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Ch. 18 Preoperative

Terms in this set (36)

Looking for information specific to surgical experience
1. Developmental: infants/elderly greater risk of having complications; more fragile. Infants less blood volume, difficulty keeping warm, renal/hepatic systems not fully developed...decreased metabolism and excretion of drugs. Elderly on the other end of spectrum, may not have as good renal/hepatic function, may have other chronic diseases or 'comorbidities' that can complicate surgery. Slower reflexes, Risk for atelectasis, pneumonia, post op confusion
2. Medical History: medications, previous surgeries, allergies, skin status, cv/pulmonary /renal/hepatic/endocrine/neuro systems or problems

a) CV: history of MI, cardiac surgery, dysrhythmias, hypertension, heart failure, dvt... Elderly decreased elasticity of Blood vessels, decrease cardiac output, decreased circulation - potential shock, thrombosis, would healing
b) Resp: copd, asthma, sleep apnea, lung surgery
c) Kidney/liver: ESRD/ESLD pt will not metablolze or excrete drugs very well. Fluid status, IV access...could be problems, electrolyte imbal., bleeding - Over hydration with IVF - hyperkalemia, UTI, Urinary retention- intestinal decreased mobility - fetal impaction - Fewer T cells - wound infections wound dehiscence or evisceration.
d) Endocrine: DM; hyper/hypoglycemia, impaired healing, hyperthyroidism - thyroid storm heart rate and blood pressure become dangerously high
e) Skin: want to know if they have any areas at risk for decubiti...or have any already - Aging - skin becomes thin.