measures from the RA)
What will be seen on the monitor if the Swan-Ganz position is too deep
Loss of phase PA tracing
Who may not be able to have a PA catheter placed
Someone with a heparin allergy as the catheters are coated
What must be done is a perforation is suspected with a PA catheter
withdraw the catheter and at PEEP to the ventilator
When can a PA catheter be removed
When the patient no longer requires vasoactive support
what is the difference between AF and AFI
AF = Atrial fibrillation
AFI = A flutter
