Flashcards in PreTest Deck (18):
Earliest clinical sign of hypermagnesemia
Loss of deep tendon reflexes
Initial mgmt of asx hyponatremia
Free water restriction
Which pts are at risk for developing hyperoxaluria?
Pt who has lost a lot of ileum.
Usu, FA are absorbed by the terminal ileum, and calcium and oxalate combine in the ileum to form an insoluble cmpd that is excreted. W/o ileum, FAs aren't absorbed and go to the colon, where they combine with calcium- so there is a lot of free oxalate, and it gets absorbed. Excess oxalate is excreted by the kidneys and promotes calcium oxalate stone formation.
Where there is post-op oliguria, what is the first thing you need to determine?
If it's due to a prenrenal cause (physiological response to hypovolemia) or if it is due to acute tubular necrosis
How do you know if oliguria is dt tubular injury or to hypovolemia?
Look at FE-Na.
1 means there is a problem with the tubules.
When should you give abx to prevent surgical site infections? And what abx?
Single dose, Within 1 hr before surgery
Cefazolin (against aerobes and anerobes)
Biochemical profile of salicylate ingestion (aspirin)?
Rx for HIT heparin induced thrombocytopenia
Cessation of heparin
Start a non-heparin anticoagulant like lepirudin
Start oral warfarin when appropriate (when platelets are back to at least 100k
Significant bleeding in early post-op period is most probably dt what?
Bleeding vessel in the surgical field
What is the dx test of choice of acute mesenteric ischemia?
Dx eval and Rx for DVT in prego
Duplex and heparin (does not cross the placenta. don't give warfarin to prego)
What blood test values show you that someone has vWD?
Failure to aggregate in presence of risocetin
Transfusion of what product can provide vWF?
What drugs can be given to polycythemia vera pts to bring down their Hct and platelets
When a pt gets a large amt of blood transfusions, what factors do they become deficient in?
V and VIII (the labile factors)
banked blood is also deficient in platelets, so they may become throbocytopenic.
Give them FFP (it replaces the Vit-K dep factors) and give them platelets if they are thrombocytopenic.
Rx for heparinized pt w significant hemorrhage
Give protamine sulfate to reverse the heparin anticoagulation
Also place vena cava filter
Complications of starting TPN in a malnourished pt
Refeeding syndrome (malnourished pts who are given IV glucose)- can get hypophosphatemia, hypokalemia, hypomagnesemia
Start TPN slowly and replenish Mg, K, P
(can also get hyperglycemia, hyperchloremic acidosis)