Pre/Post Op
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| show | % of the sodium filtered by kidney which is excreted in the urine. Low --> Na retention --> non-kidney prob such as volume depletion or low output heart failure. Hi --> Na wasting due to acute tubular necrosis or other causes of intrinsic renal failure.
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| What is the formula for the fractional excretion of sodium (FENa)? | show 🗑
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| Interpretation of FENa | show 🗑
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| dopamine - low dose | show 🗑
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| show | positive inotropic and chronotropic effect through increased β1 receptor activation. It is used in patients with shock or heart failure to increase cardiac output and blood pressure.
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| show | "pressor" dose. vasoconstriction, increases systemic vascular resistance, and increases blood pressure through α1 receptor activation; but can cause the vessels in the kidneys to constrict to the point where they will become non-functional
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| show | when EF is less than 35% (nl is 55%)
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| show | JVD, MI within the last 6 months
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| What to do if pre-op pt has elevated JVD? | show 🗑
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| Operative mortality within 3 months of an MI? Within 6 months? | show 🗑
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| show | admit to ICU a day before to optimize cardiac variables
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| show | eval for coronary revascularization before the other operation.
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| What is the most common cause of increased pulmonary risk in surg? | show 🗑
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| What should a smoker do before going into surgery? | show 🗑
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| show | 1, 5, 11, 22% risk
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| Hepatic Risk - what is correlated with 40% mortality going into surgery? (bili, alb, PT, mental status) What if a pt has three of these variables? How about 4? | show 🗑
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| show | bili >4 OR albumin <2 OR blood ammonia > 150
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| show | wt loss (by 20% in few months), alb <3, anergy to skin antigens, transferrin <200. 4 or 5 days preoperative nutritional support makes a big difference.
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| show | diabetic coma. Must have rehydration, return of UOP and at least partial correction of acidosis and hyperglycemia
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| anesthetics implicated in development of malignant hyperthermia | show 🗑
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| Tx of malignant hyperthermia in surgery. What must you watch for? | show 🗑
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| show | If only cellulitis, then abx. If abscess, then open and drain. If you can't figure out which it is, use US.
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| show | 1. BAL, 2. bronchoscopy (removal of acid and particulate matter), 3. broncho dilators, 4. respiratory support. NO steroids!
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| show | IV BZ's
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| show | elderly sedentery pts (Alzh, nursing hm) --> non-abd surg --> further immobilization post surg --> large abd, non tender, distension --> xrays show dilated colon. Colonoscopy to suck out gas, decompress colon, r/u colon CA. Leave long rectal tube in.
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| show | Wound dehiscence. Salmon fluid is peritoneal fluid. If not infected, tape it up and careful of pt moving or coughing.
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| show | FETIIID - forein body, epithelializaiton, tumor, infection, irradiated tissue, IBD, distal obstruction
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| Looking at Na level, how do you know how much water a pt has lost? | show 🗑
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Created by:
christinapham
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