PreOp/PostOp Care 12% Flashcards
(25 cards)
(SmartyPance)
normal pH of blood
7.35 - 7.45
(SmartyPance)
as pCO2 increases, what happens to pH?
it DECREASES
“As pCO2 increases in the blood, the pH decreases”
(SmartyPance)
Decreased resp rate can cause retention of CO2 leading to respiratory acidosis or alkalosis?
RESP ACIDOSIS
“Decreased resp rate can cause retention of CO2 leading to respiratory acidosis”
(SmartyPance)
As the HCO3- level increases in the blood, what happens to the pH?
INCREASES
“As the HCO3- level increases in the blood, the pH increases”
(SmartyPance)
ABG:
pH 7.52; pCO2 25; HCO3- 22
what type of acid-base disorder?
RESP ALKALOSIS
(SmartyPance)
six predictors of surgical cardiac complications
ischemic heart disease CHF cerebrovascular disease high-risk operation preop trtmt w/ insulin preop serum Cr >2.0 mg/dL
(SmartyPance)
if pt has a hx of rheumatic heart disease, what should be done before surgery?
prophylactic antibiotic therapy
(SmartyPance)
if a pt has a PMH of MI, there is _______ percent risk of ____________?
5-10%; postoperative MI
“If the patient has a prior history of MI, there is a 5-10% risk of postoperative MI”
(SmartyPance)
if a patient has unstable angina, what must be done before noncardiac operations?
noninvasive stress testing
(SmartyPance)
what kinds of pt cardiac situations need coronary revascularization before noncardiac operations (5)?
- left main coronary artery stenosis
- stable angina w/ three-vessel coronary disease
- stable angina w/ two-vessel disease
- significant LAD stenosis with either:
- EF <50% or
- ischemia on noninvasive testing
- high-risk unstable angina
- or NSTEMI
- or acute STEMI
(SmartyPance)
Virchow’s triad (risk for clot formation/DVT)
stasis
trauma (sx, cellulitis)
hypercoagulable states (Factor V Leiden, CA, OCP + smoking, pregnancy)
(SmartyPance)
what is first line imaging test for suspected DVT?
venous duplex u/s
(SmartyPance)
what is the gold standard test for suspected DVT?
venography
(RR)
What does an elevated INR that corrects with Vit K administration suggest in the setting of obstructive jaundice?
impaired intestinal absorption of fat-soluble vitamins
(RR)
IF a pt has immune thrombocytopenia and is scheduled for an exploratory laparotomy to evaluate a 15 cm ovarian mass, what is the minimum platelet count for this procedure?
50,000/microL
(RR)
Central Venous Catheter infection rates - list three central line sites in order of lowest risk of infection to highest
subclavian vein (lowest risk of infection)
Int Jugular (double the risk of infection compared to subclavian)
Femoral Vein (highest risk)
(RR)
two common dysrhythmias that may occur in post op period after a cardiac procedure
AFib and A flutter
(RR)
if pt is stable with post op AFib or AFlutter, preferred medical treatment is
IV esmolol
typically BB or CCB
(RR)
if pt is UNSTABLE with post op AFib or AFlutter, preferred medical treatment is
cardioversion
(RR)
MC clinical presentation of primary hyperparathyroidism
asymptomatic hypercalcemia
mean serum Ca conc is typically elevated less than 1.0 mg/dL
(RR)
Classical presentations of hyperparathyroidism
bone disease nephrolithiasis weakness fatigue neurobehavioral symptoms
(RR)
first line treatment for hypoparathyroidism
calcium and vit D supplementation
only curative Rx: parathyroidectomy
(RR) which of the following should be stopped one day prior to surgery? a) ASA b) atenolol c) levothyroxine d) metformin
D) METFORMIN
(“oral diabetic medications such as metformin should be held 24 hrs prior to surgery”
ASA should be stopped 1 week prior to surgery
atenolol and levothyroxine should be continued before and after surgery
(RR)
Incentive spirometry is used to prevent what postoperative complication?
atelectasis
