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20 Cards in this Set
- Front
- Back
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How much fluid can be absorbed during TURP?
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20cc/min
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What determines the amount of water that enters through the venous sinuses during a TURP?
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how many sinuses are open, how long the resection takes, how high the fluid is hung
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How do the electrolyte fluids affect the current used during TURP?
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leads to dispersion of high frequency current
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Why are glycine and cytal(sorbital and mannitol) used during TURP?
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isotonic(prevents hemolysis), good refractive index(minimize dispersion of current)
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What is the best treatment for hyponatremia during surgery?
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stop surgery, administer NS/diuretics(lasix)/fluid restriction or hypertonic saline/lasix/fluid restriction if the patient is seizing or serum Na <120meq/l, d/c hypertonic saline when Na is in 120-130 range
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What is your goal correction of serum Na in hyponatremia?
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2meq/hr
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What are signs of hyponatremia?
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irritability, confusion, restlessness(due to cerebral edema), as serum sodium falls below 120meq/l, EKG changes(widened QRS, ST elevation) when serum Na is 105meq/l, vtach/fib occur when Na<100meq/L
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What is the best monitor for hyponatremia during TURP?
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mental status
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What is the best sign of hyponatremia in a patient under GA?
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transient hypertension followed by hypotension
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What are the causes of fluid overload during TURP?
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fluid absorption in the prostatic venous sinuses, autotransfusion from the lithotomy position
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what are signs of bladder perforation?
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pain in the periumbilical, inguinal, or suprapubic region radiating to the diaphragm, tachycardia, hypotension, shoulder pain(diaphragm irritation), bladder distention can result in bradycardia
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What is the mechanism of aminocaproic acid?
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prevents the formation of plasmin, and thus prevents the breakdown of clot
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When is aminocaproic acid indicated?
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excessive and severe bleeding(when other causes have been corrected and other remedies have failed) of the bladder prostate and urethra
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when is aminocaproic acid not recommended?
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renal or ureteral bleeding because clot formation and obstruction can occur, if used in setting of DIC fatal thrombosis can occur
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What is the dose of aminocaproic acid?
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6g over 24 hours
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What can result from glycine toxicity?
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transient blindness
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During TURP what can be the symptoms of ammonia toxicity?
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CNS depression and delayed awakening
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Why can patients getting TURP get septic?
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urethral instrumentation
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What are complications of lithotripsy?
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arrhythmias(mechanical effects of shock waves), tissue injury(skin bruising, flank ecchymoses), alveolar rupture, hemoptysis
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During resection of the lateral wall of the bladder the patients leg starts to move what nerve is being stimulated?
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obturator is adjacent to the lateral wall of the bladder, sciatic is posterior to the lateral wall of the bladder
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