Post-op Complications Flashcards Preview

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Flashcards in Post-op Complications Deck (44):
1

Hematoma- Eti

- Blood or clot in wound
- Aspirin and LMWH increases risk
- D/t imperfect hemostasis

2

Hematoma- Timeline

Day 5-8 post-op

3

Hematoma- Sx

- Elevation and discoloration of wound edges
- May resorb
- Discomfort, pressure and swelling at site

4

Hematoma- Tx

- Evacuate clot
- Ligate bleeding vessels

5

Seroma- Eti

Fluid collection at wound site
- Common in mastectomy
- Lymph removal

6

Seroma- Timeline

Day 5-8 post-op

7

Seroma- Sx

- Painless swelling below wound
- Yellow needle aspirate

8

Seroma- Tx

- Needle aspriation
- Compression
- Allow small seromas to resorb

9

Dehiscence/ Evisceration- Eti

Dehiscence- partial to total disruption of wound layers
- Evisceration- Rupture of all layers of abd wall, extrusion of viscera
- Immunosuppression, steroids, cancer

10

Dehiscence/ Evisceration- Time

5-8 days postop

11

Dehiscence/ Evisceration- Sx

- Serosanguineous discharge from wound
- Popping sensation

12

Dehiscence/ Evisceration- Tx

Dehiscense = reclosure
- Keep stitches in at least 2 weeks
- Corset and compression
- Clean, return to abdomen and re-close

13

Atelectasis- Eti

- Most common pulm complication
- Partial or total collapse of lung

14

Atelectasis- Time

Within 48 hrs post-op

15

Atelectasis- Sx

- Ventilation perfusion mismatch
- Decreased o2
- Rales, elevated diaphragm
- Decreased breath sounds
- Tachypnea, cardia

16

Atelectasis- Tx

- Commonly self limited
- Clear airway though coughing, nasotrach suction
- Bronchodilators or mucolytics
- Suction

17

Atelectasis- Prevent

- Early mobilization
- Position changes
- Incentive spirometer

18

Fat embolism- Eti

- Fat particles in pulm vasc bed
- Fractures of long bones or joint replacements- risk

19

Fat embolism- Time

12-72 hrs post op

20

Fat embolism- Sx

- Neuro dysfxn
- Resp insufficiency
- Petechiae to axillae, chest and proximal arms

21

Fat embolism- Tx

- Supportive O2 unti sx resolve
- positive end-expiratory pressure

22

Air embolism- Eti

- Insertion of catheter with air induction
- Lodges in rt atrium

23

Air embolism- Time

- Soon after IV insertion

24

Air embolism- Sx

Hypotension
- JVD
- Tachycardia

25

Air embolism- Tx

Aspirate air with syringe
- Place pt rt side up, head down to dislodge air

26

Fecal impation- Eti

- Common due to post-op illius and opioid use
- Common in elderly, toxic megacolon and paraplegia

27

Fecal impation- Sx

Anorexia
- Constipation or diarrhea
- Marked dissension of abd

28

Fecal impation- Tx

Manual removal of fecal impaction
- enemas and poly-ethelene glycol

29

Urinary retention- Eti

- Common under spinal anesthesia
- Inhibition of bladder contraction
- Pelvic and perineal operations

30

Urinary retention- Sx

Severe urgency
- Suprapubic pain
- Distended, palpable bladder

31

Urinary retention- Tx

Catheter

32

Anemia- Eti

- Gastric operations
- Intrinsic factor made by stomach

33

Anemia- Sx

- Fatigue, paresthesias
- brittle nails
- Chelosis
- Pica

34

Anemia- Tx

Supplement with B12 or folate
- Packed RBCs

35

IV phlebitis- Eti

Inflammation at IV entry site

36

IV phlebitis- Time

Day 3 post-op

37

IV phlebitis- Sx

- Induration
- Edema
- Tenderness

38

IV phlebitis- Tx

Remove catheter, rotate insertion site

39

Fever- Eti

- 40% pts after surg
- 48 hrs = catheter, pneumonia, UTI
- > 5 days abscess, sepsis

40

Fever- Sx

- Febrile
- Diaphoresis
- Chills
- Muscle and HA
- Weak, confused

41

Fever- Tx

- Tx underlying cause
- CT abd/ pelvis

42

DVT/ PE- Eti

- 21 fold risk
- Resp failure > 3 days post op
- 20% surg pts
- 50-60% hip or knee pts

43

DVT/ PE- Sx

- PE: Acute onset dyspnea
- Chest pain
- Hemoptysis
- Tachy
- AMS
- DVT- unilateral, mid-calf pain
- Low grade fever

44

DVT/ PE- Tx

Anticoagulation
- Routine DVT prophylaxis if moderate or high risk