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17 Cards in this Set

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What meds provide protection from post-op GI bleeding?

- H2 blockers


- PPIs

What measures provide protection from post-op atelectasis / pneumonia?

- Incentive spirometry


- Coughing


- Smoking cessation


- Ambulation

What treatments provide protection from post-op DVT?

- Low molecular weight heparin (LMWH)


- Subcutaneous low-dose unfractionated heparin


- Sequential compression devices (SCD) for lower extremities


- Early ambulation

What measures provide protection from wound infection?

- Shower the night before surgery with chlorhexidine scrub


- Never use a razor for hair removal (electric shavers only)


- Ensure adequate skin prep in OR


- Do not close skin in a contaminated case


- Ensure pre-op antibiotics in bloodstream before incision


- Ensure no excess Bovie (necrotic tissue)

Why not use a razor to remove hair prior to surgery?

Micro cuts are a nidus for bacteria and subsequent wound infection

How long should "prophylactic antibiotics" be given prior to surgery?

<24 hours

What treatment provides protection from oral / esophageal fungal infection during IV antibiotic treatment?

PO nystatin

What measures prevent ventilator-associated pneumonia (VAP)?

Head of bed >30 degrees, handwashing, pt oral hygiene, avoidance of gastric overdistention

What is the classic pre-op "bowel prep"?

1. Bowel prep: lower bacterial count in colon by catharsis (GoLytely or Fleets)



2. PO antibiotics (neomycin, erythromycin) pre-operatively



3. Pre-op IV antibiotic with spectrum versus anaerobes (eg, Cefoxitin)

Is there any evidence that a bowel prep decreases infections?

No

What treatment provides protection from OPSS after splenectomy?

Immunization against H. influenzae, Streptococcus, Meningococcus, and PN when illness/fever occurs

What treatment provides protection from endocarditis with faulty heart valve or prosthetic heart valve?

Antibiotics prior to dental procedure or any surgery

What treatment provides protection from tetanus infection?

Tetanus toxoid (and tetanus immune globulin, if one or no previous toxoid with dirty wound)

What treatment provides protection from EtOH withdrawal?

Chlordiazepoxide (Librium), also give Rally pack

What treatment provides protection from Wernicke's encephalopathy?

Rally pack (aka banana bag because IV is yellow with vitamins in it); pack includes thiamine, folate, and magnesium

What is Wernicke's encephalopathy?

Condition resulting from thiamine deficiency in pts with alcoholism, causing a triad of symptoms:


1. Confusion


2. Ophthalmoplegia


3. Ataxia

What treatment decreases the risk of perioperative adrenal crisis in a patient on chronic steroids?

"Stress-dose" steroids: 100 mg hydrocortisone administered pre-operatively, continued post-operatively q8h, and then tapered off