Flashcards in the surgical patient Deck (13)
How long before surgery should aspirin be held?
Should anti-hypertensives be held before surgery?
Generally, cont anti-HTN drugs except for diuretics and possibly ACE-I's
What type of valvular disease increases mortality in surgery?
Aortic stenosis (when 50 mm Hg)
What might be a possible endocarditis ppx regimen for MVP or prosthetic valves?
30 min before incision: ampicillin and gentamicin. 6 hrs after incision: amoxicillin, or 2nd dose of amp/genta
How do SCDs work?
Stimulate endothelial cell fibrinolytic activity. So still works if one leg is injured and can only have one SCD on!
What should DM patients do with meds day of surgery?
Discontinue oral hypoglycemics the night before. Take 1/2 dose or entirely hold insulin the day of surgery.
What is the classification system for surgical risk for patients with ascites?
Child's classification (A, B, C)
In what order does the GI system "wake up" after surgery?
Small intestine, then stomach, then colon
How to estimate when bowel function will return?
Roughly one POD per decade for major abdominal surgery
One unit of platelets is expected to raise platelet count by..?
5 to 10,000
What to do with patients on warfarin?
1) hold for 3 days and restart on POD#2 or 2) admit preop and change to heparin which can be held only a few hours ahead or 3) switch to subq LMWH
Should thyroid meds be given on day of surgery?
Given levothyroxine. Hold anti-thyroid meds (e.g. PTU, MMA)