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Surgery -
PA Clin Med
46
Health Care
Graduate
07/25/2010

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Cards

Term
phases of wound healing
Definition
1. defensive (inflammatory)
2. proliferative (collagen)
3. maturation (scar)
Term
defensive stage of wound healing lasts _-_days and includes:
Definition
3-4d and includes hemostasis and inflammation
Term
proliferative phase of healing beins around ___ and lasts for ___
Definition
begins aroudn 3-4days and lasts up to 3wks
Term
what happens in proliferative phase of healing?
Definition
fibroblasts form a scaffold; can be felt as a helaing edge under the suture
Term
whaich phase of wound healing contains new granulation tissue?
Definition
proliferative
Term
when does maturation phase of wound healing begin
Definition
>21days
Term
when does dehiscence of a wound usually occur?
Definition
day 4-5d after a wound; sensation that something let go
Term
describe stage I decubitus ulcer:
Definition
nonblanchable erythema of intact skin
Term
describe stage II decub ulcer:
Definition
partial thickness loss presenting as abrasion, blister or shallow crater
Term
describe stage III decub ulcer:
Definition
full thickness loss down to fascia
Term
describe stage IV decub ulcer:
Definition
full thickness loss through fascia; could be into bone
Term
penrose
Definition
drain/tube that provides a sinus tract
Term
T-tube
Definition
provides bile drainage
Term
albumin role in wound healing
Definition
protein critical for wound healing normal range 3.5-5.0
Term
WBC monitored for wound healing
Definition
lymphocyte
Term
prevention of decub ulcers
Definition
turn pt q2h
Term
most common cleaning agent used for wounds
Definition
normosaline
Term
most common chronic wounds in adults
Definition
venous stasis ulcers
Term
arterial insufficiency ulcers tx:
Definition
wet to dry gause or abx ointment
angioplasty, stent, bypass
Term
charcot's foot
Definition
rocker bottom foot of DM
Term
common causes of fever post-op:
Definition
WWWWW - 1Wind(pneumo), 3Water(UTI), 5Walk(DVT), 7Wound(infection), Wonder drugs(xfusion or drug rxn)
Term
3 causes for post op pulmonary infection
Definition
1. atelectasis
2. respirator
3. aspiration
Term
positive UA does not necessarily indicate a cause for post op fever; explain:
Definition
bacteriuria doesn't indicate invasive UT sepsis, remove cath flush with volume diuresis, recheck UA and consider other sources of fever
Term
which is more common post op, peritonitis or intraabdominal abcess
Definition
abcess
Term
pleural empyema most likely seen after:"
Definition
chest tube placement
Term
anesthesia: metabolized by serum cholinesterases and cause more allergies:
Definition
Esters
Term
epinepherine seems to be most effective when used with which 2 amide anesthesias
Definition
lidocaine and mepivacine
Term
use of vasoconstrictor adjuvants with anesthetics, has what affect?
Definition
shortens onset and extends duration of action
Term
HCO3 role in anesthesia:
Definition
Term
which class of anesthesia is cleared by the liver
Definition
amides
Term
which class of anesthesia is avoided in renal disease?
Definition
esters
Term
which class of anesthetics are assoc w TRUE allergic reactions?
Definition
amides
Term
functions of inhaled anesthesia
Definition
1. unconsciousness
2. analgesic
3. muscle relax
Term
functions of IV anesthesia
Definition
unconsciousness
Term
function of neuromuscular blocking agent
Definition
muscle paralysis/relax
Term
these are added to optimize the anesthetic
Definition
1. Opiods
2. Neuromuscular blockers
Term
bariatric surgery is considered with pts who are morbidly obese; BMI = ?
Definition
>40 or >35 w comorbid condition
Term
size of thyromental distance that may be difficult to intubate
Definition
<6.5cm
Term
what fraction of the TBW is intracellular?
Definition
2/3
Term
what fraction of TBW is extracellular?
Definition
1/3; 15% intersitial and 5% intravascular
Term
rule of 10's for fluid requirements
Definition
first 10kg = 100ml/kg/d
second 10kg = 50ml/kg/d
weight >20kg = 20ml/kg/d
Term
To calculate BSA for child use:
Definition
rule of sixes; weight in lbs (3,6,12,18) correlates to BSA (0.1,0.2,0.3,0.4)... add 0.1q10#>60
Term
hypertonic saline is reserved for:
Definition
severe hyponatremia and coma
Term
IV K+ has a risk of what local reaction?
Definition
phlebitis; IV K+ is irritating to the vein
Term
hypophosphatemia in the critical care setting can result in acute respiratory failure
Definition
Term
hypermagnesemia tx:
Definition
normal saline and furosimide. if cardiac irritability = calcium gluconate
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