Chapter 16

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swansokj02
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193065
Filename:
Chapter 16
Updated:
2013-01-28 17:17:36
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Pre Operative Lab Values
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Description:
Care of Preoperative patients
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  1. Surgical procedures are categorized by
    the purpose, body location, extent, and degree of urgency.
  2. Diagnostic surgery
    Performed to determine the origin and cause of disorder or the cell type for cancer. Example: Breast biopsy
  3. Curative Surgery
    Performed to resolve a health problem by repairing or removing the cause. Example: Appendectomy
  4. Restorative Surgery
    Performed to improve a patients functional ability. Example: total knee replacement
  5. Pallative Surgery
    Performed to relieve the symptoms of a disease process, but does not cure. Example: Tumor debulking
  6. Cosmetic Surgery
    Performed to alter or enhance.
  7. Elective Surgery
    Planned for correction of a nonacute problem. Example: Hernia repair
  8. Urgernt Surgery
    Requires prompt intervention; may be life threatening if treatment is delayed 24-48 hrs. Example: Eye injury
  9. Emergent Surgery
    Requires immediate intervention. Example: Gunshot or stab wound
  10. Minor Surgery
    Procedure without significant risk. Example: Incision and drainage
  11. Major Surgery
    Procedure of greater risk. Example: Mitral Valve replacement
  12. Simple Surgery
    Only the most overy affected areas involved in the surgery.
  13. Radical Surgery
    Extensive surgery beyond the area obviously involved.
  14. Minimally invasive surgery
    a body cavity or body area through one or more endoscopes
  15. Factors that increase surgical risk or increase the risk for postoperative complications
    • Age
    • Medications
    • Medical History
    • Prior surgical experiences
    • Health History
    • Family History
    • Type of surgery planned
  16. Potassium- normal range for adults
    3.5-5.0 mEq/L

    Increased in: Dehydration, Renal failure, acidosis, cellular/tissue damage

    Decreased in: NPO status when potassium replacement is inadequate, excessive use of diuretics, vomiting, diarrhea, alkalosis
  17. Sodium- normal range
    • <90: 136-145 mEq/L
    • >90: 132-146 mEq/L

    Increased in: Cardiac or renal failure, hypertension, edema, excessive amounts of IV fluids, dehydration.

    Decreased in: nasogastric drainage, vomiting or diarrhea, excessive laxative use
  18. Chloride- normal range
    • <90: 98-106 mEq/L
    • >90: 98-111 mEq/L

    Increased in: respiratory alkalosis, dehydration, renal failure, IV fluids

    Decreased in: nasogastric drainage, vomiting, diarrhea, diuretics
  19. Carbon Dioxide- normal value
    • <60: 23-30 mEq/L
    • 60-90: 23-31 mEq/L
    • >90: 20-29 mEq/L

    Increased in: COPD, intestinal obstruction, vomiting, metabolic alkalosis

    decreased in: hyperventilation, DKA, Diarrhea, renal failure, lactic acidosis
  20. Glucose- normal value(fasting)
    • <60: 70-110 mg/dL
    • 60-90: 82-115 mg/dL
    • >90: 75-121 mg/dL

    increased in: hyperglycemia,stress, steroid use, pancreatic or hepatic disease

    decreased in: hypoglycemia, excess insulin
  21. Creatinine- normal value
    • Females:
    • <60: 0.5-1.1
    • 60-90: 0.6-1.2
    • >90: 0.6-1.3

    • Males:
    • <60: 0.6-1.2
    • 60-90: 0.8-1.3
    • >90: 1.0-1.7

    Increased in: renal damage, renal insufficiency, acute renal failure

    decreased in: atrophy of muscle tissue
  22. BUN- normal value
    • <60: 10-20 mg/dL
    • 60-90: 8-23
    • >90: 10-31

    increased in: Dehydration, renal failure, excessive protein in diet, liver failure

    decreased in: overhydration, malnutrition
  23. INR- normal value
    11-12.5 sec

    increased in: coagulation defect, Vit K deficiency

    decreased in: coagulation disorder
  24. WBC count- normal range
    5,000-10,000/mm^3
  25. Hemoglobin- normal value
    • Females:
    • 18-44: 12-16g/dL
    • 45-64: 11.7-16.0g/dL
    • 65-74: 11.7-16.1g/dL

    • Males:
    • 18-44: 14-18g/dL
    • 45-64: 13.1-17.2g/dL
    • 65-74: 12.6-17.4
  26. hematocrit- normal value
    • Females:
    • 18-44: 35-45%
    • 45-74: 37-47%

    • Males:
    • 18-44: 42-52%
    • 45-64: 39-50%
    • 65-74: 37-51%
  27. Risk factors for VTE
    • Obesity
    • >40
    • have cancer
    • decreased mobility
    • history of VTE
    • smoke
    • taking oral contraceptives
    • smoke
    • decreased cardiac output
  28. Calcium- normal value
    8.4-10.5 mg/dL
  29. Magnesium- normal value
    1.5-2.5 mEq/L
  30. Phosphate- normal value
    2.7-4.5 mg/dL
  31. pH arterial blood gases- normal value
    7.35-7.45
  32. Hypokalemia
    • decreased serum potassium level.
    • Increases the risk for toxicity if the patient is taking digoxin
    • slows recovery from anesthesia
    • increases cardiar irritability
  33. hyperkalemia
    • increased serum potassium level.
    • increases the risk for dysrythmias

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