ST2E2
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each of the black spaces below before clicking
on it to display the answer.
Help!
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| 1 cm/day (rate of removal of a ___) | rate to pull a PENROSE DRAIN out of a wound that it is draining
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| 3 functions of drains | Evacuate fluid, approximate tissue, prevent a potential space
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| 4 parts of a drain | Collection chamber, on/off valve (e.g. heplock), fenestrated tubing, air vent plug
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| 2 things to check daily with a drain | Signs of infection, if it’s WORKING
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| 48 hours (wounds and drains) | 1. WOUNDS: Substrate phase…..2. DRAINS: After 2 days, infection rates soar….
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| 30 cc/24 hr (drains) | When have less than this amount, can REMOVE a drain
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| 1-3 days, 2-5 days, 2-7 days. Drain removal after these # of days for: | 1-3 - POSTOP BLEEDING. 2-5 days - ABSCESS/BACTERIAL INFECTION. 2-7 days - LARGE DEAD SPACE.
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| 16 French (usu size for_____) | Usual adult size for NG tube
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| 14-20 French (range for ___) | Range NG tube sizes
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| Example: 21 French is the same as _______mm | 7 mm
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| 4 areas of resistance when inserting an NG tube | Soft palate, crichoid area, carina, LES
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| 100 cc/hr | Basic IV fluid rate
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| 1:1 | Ratio for colloid:fluid loss replacement
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| 3:1 | Ratio for blood:fluid loss replacement
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| 48 hours, 72 hours - time for GI function to return (after complete anesthesia) to: | 48 - SMALL BOWEL PERISTALSIS. 72 - LEFT COLON.
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| 20cc of sterile water (NG tubes) | The FLUSH needed before removing NG tube to prevent drawing stomach acid into nose.
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| 16-18 French (range for ___) | Range of catheter sizes
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| 6 hours between checking on pts ability to ______ after removing a ______. | Checking on ability to urinate. Example: 12:30 complaint. 6p check with pt, or do straight cath. New foley at midnight if needed.
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| 14ga needle, catheter unit, and a strip of tape. 2nd ICS and 90 degree angle. All for a: | Needle chest compression
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| 4th or 5th ICS. 1.5-2cm incision. All for a: | Chest tube for pneumothorax, effusions.
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| If have less than 200 ccs for a pneumo: | The chest can resolve on its own
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| 24 hours after leaks stop, or if drainage is <200mL/24h and serous: | Can remove a chest tube. NOTE: For intubated pts, leave chest tubes in until off of vent.
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| 3 haustral markings | Sign of large bowel obstruction
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| 10-12cm (on AXR) | Indicates operation of bowel obstruction – this will rekink at home!
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| 1/3rd’s (spleen) | 1/3rd of platelets stored in spleen. 1/3rd of spleen required to maintain physiologic function.
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| 200 gm (spleen) | Normal mass. >200gm is splenomegaly.
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| The three fifties of splenectomy complications: | Pulmonary complications up to 50%. Leokocytosis in 50% of pts. Thrombocytosis (plts >400k!) in 50% of pts.
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| ____ count of > 750k requires action! | Platelets. E.g. ASA to address plt plugs.
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| 5 steps of splenectomy PROCEDURE | 1. Dissect inferior pole @ flexure… 2. Dissect splenorenal ligament, move posterior… 3. Transect @ splenic hilum, preserve pancr bl flow! … 4. Dissect short gastric using underrun… 5. Remove spleen w/ underrun and clamps.
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| 5 steps of splenectomy PREP | 1. Supine pt…. 2. Skin prep…. 3. Four squareout towels… 4. Two halfsheet drapes… 5. Final covering drape
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| 25-60 mmHG. (esoph) | Normal resting pressure of UES. Usu about 30mmHG.
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| 20 mmHG, 0mmHG. (esoph) | Normal resting pressure of LES, pressure of LES at swallowing
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| A 5 cm leiomyoma (cutoff between) | Not problematic and problematic – it is now OBSTRUCTIVE.
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| A 6 cm Zenker diverticula (cutoff between) | Imbrication and diverticuloplexy – both usu accompanied with myotomy
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