Hypotension is a common and serious complication of a patient’s hospital course. In mild and early stages, there are many compensatory responses that can support tissue perfusion. If it worsens, circulatory collapse can ensue, resulting in shock. Shock is the…
The goal on call is to treat hypertensive episodes that are symptomatic or that put the patient at risk for myocardial infarction (MI), stroke, or bleeding. As the on-call physician, it is best to leave the fine-tuning of a patient’s…
While on call, you will be asked to evaluate and treat patients with headache. Postsurgical patients may develop headache as a sequela of anesthesia, stress, sleep disturbance, drug reaction, hypertension, increased intracranial pressure (ICP), and other causes. Other patients may…
This chapter covers briefly the nutritional needs of surgical patients. Surgical patients differ from other patients in the hospital because in addition to basal metabolic demands and the increased nutritional requirements of disease and immune defense, they also have demands…
Gastrointestinal (GI) bleeding is a stressful on-call problem to manage. It is common in hospitalized patients, and it includes a broad spectrum of disorders. GI bleeding can represent a minor problem or a life-threatening emergency. Initial management involves resuscitation, stabilization,…
Surgical disease and treatment is often associated with aberrations in fluids, electrolytes, and acid–base status. Rapid fluid status assessment is a constant exercise in the management of surgical patients and the application of therapies best suited to treat respective abnormalities.…
All patients with fever warrant clinical investigation. Although most febrile patients in the postoperative period are not infected, the evaluation is directed toward the discovery of infection, as this is the most threatening cause. Phone Call Questions 1. How high…
When a patient falls, it is a serious event. Whether the patient falls from bed or falls elsewhere in the hospital, be mindful of the following two questions after the fall: Is the patient injured? And, what was the cause…
Abnormalities of heart rate (HR) and rhythm include both harmless and potentially life-threatening processes. Rate and rhythm disturbances include bradycardias, tachycardias, and irregular rhythms. Bradycardias are rhythms resulting in a ventricular rate of less than 60 beats Tachycardias are defined…
Reactions to medications may be wide ranging, from complaints of bad aftertaste to more serious problems with allergic reactions and anaphylaxis. Most calls will encompass three major groups of symptoms: rashes, anaphylaxis, or other complaints of patient intolerance. All drugs…