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Master the boards: Surgery > Postoperative Care > Flashcards

Postoperative Care Flashcards

(50 cards)

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1
Q

What is Post-op fever days 1-2 associated with?

A

Wind; Atelectasis or Pneumonia

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2
Q

What test is used for POD1-2 fever?

A

CXR followed by sputum cx

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3
Q

What therapy is used for POD1-2 fever?

A

Prevention with incentive spirometry
Abx for HAP

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4
Q

What is POD3-5 fever associated with?

A

Water: UTI

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5
Q

What test is used for POD3-5 fever?

A

UA showing (+) Nitrates and Leukocyte esterase

Ucx for species and sensitivity

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6
Q

What therapy is used for POD3-5 fever?

A

Abx

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7
Q

What is POD5-7 fever associated with?

A

Walking: DVT, Thrombophlebitis of IV access, PE for new-onset tachycardia and chest pain

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8
Q

What tests are used for POD5-7 Fever ?

A

Doppler US of the extremities, change IV lines, Cx iv tips

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9
Q

What therapy is used for POD5-7 fever?

A

DOAC for clot

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10
Q

What is POD7 fever associated with?

A

Wound: wound infection, cellulitis

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11
Q

What tests are used for POD7 fever?

A

Physical exam for wound erythema, purulent discharge and or swelling

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12
Q

What therapy is used for POD7 fever?

A

I&D if abscess of fluid followed by Abx

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13
Q

What is POD8-15 Fever associated with?

A

Wonder: drug fever or deep abscess

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14
Q

What tests are used for POD8-15 Fever?

A

CT to examine for deep fluid collection

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15
Q

What therapies are used for POD8-15 Fever?

A

CT guided percutaneous drainage of the abscess: otherwise surgery

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16
Q

What are common causes of post-op confusion?

A

Hypoxia or septic

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17
Q

What should you order for a patient with post-op confusion?

A

ABG, CXR, blood Cx, urine Cx, CBC

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18
Q

What is Superficial Wound Dehiscence?

A

Skin and tissues have separated but rectus fascia is intact

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19
Q

How do you treat superficial wound dehiscence?

A

Careful dressing changes

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20
Q

What is Deep wound dehiscence?

A

Involves the rectus fascia exposing the abdominal organs to external air

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21
Q

How do you manage Deep wound dihiscence?

Study These Flashcards
A

emergency surgery and Abx

22
Q

How does Acute Respiratory Distress Syndrome (ARDS) present?

Study These Flashcards
A

severe hypoxia, tachypnea, accessory muscle use and hypercapnia

23
Q

How do you diagnose ARDS?

Study These Flashcards
A

CXR; bilateral pulmonary infiltrates without JVD

24
Q

How do you manage ARDS?

Study These Flashcards
A

Positive end expiratory pressure (PEEP)

25
How does a pulmonary embolism (PE) present?
Acute onset chest pain with clear lungs
26
What is the best initial test for a PE?
EKG; sinus cardia
27
What test can follow-up for a PE?
CT angiogram: Most accurate test for PE
28
What is dumping syndrome associated with?
Gastric bypass and sleeve gastrectomy
29
What are symptoms of Early dumping syndrome?
Hypotension Autonomic: flushing, tachycardia, syncope
30
What is the cause of Early dumping syndrome?
rapid emptying of hyperosmolar food causes fluid to shift from the plasma into the bowel
31
How do you treat Early dumping syndrome?
Small, frequent meals Solid food separated from liquids by 30 minutes
32
What are symptoms of Late-Onset Dumping syndrome (postprandial hyperinsulinemic hypoglycemis [PHH])?
Hypoglycemia, dizziness, fatigue, diaphoresis, weakness
33
What is the cause of Late-Onset Dumping syndrome (postprandial hyperinsulinemic hypoglycemis [PHH])?
most commonly Roux-en-y-gastric bypass: begins several months after surgery and occurs 1-3hours after ingestion of a carbohydrate rich meal
34
How do you manage Late-Onset Dumping syndrome (postprandial hyperinsulinemic hypoglycemis [PHH])?
small, frequent meals: separate solids and liquids by 30 minutes Trial of Octreotide: slows motility
35
What is Postoperative Ileus?
obstipation and intolerance of intake following surgery
36
What are the most common causes of Postoperative Ileus?
Electrolyte abnormalities Prolonged abdominal or pelvic surgery Sepsis Perioperative opioid use
37
What are common symptoms of Postoperative Ileus?
Oral intolerance, N/V, obstipation and lack of flatus
38
What is seen on physical exam in Postoperative Ileus?
Decreased or absent bowel sounds
39
What is the best initial test for Postoperative Ileus?
Abdominal x-ray: air-fluid levels
40
What is the most accurate test for Postoperative Ileus?
CT: lack of transition zone
41
What is the treatment for Postoperative Ileus?
Supportive care, electrolytes, stop offending agents
42
What is indicated for Postoperative Ileus following partial LB or SB resection with primary anastamosis?
Alvimopan: Mu-opioid receptor antagonist
43
What is Postcardiac Surgery Syndrome?
Pericarditis with or without a pericardial effusion from injury to the pericardium
44
What causes Postcardiac Surgery syndrome?
damage to mesothelial pericardial cells releases cardiac Ag and stimulates an immune response that causes an inflammatory cascade in the local tissue
45
How will a patient present with Postcardiac surgery syndrome?
Tachycardia, Tachypnea, distant muffled heart sounds
46
What does a CXR show in postcardiac surgery syndrome?
Cardiomegaly
47
What is the best initial test for Postcardiac surgery syndrome?
EKG
48
What is the most accurate test for postcardiac surgery syndrome?
Echocardiogram
49
How do you treat Postcardiac surgery syndrome?
NSAIDs and Colchicine
50
How can you prevent Postcardiac Surgery Syndrome?
Colchicine after surgery

Master the boards: Surgery (12 decks)

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