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42 Cards in this Set
- Front
- Back
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peaked T waves, hyperkalemia.
next step? |
calcium
(stabilize cardiac membranes) |
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uremia --> platelet dysfxn --> intraop bleeding.
next step? |
desmopressin (ddAVP)
or FFP |
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most common cause of early postop death after LE revascularization
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MI
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LBBB indicative of...
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underlying IHD (never nl)
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general anesthesia drawbacks
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1.pulmonary complications
2.mild cardiodepression |
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ASA = reversible/irreversible?
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irreversible (7-10 days)
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poorly controlled diabetics have increased risk of post-op...
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infections!
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cardiomyopathy pts at risk for...
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1.arrhythmias
2.CHF 3.outflow obstruction 4.sudden death |
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golytely
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(polyethylene glycol electrolyte solution) causes NO NET secretion/absorption of ions
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fleets phospho-soda:
contraindicated in... |
1.diabetics
2.salt-restricted diets |
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high magnesium levels.
next step? |
calcium gluconate
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bacterial endocarditis prophylaxis:
dental/oral/respiratory tract/esophageal procedures |
1.amoxicillin (1 hr prior)
or 2.clinda/ceph/clarith (1 hr prior) |
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bacterial endocarditis prophylaxis: GI/GU procedures in high-risk pts
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high-risk = ampicillin + genta (30 min prior), ampicillin (6 hrs post)
or vanco + genta (30 min prior) |
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bacterial endocarditis prophylaxis: GI/GU procedures in moderate-risk pts
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mod-risk =
1.amoxicillin/amp (1 hr prior) or 2.vanco (1-2 hr prior) |
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bowel "prep" purpose
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decrease fecal mass & bacterial content in colon
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most important of bowel preps...
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mechanical removal:
1.cathartics 2.enemas |
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abx decreasing bacterial load in gut?
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1.neomycin
2.erythromycin |
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bacterial endocarditis prophylaxis - not needed for...
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1.s/p CABG
2.s/p ASD/VSD 3.MVP w/o regurg 4.murmurs 5.pacemakers |
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bacterial endocarditis prophylaxis - high risk...
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1.prosthetic heart valves
2.endocarditis Hx 3.complex congenital HD 4.prosthetic vascular grafts |
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severe liver failure signs
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1.jaundice, ascites
2.muscle wasting 3.asterixis, advanced encephalopathy 4.caput medusa 5.splenomegaly 6.gastric/esophag varices |
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Child's classification
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liver failure
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Child's classification - categories
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1.bili
2.alb 3.ascites 4.enceph 5.nutrition 6.mortality |
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cardiac complications - 5 factors assessed
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1.Q waves
2.Hx ventricular ectopy 3.Hx angina 4.DM 5.age>70 |
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laparoscopy may increase...
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CO2 in blood
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RR post-op complications in smokers
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2-6x
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nl urine output
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0.5-1 ml/kg/hr
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NS [Na+]
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154
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D5W [glucose]
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50
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D10W [glucose]
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100
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lactated Ringer's [Na+]
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130
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72 y.o. w/a-fib c/o severe abdominal pain out of proportion to exam
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mesenteric ischemia
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75 y.o. Hx MI c/o gnawing abdominal pain after eating. 15 lb wt loss in past month
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chronic mesenteric ischemia
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increased lactate
metabolic acidosis hypercoagulable state |
mesenteric ischemia
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mesenteric ischemia - causes
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1.atherosclerosis
2.a-fib 3.low-flow state 4.hypercoagulable state |
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mesenteric ischemia - Tx
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1.tissue perfusion w/fluids
2.surgery!!! (bypass w/saphenous vein) |
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AAA - risk factors
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1.atherosclerosis
2.>5cm (20-40% risk in 5 yrs) |
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abdominal/back pain
pulsatile mass in abdomen hypotension Hx vascular dz/atherosclerosis |
AAA
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AAA Dx
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A) MRI or CT w/contrast
B) angiogram |
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AAA Tx
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1.good IV access, type & cross
2.surgery (if rupture in suspected) |
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63 y.o. male
pain in "kidney" for 3 days Hx MI x2 no back tenderness |
AAA
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elderly pts w/abdominal pain - always consider...
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vascular causes
1.AAA 2.mesenteric ischemia 3.MI |
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most common cause of post-op fever
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atelectasis
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