Happy Monday, and welcome to Medical Mondays!
I had all these grand plans to make most Medical Mondays pertinent health-month-related topics, but…I gotta study. It is crunch time! (Nooo!) A whole lot of the topics that I planned to write about have been shunted over to…2016.
Anyone wanna hazard a guess as to how many drafts I have piled up on this blog thus far?! (I’ll give you a hint–it’s more than 100.)
I’m gonna talk at you about Post-Operative Fever today, because I wrote this whilst on my surgery rotation! It’s one of the things we’re always on the lookout for after we’ve operated on a patient, and this is where a super-handy mnemonic (the basis of how I memorized/learned most things in anatomy back in the day) comes into play!
Post-op fever can be caused by malignant hyperthermia, a potentially fatal disorder that’s associated with the administration of certain anesthetic agents.
Malignant hyperthermia classically presents with a high fever (typically >104 F) shortly after an anesthetic is given, and is generally treated with IV dantrolene, 100% O2, and cooling blankets.
Bacteremia is a cause of fever within hours of a surgery, and blood cultures/empiric antibiotics should be ordered.
The Five “W’s”
- Wind – These usually occur the earliest, on post-op days 1-3
- Atelectasis (the complete or partial collapse of a lung or lobe of a long) is the most common, and is treated with coughing, deep breathing, ambulation + incentive spirometry; most common on days 0-1
- Pneumonia is usually suspected when an initial fever on post-op day 0-1 persists for 2-3 days
- Pulmonary issues can also be associated with fever; these are usually related to pre-existing pulmonary dysfunction coupled with the incisional pain, respiratory depression from narcotics, and abdominal distention
- Water (UTIs, pyelonephritis)
- UTIs usually present between post-op days 3-5, often after bladder catheterization
- UTI = 3 letters => “day 3”
- UTIs usually present between post-op days 3-5, often after bladder catheterization
- Walking (DVTs, aka blood clots)
- Deep venous thrombosis (DVTs) or phlebitis usually start in the lower extremities + can involve more proximal veins; check for edema in the legs!
- Pulmonary embolisms can be associated with fever
- Can occur at any time postoperatively, but often in post-op days 4-6
- Wound (infection)
- Usually occur on post-op days 5-8 (only strep + clostridial wound infections cause fever earlier than this).
- First step in treatment is typically to remove the staples in order to allow fluid to drain
- Wonder drugs (pretty much any kind of drug, but most commonly antibiotics or heparin)
- Usually presents on post-op day >7
General Management
- Daily examination of the patient (or more frequent if necessary), including the surgical wound
- Removal of surgical tubes as soon as possible
- Early ambulation, to prevent elevated risk of blood clots
- Close monitoring of fluid balance + electrolyte levels
- Adequate but not excessive pain medication/management
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The first I heard of the 5 “W”s was when Meredith Grey recited them on the pilot of Grey’s Anatomy. I totally hear her voice in my head whenever I list them off for myself haha. Good luck with the studying! You’ve got this!!
Ahahaha I love this!
Hannah @ Hannah Ever After recently posted…Unicorn Eggs
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hehehe, I should’ve watched more medical dramas! ;_;
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Darnit! I should’ve watched Grey’s, hahaha. I’ve only ever seen a couple episodes!
Thanks so much! <3 I cannottt wait til it's over! I hope it goes well! *-*
Yikes! Sounds scary!!
More good luck studying!
Julie @ Running in a Skirt recently posted…Fashion Friday- Navy Dress with Pink Accessories
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Thankfully, we only had a couple instances where this happened while I was on my surgery rotation! :O
Thanks so much! I can’t wait to be done with it! *-*
I learn so much from your medical posts:)
Knowledge is power, you never know when you might need to know things like this, or how they could help you or others around you, that is why I find it all so interesting!
Love that you have 100 posts sitting around to be used. I have about 30, but mine need some serious editing, they are just when I sit around bored at work and have idea’s jumble though my head, LOL
Kristy @Runaway Bridal Planner recently posted…The Hills are Alive With The Sound of Music
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Thanks so much! <3
Most of my drafts definitely need editing to some sort of degree too, but I like having them there in case I have nothing to write about every here and there! :P There have been several that I've kinda been shoving back further and further because I can't seem to find a good place to schedule them (sigh). One of these days!
I had no idea what this was before reading this post!! Love the information you take time to provide us :) NOW, time to catch up on the rest of your posts after a crazy couple of weeks!
Jess @hellotofit recently posted…Try This Thursday 7/23 – aerial yoga
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hehehe, thanks so much! :D I’m glad you’ve been having fun over these past couple of weeks! :]!