Sensitivity to foreign plasma proteins Anaphylactic and severe allergic

Sensitivity to foreign plasma proteins anaphylactic

This preview shows page 19 - 24 out of 25 pages.

Sensitivity to foreign plasma proteins Anaphylactic and severe allergic Sensitivity to foreign plasma proteins
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Circulatory overload Fluid administered faster than circulation can accommodate Sepsis Transfusion of bacterially infected blood components Transfusion related acute lung injury Reaction between transfused antileukocyte antibodies and recipient’s leukocytes causing pulmonary inflammation and capillary leak o What to do Stop immediately Maintain IV with 0.9% saline Monitor VS and I/O Recheck ID and blood tags Notify blood bank and HCP Treat symptoms per MD Save blood bag and tubing, return to blood bank Complete work up Collect ordered blood and urine PACU discharge criteria o Patient awake or baseline o VSS o No excessive bleeding or drainage o No respiratory depression o O2 sat >90% o Report given Postoperative complications o Anaphylactic reactions o Respiratory Hypoxemia o Cardiovascular Hypotension and tachycardia Hypertension Dysrhythmias Fluid and electrolyte imbalances DVT Syncope o Neuro/psych Delirium Delayed emergency o Pain o Temperature Hypothermia Hyperthermia o GI N/V
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Distention Hiccups o GU Oliguria Urinary retention o Integumentary Poor wound healing Wound dehiscence Wound evisceration Elimination: 6 questions Constipation o Causes Insufficient fiber Inadequate fluid Decreased physical activity Ignoring urge to go Meds- opioids Diseases- DM, neurologic o Medications Daily Bulk forming Stool softeners Saline and osmotic solutions Stimulants Can cause dependence Stool lubricants Saline and osmotic solutions Stimulants Diverticulosis and Diverticulitis o Diverticulosis No s/s sometimes Routine colonoscopy can dx s/s abdominal pain bloating flatulence change in bowel habits blood in stool o Diverticulitis s/s LLQ pain elevated temp Leukocytosis Palpable abdominal mass Treatment Home
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o Clear liquid diet o Rest o PO antibiotics Hospital o NPO o Bedrest o IV antibiotics o IV fluids Diarrhea o Nursing implications Skin breakdown 3 loose stools in 24 hrs Metabolic alkalosis Hydration Indications for indwelling urinary catheters (Foleys), prevention of catheter associated UTIs o Indwelling Urinary retention Bladder decompression before or after abdominal or pelvic surgery Genitourinary surgery I/O measurements Contamination of stage III or IV pressure ulcers Terminal illness o Intermittent Study of anatomic structures Urodynamic testing Sterile specimens Instillation of medications into bladder PVR o Preventing infection d/c foley ASAP wipe with CHG wipes daily sterile insertion techniques Medical and surgical treatment for BPH; postoperative and home care after TURP o Medication 5a reductase inhibitors A blockers o Surgical treatment TUMT TUNA Laser prostatectomy TUVP Intraprostatic uretheral stents TURP Post op
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o Bleeding management o CBI Home care o Continence will return after a few weeks o Fluid intake o UTI or wound infection o Sexual dysfunction Diabetes: 7 questions Insulin: o Administration practices Vary sites to prevent adipose build up Give subq NOT IM o Insulin Rapid Lispro Aspart Glulisine Onset- 15 mins Peak- 60-90 mins Duration- 3-4 hours Short Regular Onset- ½ - 1 hr
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