Podcast
Questions and Answers
Which of the following prophylactic measures does NOT simulate normal muscle pump activity?
Which of the following prophylactic measures does NOT simulate normal muscle pump activity?
What is the primary goal of wound management?
What is the primary goal of wound management?
Which of the following is NOT a component of wound assessment?
Which of the following is NOT a component of wound assessment?
What is the primary purpose of using ankle rests during surgery?
What is the primary purpose of using ankle rests during surgery?
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What is the primary goal of nutritional support in wound management?
What is the primary goal of nutritional support in wound management?
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Which of the following is a key aspect of pressure sore prevention?
Which of the following is a key aspect of pressure sore prevention?
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What is the primary reason for the accumulation of secretions in the airways?
What is the primary reason for the accumulation of secretions in the airways?
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What is the primary goal of deep breathing exercises in the prevention of atelectasis?
What is the primary goal of deep breathing exercises in the prevention of atelectasis?
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What is the typical characteristic of mucopurulent sputum in bronchopneumonia?
What is the typical characteristic of mucopurulent sputum in bronchopneumonia?
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What is the time frame for immediate post-operative complications?
What is the time frame for immediate post-operative complications?
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What type of surgery may require extensive physiotherapy?
What type of surgery may require extensive physiotherapy?
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What is the primary treatment for severe cases of diffuse atelectasis?
What is the primary treatment for severe cases of diffuse atelectasis?
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What is the leading cause of death in surgical patients?
What is the leading cause of death in surgical patients?
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What is a common complication of anesthesia?
What is a common complication of anesthesia?
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What is the key to treating arrhythmias?
What is the key to treating arrhythmias?
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What is a factor that reduces lung expansion after surgery?
What is a factor that reduces lung expansion after surgery?
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What type of surgery may involve transfer to the CCU for 24 hours?
What type of surgery may involve transfer to the CCU for 24 hours?
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What is a potential complication of local anesthesia?
What is a potential complication of local anesthesia?
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What is the typical characteristic of breathing in adult respiratory distress syndrome?
What is the typical characteristic of breathing in adult respiratory distress syndrome?
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What is a potential complication of surgery that can affect body image?
What is a potential complication of surgery that can affect body image?
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What is a classification of complications based on the time of occurrence?
What is a classification of complications based on the time of occurrence?
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What is the most common cause of late postoperative hemorrhage?
What is the most common cause of late postoperative hemorrhage?
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What is a systemic effect of a local anaesthetic agent that can occur due to excess dosage?
What is a systemic effect of a local anaesthetic agent that can occur due to excess dosage?
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What is a complication of spinal, epidural, or caudal anaesthesia that can be introduced by the needle?
What is a complication of spinal, epidural, or caudal anaesthesia that can be introduced by the needle?
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What is a major effect of general anaesthesia?
What is a major effect of general anaesthesia?
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What is a general complication of any operation?
What is a general complication of any operation?
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What is the term for hemorrhage occurring during an operation?
What is the term for hemorrhage occurring during an operation?
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What is a complication of general anaesthesia that can occur due to an inappropriate choice of drugs or dosage in relation to age?
What is a complication of general anaesthesia that can occur due to an inappropriate choice of drugs or dosage in relation to age?
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What is the term for hemorrhage occurring several days after an operation?
What is the term for hemorrhage occurring several days after an operation?
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What is a potential consequence of injury to diseased bones and joints from manipulation during surgery?
What is a potential consequence of injury to diseased bones and joints from manipulation during surgery?
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What is a predisposing factor for deep vein thrombosis and pulmonary embolism?
What is a predisposing factor for deep vein thrombosis and pulmonary embolism?
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What is the typical presentation of pulmonary embolism?
What is the typical presentation of pulmonary embolism?
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Which of the following is a clinical feature of deep vein thrombosis?
Which of the following is a clinical feature of deep vein thrombosis?
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What is the typical presentation of occlusion of the ilio-femoral veins?
What is the typical presentation of occlusion of the ilio-femoral veins?
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What is a method for preventing venous thromboembolism?
What is a method for preventing venous thromboembolism?
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What is a potential complication of pelvic masses?
What is a potential complication of pelvic masses?
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What is a common predisposing factor for both deep vein thrombosis and pulmonary embolism?
What is a common predisposing factor for both deep vein thrombosis and pulmonary embolism?
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Study Notes
Classifications of Complications
- Complications can be classified according to the time of occurrence: immediate (within 24 hours), early (within 1 week), late (within 1 month), and long-term (after 1 month)
- Complications can also be classified as general or specific to a particular surgery
Post-Operative Complications
- Pulmonary complications:
- Respiratory problems can occur due to reduced lung tidal volume, lung expansion, and reduced cough reflex
- Prophylactic measures to prevent venous thromboembolism include low-dose heparin, calf compression devices, and graded compression stockings
- Circulatory complications:
- Cardiac complications can occur, including ischemia, infarction, and arrhythmias
- Hypertension is a key cause of cardiac complications
- Wound complications:
- Wound healing principles include optimizing the host, evaluating barriers to healing, promoting perfusion and oxygenation, and managing pain and psychological factors
- Components of wound assessment include wound location, type, measurement, tissue color, drainage, odor, and surrounding skin
Pressure Sores
- Prevention and management of pressure sores include:
- Relieving pressure on the heels using ankle rests and heel pads
- Regularly changing posture and checking pressure areas
- Managing incontinence and using special bed surfaces
Respiratory Complications
- Atelectasis:
- Predisposing factors include shallow ventilation, loss of periodic hyperinflation, and inhibition of coughing
- Prevention and treatment include deep breathing exercises, nebulizer bronchodilators, and endotracheal intubation
- Pneumonias:
- Typical form of chest infection in surgical patients
- Symptoms include pyrexia, tachypnea, tachycardia, and cyanosis
- Treatment includes antibiotics such as amoxicillin
- Respiratory Distress Syndrome:
- Characterized by rapid, shallow breathing, severe hypoxemia, and stiff lungs
- Chest X-ray findings include pulmonary edema and pleural effusion
Hemorrhage
- Intraoperative hemorrhage:
- Occurs during the operation and should be controlled by the surgeon
- Early postoperative hemorrhage:
- Occurs during the immediate postoperative period and indicates inadequate operative hemostasis or unrecognized trauma to a blood vessel
- Late postoperative hemorrhage:
- Occurs several days after operation and is usually related to infection which erodes vessels at the operation site
Thromboembolism
- Predisposing factors include:
- Direct trauma to the pelvis and lower limbs
- Previous venous thromboembolism
- Pre-existing lower limb venous disorder
- Venous stasis during general or regional anesthesia
- Malignant disease
- Immobility
- Pregnancy
- Obesity
- Dehydration
- Symptoms of deep vein thrombosis include swelling of the leg, tenderness of the calf muscles, increased warmth of the leg, and calf pain on passive dorsiflexion of the foot (Homan's sign)
- Pulmonary embolism:
- Classic picture includes sudden dyspnea and cardiovascular collapse, followed by pleuritic chest pain, development of a pleural rub, and hemoptysis
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