What is a postoperative risk factor for COPD? Recent thoracic or abdominal surgery CHF, CAD, Dysrhythmias >20 pack yr smoking hx Severe HTN, PVD

Recent thoracic or abdominal surgery

What is a postoperative renal risk factor? Renal insufficiency, acute adrenal failure CHF, CAD, Dysrhythmias Severe HTN, PVD DMT1, DMT2, Chronic steroid use

Renal insufficiency, acute adrenal failure

Which of the following is a postoperative endocrine risk factor? Severe HTN, PVD CHF, CAD, Dysrhythmias DMT1, DMT2, Chronic steroid use Renal insufficiency, acute adrenal failure

DMT1, DMT2, Chronic steroid use

Identify a postoperative hematologic risk factor. Leukopenia, thrombocytopenia, DIC DMT1, DMT2, Chronic steroid use Severe HTN, PVD Renal insufficiency, acute adrenal failure

Leukopenia, thrombocytopenia, DIC

Exam 2: Post op care

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Medicine - Surgery

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Cards in this deck(100)

Which of the following is a postoperative pulmonary/respiratory risk factor?

What is a postoperative risk factor for COPD?

Which of the following is a postoperative cardiovascular risk factor?

Identify a postoperative vascular risk factor.

What is a postoperative renal risk factor?

Which of the following is a postoperative endocrine risk factor?

Identify a postoperative hematologic risk factor.

What does PACU stand for in postoperative care?

Your patient has had surgery and is stable in the PACU. Where should they be sent next?

Your patient in the PACU needs continued support and invasive monitoring. Where should they be sent?

What is the primary responsibility of the anesthesia service?

Who is responsible for the operative site and all other aspects of care?

In postoperative care, how often should a physical examination be performed?

What should be used to replete intravascular volume as needed in postoperative patients?

What can you make the patients do to help decrease the risk of DVT/PE and create better outcomes?

What can you tell patients to do to decrease the risk of atelectasis and PE after surgery?

When can a patient start eating again after surgery?

In outpatient procedures, patients can generally resume their post-op diet as tolerated once their _____ and _____ returns.

_____ is a major trigger of the neuroendocrine stress response to surgery.

Pain causes the release of _____ and _____ into circulation, curtailing the inflammatory response.

What should be used immediately post-op to help with pain management?

What are the new non-opioid therapies for pain management?

NSAIDs should not be given _____ hours post-op.

A patient post-op presents with short, shallow breaths. What could this indicate?

What is the normal respiratory rate (RR) and oxygen saturation (O2 sat) post-op?

What degree should you elevate the head of the bed (HOB) to increase tidal volumes and facilitate clearing of oral secretions?

A patient is in respiratory distress post-op and exhibiting hypotension. What could this indicate?

A patient is in respiratory distress post-op and exhibiting a fever. What could this indicate?

A patient is in respiratory distress post-op and exhibiting stridor. What could this indicate?

A patient is in respiratory distress post-op and exhibiting distended neck veins. What could this indicate?

A patient is in respiratory distress post-op and exhibiting distended neck veins and an airway shift. What could this indicate?

A post-op patient is displaying new onset of dysphagia and hoarseness. What should you immediately check?

A patient is in respiratory distress post-op and exhibiting chest pain. What could this indicate?

A patient is in respiratory distress post-op and exhibiting Homan sign. What could this indicate?

What are the differential diagnoses of respiratory distress post-op?

A patient is in respiratory distress post-op. What should you order?

When assessing a post-op patient, urine output should be _____ ml/hr (nontrauma). What if it is trauma related?

Hypothermia post-op is associated with postoperative _____

If your patient is tachycardic post-op, this could indicate:

Post-op hypotension/tachycardia should be assumed to be _____ until proven otherwise.

If your post-op patient is experiencing third spacing due to surgical stress, what solution should you use to replete intravascular volume?

Where would you look for effusions if you suspect third spacing?

What labs would you monitor if assessing renal function post-op?

Urine output in a patient with normal renal function usually reflects:

How often do you monitor I&Os post-op?

What is the normal I&O post-op? (ml/hr)

Oliguria is defined as _____ ml/24hrs.

A clear liquid diet can be ordered once _____ are auscultated and/or the patient _____

A patient presents post-op with no bowel sounds and no passage of flatus. What could this be?

Post-op ileus can be due to:

In what order and hours does GI function return post-op?

Do post-op ileuses usually resolve spontaneously?

If a patient is still NPO after _____-_____ days, enteral feeding MUST begin.

If a patient is NPO for a long period of time, they are in a _____ state.

In an ileus, is there air throughout the bowel on X-ray?

If your post-op patient has diabetes, when should their glucose levels be checked?

Post-op diabetic patients should be given IVFs that do or do not contain glucose until a PO diet is tolerated?

If your post-op patient is on steroid therapy or has an adrenal insufficiency problem, what should they receive?

Normally nurses take care of the insulin sliding scale, but when would you expect to get a call?

When assessing a wound post-op, what is essential?

What is included in a SOAP note post-op?

What are post-op orders and what do they include?

Maintenance needs of fluid and electrolyte administration are approximately _____ -_____ ml/day.

What is most frequently used in maintenance fluids post-op?

If a person weighs 28kg, what would their maintenance IVF dose be?

Post-op medications always include:

Progress notes post-op are written in _____ format.

"35 yo male presents S/P elective appendectomy" is part of the _____ portion of a SOAP note.

Each daily note must include these elements:

What should be at the top of every progress note post-op?

What does POD #1 refer to?

What does SSI stand for in postoperative care?

_____ _____ is key to preventing surgical morbidity and mortality when it comes to SSIs.

Can SSIs be cured by antibiotics alone?

A patient presents post-op C-section with pain, fever, hemodynamic changes, and discharge/redness from the incision site. What is this?

What type of drainage is clear/light yellow, thin, and watery?

What type of drainage is red (with fresh blood) and thin?

What type of drainage is pink to light red, thin, and watery?

What type of drainage is creamy yellow, green, white, tan, thick, and opaque?

What are the three classifications of post-op infections?

Which antibiotics are used for Gram + post-op infections?

Which antibiotics are used for Gram - post-op infections?

Which antibiotics are used for anaerobic post-op infections?

What is the most common pathogen of SSI?

A post-op patient presents with a necrotizing soft tissue infection (1-3 days post-op). How do you diagnose and treat?

A post-op patient presents with purulent drainage from the incision site, erythema, and fever. What type of wound could this be and when would it present?

What type of post-op infection is characterized by fever, pain, hypermetabolic state, fluid shifts, and can lead to multisystem organ failure?

How do you treat intra-abdominal infections post-op?

When do you discontinue antibiotics after a post-op infection?

What is an anastomotic leak in post-op care?

If there is an early disruption of layers of a post-op wound, what is this called?

If there is a late disruption of any layer of a post-op wound, what is this called?

What is a seroma in post-op care?

What is a hematoma in post-op care?

What are incisional hernias in post-op care?

What is a patient at risk for if they have a history of cardiac, pulmonary, renal disease, DVT, PE, pulmonary edema, immobilization, hypercoagulopathies, sepsis, or deteriorating renal function?

What do arterial blood gases (ABGs) measure?

Pulmonary embolisms (PEs) are missed in approximately _____% of patients.

What imaging study is best for diagnosing pulmonary embolisms?

What is the treatment for DVT or PEs?

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