Term
| Fluid management 3 for 1 rule |
|
Definition
1-2 hours after 1L bolus, 300cc remains intravascular
3-4x the vascular deficit should be bolused |
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Term
| Urine output for adequate hydration (adult) |
|
Definition
| 1/2 cc/kg/hr or ~30 cc/hr |
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Term
| Electrolyte disorder: decreased salivary and colon secretions |
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Definition
|
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Term
|
Definition
*ectopy, T wave depression, prominent U waves
*V-tach, increased digoxin sensitivity |
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|
Term
|
Definition
PO supplement
IV K if NPO, <10 mEq/hr
Correct hypoMg
K sparing diuretics |
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|
Term
| Electrolyte disoder: stomach, ileum, bile secretion loss |
|
Definition
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|
Term
| Electrolyte disorder: salivary, ileum, pancreas, bile secretion deficit |
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Definition
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|
Term
| PT: which factors are you measuring? |
|
Definition
Extrinsic
Thromboplastin --> 7 --> 10 |
|
|
Term
| PTT: which factors are you measuring? |
|
Definition
| Intrinsic: 12 --> 11 --> 9 --> 7 --> 10 |
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|
Term
| Vit K deficiency causes long bleeding and affects intrinsic and extrinsic factors (2, 7, 9, 10, C, S). What is the first sign? |
|
Definition
| PT due to short 1/2 life of factor 7 |
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|
Term
|
Definition
| Helps with gamma carboxylation so factors can interact with Ca |
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|
Term
Bleeding time measures what function?
What disorders are commonly affected? |
|
Definition
Platelet function.
Von Willebrands and vasculitis |
|
|
Term
Thrombin time:
What is it?
What is commonly affected? |
|
Definition
Time to clot after addition of thrombin (which converts fibrinogen to fibrin)
Long TT: high fibrin, dysfibrinogenemia, DIC, heparin |
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|
Term
| PRBC inc hgb and hct how much? |
|
Definition
|
|
Term
| Plt count at which bleeding risk increases --> transfuse |
|
Definition
|
|
Term
| Most common complicatin of plt transfusion |
|
Definition
|
|
Term
| FFP: what does it have and why to you use it? |
|
Definition
| All the coags, use for any clotting factor deficit |
|
|
Term
| Cryoprecipitate: what does it have? |
|
Definition
| factor 7, fibrinogen and fibronectin |
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|
Term
Do plasma products require cross and match?
What about ABO compatibility? |
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Definition
|
|
Term
| What are strokes caused by post-op? |
|
Definition
| Hypotension, a fib emboli |
|
|
Term
| When do you stop anticoagulation? |
|
Definition
|
|
Term
| What system is usually affected by post op complications? |
|
Definition
|
|
Term
| What risk index is used to assess and stratify risk? |
|
Definition
Goldman Cardiac Risk Index
S3 gallop, JVD = CHF
MI w/i 6 mo = CV injury
EKG abnormal = Conduction problem
>5 PVC / min = inc excitability
Age > 70 = inc comorbidity
Poor health = inc morbidity
Aortic stenosis = L ventricular outflow obstruction
Peritoneal/thoracic/aortic surgery = major surgery
Emergent = emergency surgery |
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|
Term
Most important risk for pulmonary complication
Other risks |
|
Definition
COPD
Although other risks are obesity, abdominal/intrathoracic procedures, smoking hx |
|
|
Term
Renal failure post op: problem? Mortality?
Why?
Risks?
Tx? |
|
Definition
Problem. >50% mortality.
Metabolic disturbances, underlying concerns.
Azotemia, sepsis, itra-op hypotension, nephrotoxic drugs, radiocontrast
IV fluids, diuretics after IV contrast |
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