Bone Disease
inflammation of bone cause by infection
osteomyelitis
Target A1C level
Less than 6.5
thickening of artery walls resulting in a progressive narrowing of the arteries of the upper and lower extremities
Peripheral Artery Disease (PAD)
Patient must stop foods at least ___ hours before a surgery
What to avoid 1 week prior to surgery that causes excess bleeding?
Supplements
diagnostic procedure for definitive diagnosis of osteomyelitis
Bone or tissue biopsy
Distinction between type 1 and type 2?
Type 1 DM does NOT produce insulin. Type 2 DM still produces insulin but has reduced insulin sensitivity/ decreased insulin production
What are risk factors for PAD?
smoking, hypertension, diabetes, obesity
Cardiac risk factors for surgical complications?
HTN, Angina, history of MI, CHF, CAD and DM
used to prevent postoperative lung atelectasis
incentive spirometer
___ might be necesssary if left untreated
Amputation
uncontrolled blood sugar and vascular insufficiency make patients with diabetes prone to this type of wound.
diabetic ulcer
What other cardiovascular disease is commonly seen in patients with peripheral arterial disease?
coronary artery disease
Which supplements increase the chances of bleeding?
Garlic, vitamin E, fish oil, ginko
What is recommended for promoting tissue perfusion post operatively?
Ambulation
Type of IV line used for antibiotic treatment of osteomyelitis
PICC
What is the role of Glyburide in diabetes?
Work by increasing insulin production from pancreas
Characteristics you may find of the lower extremities related to PAD?
loss of hair, thickened nails, skin is cool to touch, thin/shiny skin, decreased or absent peripheral pulses. Pain in affected extremity
What Pre-op labs would be appropriate to review?
CBC, WBC, A1C, Blood Glucose, pregnancy test
What is critical in management of diabetes?
Self-monitoring of blood glucose (SMBG)
plantar flex foot on affected side
Increasing _____ can help manage blood sugar in type II diabetes
Diagnostic testing that is obtained using Doppler ultrasound and a sphygmomanometer at the thigh, below the knee, and at ankle level while the patient is supine. A drop of 30mmHg or greater suggests PAD.
Segmental Blood Pressure
_____ increases the risk of pulmonary complications during and after the surgery.
smoking
How often should patients perform skin assessments and foot care?