Med Surg

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  1. What is the most impt assessment post-operatively?
  2. What are all pts at risk for during the post op period?
    pneumonia, shock, cardiac arrest, resp arrest, DVT, and GI bleeding
  3. What is the first thing to assess when pt is admitted to PACU?
    • immediately assess for patent airway and adequate gas exchange.
    • *talking is not a good indicator of adequate gas exchange
  4. What could a RR of below 10 BPM indicate?
    anesthetic or opioid analgesic depression
  5. What could rapi shallow resp indicate?
    shock, cardiac problems, increased metabolic rate, or pain
  6. What would you suspect if lung sounds were absent on L and R chest wall was the only one rising and falling?
    ET tube has moved down into R lung
  7. stridor
    high pitched crowing sound
  8. what could it mean if a pt is snoring and you hear stridor?
    airway obstruction from tracheal or laryngeal spasm or edema, mucus in the airway, or blockage of the airway from edema or tongue relaxation.
  9. What could decreased BP and pulse and abnormal heart sounds indicate?
    Possible cardiac depression, fluid vol. deficit, shock, hemorrhage, or the effects of drugs.
  10. What could bradycardia mean?
    Anesthesia effect or hypothermia
  11. What could increased pulse rate mean?
    shock, hemorrhage, or pain
  12. pulse deficit
    difference btwn the apical and peripheral pulses
  13. What could a pulse deficit mean?
  14. What urine output is red flag? what could this indicate?
    Report less than 30 ml/hr; may indicate hypovolemia or renal problems
  15. What could cause delayed Int. peristalsis
    Long anesthesia time, amt of bowel handling , and opiod analgesic use.
  16. What is the best indicator of int activity?
    passage of flatus or stool
  17. What does ab cramping along with distention indicate?
    trapped nonmoving gas, not peristalsis
  18. How long does it take to completely heal all layers of tissue?
    6 months to 2 years
  19. Which wounds heal quickest?
    Head and facial wounds heal quicker than ab and leg wounds cause of the better blood flow to the head and neck.
  20. Sanguineous
    bloody drainage
  21. serosanguineous
    yellow and bloody; should gradually decrease, considered normal until 5th day post-op
  22. serous
    serum-like, yellow
  23. dehiscence
    partial or complete separation of the outer wound layers
  24. Evisceration
    total separation of all wound layers and protrusion of internal organs through the open wound.
  25. When does pain usually reach its peak?
    second day after surgery
  26. Why is the T tube considered a special drain?
    Cause it may be placed for specific drainage purposes, such as to drain bile after cholecystectomy
Card Set
Med Surg
Med Surg: Ch. 18
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