Surgical Prophylaxis, C29 P181-183 Flashcards Preview

Section I, Surgical Recall Sixth Edition > Surgical Prophylaxis, C29 P181-183 > Flashcards

Flashcards in Surgical Prophylaxis, C29 P181-183 Deck (17):
1

What medications provide
protection from postoperative
GI bleeding?
P181

H(2) blockers, PPI (proton-pump inhibitor)

2

What measures provide
protection from postoperative
atelectasis/pneumonia?
P181

Incentive spirometry, coughing, smoking
cessation, ambulation

3

What treatments provide
protection from postoperative
DVT?
P181

Low-molecular-weight heparin (LMWH),
subcutaneous low-dose unfractionated
heparin, sequential compression device
(SCD) for lower extremities, or both;
early ambulation

4

What measures provide
protection from wound
infection?
P182

Shower the night before surgery with
chlorhexidine scrub
Never use a razor for hair removal
(electric shavers only)
Ensure adequate skin prep in O.R.
Do not close the skin in a contaminated case
Ensure preoperative antibiotics in the
bloodstream before incision
Ensure no excess Bovie (necrotic tissue)

5

Why not use a razor to
remove hair?
P182

Micro cuts are a nidus for bacteria
and subsequent wound infection

6

How long should “prophylactic
antibiotics” be given?
P182

< 24 hrs

7

What treatment provides protection
from oral/esophageal
fungal infection during IV
antibiotic treatment?
P182

PO nystatin

8

What measures prevent
ventilator-associated
pneumonia (VAP)?
P182

Head of bed 30, handwashing, patient
oral hygiene, avoidance of gastric
overdistention

9

What is the classic
preoperative “bowel prep”?
P182

1. Bowel prep: Lower bacterial count in
colon by catharsis (GoLYTELY or
Fleets)
2. PO antibiotics (neomycin, erythromycin)
preoperatively
3. Preoperative IV antibiotic with spectrum
versus anaerobes (e.g., Cefoxitin)

10

Is there any evidence that a
“bowel prep” decreases
infections?
P182

NO

11

What treatment provides
protection from OPSS after
splenectomy?
P182

Immunization against H. influenzae,
Streptococcus, Meningococcus, and
penicillin when illness/fever occurs

12

What treatment provides
protection from endocarditis
with faulty heart valve or
prosthetic heart valve?
P182

Antibiotics prior to dental procedure or
any surgery

13

What treatment provides
protection from tetanus
infection?
P183

Tetanus toxoid (and tetanus immune
globulin, if one or no previous toxoid
with dirty wound)

14

What treatment provides
protection from EtOH
withdrawal?
P183

Chlordiazepoxide (Librium®), also give
Rally pack

15

What treatment provides
protection from Wernicke’s
encephalopathy?
P183

Rally pack (a.k.a. banana bag because
the IV is yellow with the vitamins in it);
pack includes thiamine, folate, and
magnesium

16

What is Wernicke’s
encephalopathy?
P183

Condition resulting from thiamine
deficiency in patients with alcoholism,
causing a triad of symptoms; think “COA”:
1. Confusion
2. Ophthalmoplegia
3. Ataxia

17

What treatment decreases
the risk of perioperative
adrenal crisis in a patient on
chronic steroids?
P183

“Stress-dose” steroids: 100 mg hydrocortisone
administered preoperatively,
continued postoperatively q 8 hours,
and then tapered off