Chapter 12: Preop 101 Flashcards
When can a patient eat prior to major surgery?
Patient should be NPO after midnight the night before or for at least 8 hours before surgery
What risks should be discussed with all patients and documentedon the consent form for a surgical procedure?
- Bleeding
- infection
- anesthesia
- scar
- other risks are specific to the individual procedure
- also MI, CVA, and death if cardiovascular disease is present
If a patient is on antihypertensive medications, should the patienttake them on the day of the procedure?
Yes (remember clonidine “rebound”)
If a patient is on an oral hypoglycemic agent (OHA), should the patient take the OHA on the day of surgery?
Not if the patient is to be NPO on the day of surgery
If a patient is taking insulin, should the patient take it on the day ofsurgery?
No, only half of a long-acting insulin (e.g., Lente) and start D5NS IV; check glucose levels often p_reoperatively, operatively, and postoperatively_
Should a patient who smokes cigarettes stop before an operation?
Yes, improvement is seen in just 2 to 4 weeks after smoking cessation
What laboratory test must all women of childbearing age have before entering the O.R.?
β-HCG and CBC because of the possibility of pregnancy and anemia from menses
What is a preoperative colon surgery “bowel prep”?
Bowel prep with
- colon cathartic (e.g., GoLYTELY®)
- oral antibiotics (neomycin and erythromycin base),
- IV antibiotic before incision (controversial)
Has a preoperative bowel prep been shown conclusively to decrease postoperative infections in colon surgery?
No, there is no data to support its use
What must you always order preoperatively for your patientundergoing a major operation?
- NPO/IVF
- Preoperative antibiotics
- Type and cross blood (PRBCs)
What electrolyte must you check preoperatively if a patient is on hemodialysis?
Potassium
Who gets a preoperative ECG?
Patients age >40 years
