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ST2E2
| Question | Answer |
|---|---|
| 1 cm/day (rate of removal of a ___) | rate to pull a PENROSE DRAIN out of a wound that it is draining |
| 3 functions of drains | Evacuate fluid, approximate tissue, prevent a potential space |
| 4 parts of a drain | Collection chamber, on/off valve (e.g. heplock), fenestrated tubing, air vent plug |
| 2 things to check daily with a drain | Signs of infection, if it’s WORKING |
| 48 hours (wounds and drains) | 1. WOUNDS: Substrate phase…..2. DRAINS: After 2 days, infection rates soar…. |
| 30 cc/24 hr (drains) | When have less than this amount, can REMOVE a drain |
| 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. |
| 16 French (usu size for_____) | Usual adult size for NG tube |
| 14-20 French (range for ___) | Range NG tube sizes |
| Example: 21 French is the same as _______mm | 7 mm |
| 4 areas of resistance when inserting an NG tube | Soft palate, crichoid area, carina, LES |
| 100 cc/hr | Basic IV fluid rate |
| 1:1 | Ratio for colloid:fluid loss replacement |
| 3:1 | Ratio for blood:fluid loss replacement |
| 48 hours, 72 hours - time for GI function to return (after complete anesthesia) to: | 48 - SMALL BOWEL PERISTALSIS. 72 - LEFT COLON. |
| 20cc of sterile water (NG tubes) | The FLUSH needed before removing NG tube to prevent drawing stomach acid into nose. |
| 16-18 French (range for ___) | Range of catheter sizes |
| 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. |
| 14ga needle, catheter unit, and a strip of tape. 2nd ICS and 90 degree angle. All for a: | Needle chest compression |
| 4th or 5th ICS. 1.5-2cm incision. All for a: | Chest tube for pneumothorax, effusions. |
| If have less than 200 ccs for a pneumo: | The chest can resolve on its own |
| 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. |
| 3 haustral markings | Sign of large bowel obstruction |
| 10-12cm (on AXR) | Indicates operation of bowel obstruction – this will rekink at home! |
| 1/3rd’s (spleen) | 1/3rd of platelets stored in spleen. 1/3rd of spleen required to maintain physiologic function. |
| 200 gm (spleen) | Normal mass. >200gm is splenomegaly. |
| The three fifties of splenectomy complications: | Pulmonary complications up to 50%. Leokocytosis in 50% of pts. Thrombocytosis (plts >400k!) in 50% of pts. |
| ____ count of > 750k requires action! | Platelets. E.g. ASA to address plt plugs. |
| 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. |
| 5 steps of splenectomy PREP | 1. Supine pt…. 2. Skin prep…. 3. Four squareout towels… 4. Two halfsheet drapes… 5. Final covering drape |
| 25-60 mmHG. (esoph) | Normal resting pressure of UES. Usu about 30mmHG. |
| 20 mmHG, 0mmHG. (esoph) | Normal resting pressure of LES, pressure of LES at swallowing |
| A 5 cm leiomyoma (cutoff between) | Not problematic and problematic – it is now OBSTRUCTIVE. |
| A 6 cm Zenker diverticula (cutoff between) | Imbrication and diverticuloplexy – both usu accompanied with myotomy |
Created by:
clc4711
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