Surgery EOR: Preoperative/Postoperative Care Exam Questions and Answers
7 views 0 purchase
Course
Surgery EOR
Institution
Surgery EOR
Surgery EOR: Preoperative/Postoperative
Care Exam Questions and Answers
When can a patient eat prior to a major surgery? - Answer- NPO after midnight or at
least 8 hours
What risks should be discussed with all patients and documented on the consent form
for a surgical procedure? - Answer- Risk...
Surgery EOR: Preoperative/Postoperative Care Exam Questions and Answers When can a patient eat prior to a major surgery? - Answer - NPO after midnight or at least 8 hours What risks should be discussed with all patients and documented on the consent form for a surgical procedure? - Answer - Risk: Bleeding, infection, anesthesia, scars If a patient is on anti -HTN meds should the patient take them on the day of the procedure? - Answer - Yes Should a patient who smokes cigarettes stop before an operation? - Answer - Yes - improvement is seen in just 2 -4 weeks of smoking cessation What lab test must all women of childbearing age have before entering the OR? - Answer - B-Hcg and CBC What is a preop colon surgery "bowel prep"? - Answer - Bowel prep with a colon cathartic (GoLYTELY), oral abx (neomycin, erythromycin), IV antibiotic before incidsion What must you always order preoperatively for you patient undergoing a major surgery? - Answer - 1. NPO/IVF 2. Preop abx 3. Type and cross blood (PRBCs) What electrolyte must you check preoperatively if a patient is on hemodialysis? - Answer - Potassium Who gets a preop EKG? - Answer - Patients over 40 or undergoing cardiac procedure What is the most important preoperative eval performed by the surgical team? - Answer - H&P - no documentation exists linking a reduction in mortality and morbidity to routine lab testing in otherwise healthy patients undergoing elective procedures Detailed H&P prior to surgery including special attention to... - Answer - Hx of CVA, heart dz, pulm dz, renal dz, liver dz, GI d/o, DM, prior surgeries, bleeding problems, clotting problems, difficulty w/ anesthesia, nutrition, etoh, illicit drugs What is an ASA score? - Answer - American Society of Anesthesiologists (ASA) classification system which stratifies the degree of perioperative risk for patients Describe the ASA classification system - Answer - ASA 1: Normal healthy patient ASA 2: Patient with mild systemic disease ASA 3: Patient with severe systemic disease ASA 4: Patient with severe systemic disease with a constant threat to life ASA 5: Moribound patient who are not expected to survive without an operation ASA 6: Brain dead patient Mouth PE important to note - Answer - Teeth - if loose worry about intubation Tongue - think sleep apnea if large Jaw - TMJ could be difficult intubation Mallampati score Airway concerns with surgery - Answer - Tracheal deviation - can be issue for maintaining airway during surgery Neck concerns with surgery - Answer - If >17in there is concern for sleep apnea, masses, deformities, ROM Mallampati score - Answer - Classifies how open the airway is 1 - Can see the uvula, no prob w/ intubation IV- No uvula, hard intubation Routine preop labs/tests for patients with cardiac disease/vascular disease? - Answer - CBC EKG What are major cardiac risk factors for surgery? - Answer - Unstable coronary syndromes Recent MI Severe valvular disease Ventricular arrhythmias What are minor cardiac risk factors for surgery? - Answer - Hx of CVA Uncontrolled HTN What is the Goldman Criteria for Cardiac Risk? - Answer - Assesses risk of perioperative fatal and nonfatal cardiac events. Another used is Detsky's What are moderate cardiac risk factors for surgery? - Answer - Asymptomatic MI DM Compensated CHF What is Lee's revised cardiac risk index? - Answer - Validated way to predict risk in patients who undergo elective noncardiac procedures. There are 6 predictors (each get one point): History of ischemic heart disease CHF Hx of CVA High-risk operation Preoperative treatment with insulin Preoperative SCr >2.0 mg/dL Goldman criteria points - Answer - 0-5 = Class I 6-12 = Class 2 13-25 = Class 3 >25 = Class 4 Preop lab assessment for cardiac disease? - Answer - Resting LV function Ambulatory EKG monitoring Exercise stress test or nuclear stress test Stress echo Patients with an EF <___% are at greatest risk for complications during surgery - Answer - <35% What are indications for preop coronary angiography? - Answer - Patients with suspected left main disease, triple vessel coronary occlusive disease, or unstable coronary syndromes (high risk patients) What is appropriate medical therapy for CAD prior to surgery? - Answer - BB, CCBs, nitrates to ensure myocardial oxygen demand does not exceed supply What do patients with a history of rheumatic heart disease require prior to surgery? - Answer - Prophylactic antibiotics to prevent endocarditis What should you do if you find your patient to have carotid artery disease? - Answer - Endorterectomy prior to surgery - wait 6 months before operation if possible
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller EmilyCharlene. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.49. You're not tied to anything after your purchase.
