FINAL REVIEW
Let’s get weird
,MOD 2:CARE OF THE SURGICAL
PATIENT
• Assessment and understanding of your patient’s preop
baseline is crucial
• Get a clear H&P prior to surgery
• Helps anticipate potential complications
• How long have they been NPO
• What meds are they taking
• When did they last have them?
• What do you expect to see?
• Expected post-op vital signs
• Pain assessments
• Administer appropriate pain meds
• Appropriate goal setting
• Safety is important!
,MOD 2: SIDE EFFECTS
• Malignant Hyperthermia
• A hypermetabolic state- Medical EMERGENCY
• An inherited trait- ask about family history prior to surge
• Symptoms:
• Extreme muscle rigidity
• Temp > 104 F
• Increased lactic acid
• Metabolic Acidosis on ABG’s
• Cardiac dysrhythmias
• Cyanosis
• Treatments:
• Cooling blanket
• IV fluids
• 100% oxygen
• Dantrolene (muscle relaxant)
, MOD 3: PNEUMONIA
• Most common
• Cough
• Fever, shaking chills
• Dyspnea, tachypnea
• Pleuritic chest pain
• Green, yellow, or rust-colored sputum
• Change in mentation for older or debilitated patient
• Antibiotic therapy
• Symptoms should improve in 3-5 days, if not IV abx may be needed
• Chest x-ray is crucial for diagnosing type
• Sputum culture may be indicated
• Supportive care
• Oxygen for hypoxemia
• Analgesics for chest pain
• Antipyretics
• Individualize rest and activity
• PPSV 23 (Pneumovax)
Let’s get weird
,MOD 2:CARE OF THE SURGICAL
PATIENT
• Assessment and understanding of your patient’s preop
baseline is crucial
• Get a clear H&P prior to surgery
• Helps anticipate potential complications
• How long have they been NPO
• What meds are they taking
• When did they last have them?
• What do you expect to see?
• Expected post-op vital signs
• Pain assessments
• Administer appropriate pain meds
• Appropriate goal setting
• Safety is important!
,MOD 2: SIDE EFFECTS
• Malignant Hyperthermia
• A hypermetabolic state- Medical EMERGENCY
• An inherited trait- ask about family history prior to surge
• Symptoms:
• Extreme muscle rigidity
• Temp > 104 F
• Increased lactic acid
• Metabolic Acidosis on ABG’s
• Cardiac dysrhythmias
• Cyanosis
• Treatments:
• Cooling blanket
• IV fluids
• 100% oxygen
• Dantrolene (muscle relaxant)
, MOD 3: PNEUMONIA
• Most common
• Cough
• Fever, shaking chills
• Dyspnea, tachypnea
• Pleuritic chest pain
• Green, yellow, or rust-colored sputum
• Change in mentation for older or debilitated patient
• Antibiotic therapy
• Symptoms should improve in 3-5 days, if not IV abx may be needed
• Chest x-ray is crucial for diagnosing type
• Sputum culture may be indicated
• Supportive care
• Oxygen for hypoxemia
• Analgesics for chest pain
• Antipyretics
• Individualize rest and activity
• PPSV 23 (Pneumovax)
