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High Yield Surgery Emma Holiday Ramahi PP

Terms in this set (407)

Absolute contraindications to surgery
Diabetic coma
DKA
Poor nutrition contraindications to surgery
Albumin <3
Transferrin <200
Weight loss <20%
Contraindications to surgery due to severe liver failure
Bili >2
PT >16
Ammonia >150
Encephalopathy
Contraindications to the smoker
Stop smoking 8 weeks prior
If a CO2 retainer, go easy on the O2 in the post-op period; can suppress respiratory drive
Goldman's index
Tells you who is at greatest risk for surgery
#1 on Goldman index
CHF
Check EF. If <35% no surgery
#2 on Goldman index
MI w/in 6 months
Check: EKG --> stress test --> cardiac cath --> revasc
Other factors of Goldman's index
Arrhythmia
Old >70
Emergent?
AS, poor medical condition, surgery in chest/abd
Late systolic, crescendo decrescendo murmur that radiates to carotids
Increases with squatting
Decreases with decreased preload
Aortic stenosis
Meds to stop prior to surgery
Aspirin
NSAIDs
Vitamin E (2 weeks)
Warfarin (5 days) - drop INR to <1.5 (can use vit K)
Take half the morning dose of insulin if diabetic
If CKD in dialysis...
Dialyze 24 hours post-op
Why do we check the BUN and Creatinine? What is the worry if BUN >100?
Increased risk of post-op bleeding due to uremic platelet dysfunction
What would you expect on coag panel if BUN>100?
Normal platelets, prolonged bleeding time
Explain Assist control vent
Set TV and rate but if pt takes a breath, vent gives the volume
Explain Pressure support vent
Important for weaning

Pt rules rate but a boost of pressure is given
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