Marilyn Hughes is a 45-year-old female who suffered a left mid-shaft tibia-fibula fracture when she slipped on icy stairs this morning. She was taken to surgery for an open reduction with internal fixation (ORIF). She returned from surgery at 1:45 p.m. with a below-the-knee ace/splint dressing. Vital signs have been stable, and neurovascular checks have been within normal range. She has an IV of Lactated Ringer’s infusing at 75 mL/hour and is tolerating liquids well without nausea. Her diet could probably be advanced to regular dinner this evening. A family member has been with her at the bedside throughout the day. She began complaining of pain shortly after returning from surgery and was given morphine 6 mg IV at 2:15 p.m. She is now on every-30-minute postoperative vital signs. Last vital signs were BP: 130/82, HR: 88, RR: 16.
Please answer the following questions.
1. What complications can occur to someone after having surgery involving general anesthesia?
2. Discuss pathophysiology and pharmacological treatments of compartment syndrome.
3. Which diagnostic tests are necessary to collect prior to a patient's surgery?
4. What is a "time out" mean, in terms of a surgical procedure?
5. Which assessment data would lead you to a conclusion of compartment syndrome?

Answer:

1-Complications could be:

A misadministration of anesthetic doses that could lead to death of the patient, cardiac disorders, variation in body temperature, intolerance to liquids and solids, dizziness or headaches, mystical delays or momentary confusion.

2-The treatment consists of eliminating everything that generates compression in the area, in this case the casts would be a negative effect for said treatment, in addition, in extensive cases of necrosis due to the compartment syndrome they could be treated with the amputation of the limb.

The pathophysiology of this disease is a priority before the fracture, that is why it is necessary to remove the plaster from the fracture area or look for alternative methods that do not affect the patient in both pathologies.

3-Diagnostic tests to check a fracture would be: X-RAY, COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE. In addition to routine laboratory analysis, complete blood count, and clinical history or clinical inspection of the patient.

4-It is the time it takes for the anesthesia to stop having effect, it lasts approximately 1 or two hours.

5- The signs are: pallor, absence of pulse, presence of necrosis, increased edema in the compartments, possible altered mental state, but the most important symptom of this syndrome is worsening pain over time.

This symptom is essential to be able to detect it for the suspicion of this syndrome.

Explanation:

The success of the treatment begins in the correct detection of the diagnosis in pathologies such as this, that is why it is essential to know certain knowledge in patients where the risk of life is high.

After general anesthesia-related surgery, complications might include problems of the respiratory system, such as pneumonia, atelectasis (collapse of lung tissue), and airway blockage. Cardiovascular complications: include variations in blood pressure, unsteady heartbeats, or blood clot development.

2. Compartment syndrome is a medical disorder that develops when there is increased pressure inside a tightly confined bodily compartment, resulting in decreased blood flow and tissue damage. Pathophysiology entails a rise in compartmental pressure, which constricts blood flow, compresses blood vessels, and reduces tissue perfusion.

Included in compartment syndrome treatment are:

a. An urgent surgical procedure: It is possible to conduct a fasciotomy to release compartmental pressure and reestablish blood flow.

b. Monitoring and controlling pain: In order to stop additional tissue damage, effective pain management is crucial.

3. The required diagnostic tests that may be performed before surgery include:

Complete blood count (CBC), coagulation profile, blood chemistry, and blood typing are among the blood tests.

Urinalysis: To evaluate kidney health and check for UT infections.

4. A "time out" is a special safety routine that is carried out just before the procedure begins in terms of surgery. This is the last phase in the verification process to make that the right patient, right technique, right location, and right equipment or implants are in place.

The surgical team pauses for a moment to go over the identification of the patient, the intended surgery, and any unique concerns or requirements.

5. The following assessment information might support the diagnosis of compartment syndrome:

a. extreme discomfort that is not proportional to the wound or surgical location.

b. Increasing tension and edema in the afflicted limb.

c. Skin that has a pallor or cyanosis (bluish hue).

d. pulses that are weak or nonexistent in the afflicted leg.

To know more about the respiratory system:

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