Transverse Colostomy - ANS-soft stool
typical stool odor
stool damages the skin
empties several times per day
may or may not be at risk for fluid/electrolytes imbalances
may irrigate
sigmoid colostomy - ANS-- formed stool
ileosotomy - ANS-- high up
- liquid pasty stool
Roux-en-Y gastric bypass - ANS-Small pouch created from stomach
Part of small intestine (DUODENUM) bypassed
Restriction and malabsorption
Metoclopramide (Reglan) - ANS-- controls post-op NV
- can have extrapyrmidal side effects like tardive dyskinesia
Gastrectomy Interventions - ANS-- encourage deep breaths
- and position shifts
clonic seizure - ANS-repetitive jerking movements
, petit mal seizure - ANS-Also called absence attack. A seizure that is characterized by a
spike-and-wave EEG and often involves a loss of awareness and inability to recall
events surrounding the seizure.
Tonic seizure - ANS-sustained muscle contraction
Emergence excitement safety interventions - ANS-ok to use wrist restraints
Shivering first interventions♀️ - ANS-- anticipate order for demerol
(over warm blankets)
Interscalene nerve block - ANS-anesthetizes the brachial plexus as it passes through
the scalene triangle. It is used to provide anethesia for the shoulder and upper arm.
Nearly all patients will devleop transeint ipsilateral diaphragmatic parylasis due to
involvment of the phrenic nerve roots as tehy pass through the interscalene sheath.
Complication of rapid warming - ANS-Hypotension (rapid vasodilation can cause a drop
in blood pressure)
Hetastarch (Hespan) - ANS-- Volume expander, colloid
- less expensive than blood
- minimal co-ag effects
- less likely to cause allergic reaction
- metabolizes slowly
Why are neonates not tolerant of fluid overload? - ANS-- obligate sodium loss
- slow clearance of fluid
- inability to conserve fluid
Medication used to treat fluid overload/ ascites in patient with Cirrhosis -
ANS-Spironolactone
Steal syndrome - ANS-- Too much blood going to the fistula, leaving the hand ischemic.
Tx is with surgery or banding to decrease outflow (if high flow)
Infant should void - ANS-5ml/Kg/hr or at least 2-3ml/Kg/hr
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