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17 Cards in this Set
- Front
- Back
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What meds provide protection from post-op GI bleeding? |
- H2 blockers - PPIs |
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What measures provide protection from post-op atelectasis / pneumonia? |
- Incentive spirometry - Coughing - Smoking cessation - Ambulation |
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What treatments provide protection from post-op DVT? |
- Low molecular weight heparin (LMWH) - Subcutaneous low-dose unfractionated heparin - Sequential compression devices (SCD) for lower extremities - Early ambulation |
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What measures provide protection from wound infection? |
- Shower the night before surgery with chlorhexidine scrub - Never use a razor for hair removal (electric shavers only) - Ensure adequate skin prep in OR - Do not close skin in a contaminated case - Ensure pre-op antibiotics in bloodstream before incision - Ensure no excess Bovie (necrotic tissue) |
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Why not use a razor to remove hair prior to surgery? |
Micro cuts are a nidus for bacteria and subsequent wound infection |
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How long should "prophylactic antibiotics" be given prior to surgery? |
<24 hours |
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What treatment provides protection from oral / esophageal fungal infection during IV antibiotic treatment? |
PO nystatin |
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What measures prevent ventilator-associated pneumonia (VAP)? |
Head of bed >30 degrees, handwashing, pt oral hygiene, avoidance of gastric overdistention |
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What is the classic pre-op "bowel prep"? |
1. Bowel prep: lower bacterial count in colon by catharsis (GoLytely or Fleets)
2. PO antibiotics (neomycin, erythromycin) pre-operatively
3. Pre-op IV antibiotic with spectrum versus anaerobes (eg, Cefoxitin) |
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Is there any evidence that a bowel prep decreases infections? |
No |
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What treatment provides protection from OPSS after splenectomy? |
Immunization against H. influenzae, Streptococcus, Meningococcus, and PN when illness/fever occurs |
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What treatment provides protection from endocarditis with faulty heart valve or prosthetic heart valve? |
Antibiotics prior to dental procedure or any surgery |
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What treatment provides protection from tetanus infection? |
Tetanus toxoid (and tetanus immune globulin, if one or no previous toxoid with dirty wound) |
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What treatment provides protection from EtOH withdrawal? |
Chlordiazepoxide (Librium), also give Rally pack |
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What treatment provides protection from Wernicke's encephalopathy? |
Rally pack (aka banana bag because IV is yellow with vitamins in it); pack includes thiamine, folate, and magnesium |
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What is Wernicke's encephalopathy? |
Condition resulting from thiamine deficiency in pts with alcoholism, causing a triad of symptoms: 1. Confusion 2. Ophthalmoplegia 3. Ataxia |
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What treatment decreases the risk of perioperative adrenal crisis in a patient on chronic steroids? |
"Stress-dose" steroids: 100 mg hydrocortisone administered pre-operatively, continued post-operatively q8h, and then tapered off |
