Advanced Health Assessment, day 1 - Leersnyder Flashcards

(37 cards)

0
Q

“Mother of anesthesia” as deemed by Dr. Charles Mayo at St. Mary’s Hospital in Minnesota

A

Alice Magaw, delivered more than 14,000 anesthetics without a single complication

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1
Q

First nurse anesthetist at St. Vincent’s in Erie, PA

A

Sister Mary Bernard

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2
Q

ASA 1

A

Healthy

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3
Q

ASA 2

A

Mild Systemic Disease

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4
Q

ASA 3

A

Activity-limiting disease

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5
Q

ASA 4

A

Constant threat to life - CHF, renal failure

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6
Q

ASA 5

A

Not expected to survive 24 hours

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7
Q

ASA 6

A

Donor

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8
Q

ASA ____ E

A

“E” indicates emergency surgery

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9
Q

Organizations involved in the practice of nurse anesthesia

A

ASA, AANA, school, hospital, board exam, state and federal government, state nursing association

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10
Q

standards of care - preop assessment and eval

A

standard 1

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11
Q

standard of care obtaining and documenting informed consent

A

standard 2

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12
Q

standard for formulating a patient specific plan of anesthesia care

A

standard 3

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13
Q

six steps for preop assessment per ASA taskforce 2002

A
  1. interview patient
  2. physical exam
  3. order tests
  4. review tests
  5. ASA
  6. make plan and obtain consent
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14
Q

ASA basic standards for pre-anesthesia 2010

A
  1. review record
  2. interview and exam
  3. order and review tests
  4. order preop meds
  5. receive consent
  6. document in chart
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15
Q

Joint Commission H and P

A

within 30 days, also requires surgical reassessment to be documented within 24 hours

16
Q

CMS H and P requirements

A

completed or updated within past 7 days

17
Q

six elements of effective communication

A
Professional
Empathy
Language, lay
Touch, personal
Eye contact
Eye level
18
Q

7 steps of physical exam

A
airway
heart
breath
vitals
height/weight
neuro
mobility/disability
19
Q

METS assessment - metabolic equivalent of task

A

58.2 W/m squared (18.4 Btu/h x feet squared) - just kidding!

1 met = 1 kcal/kg/hour or sitting quietly
0.9 met = sleep
2.3 mets = very slow stroll
4.0 mets = gentle bike ride
23 mets = running
20
Q

3-3-2

A

3-3-2 rule
3 finger mouth opening
3 finger hyoid to chin
2 finger hyoid to floor of mandible (jaw)

21
Q

lemon

A
lemon
look externally
eval 3-3-2 rules
mallampati
obstruction
neck mobility
22
Q

components of airway exam

A
  1. upper incisors
  2. teeth condition
  3. relation of maxilla to mandible
  4. ability to extend mandible anterior to maxilla >3cm
  5. tongues size and mobility
  6. uvula
  7. facial hair
  8. thyromental distance
  9. big fat neck
  10. ROM of head and neck
23
Q

stop bang

A
stop bang
snore
tired
observed apnea
pressure (blood pressure)
BMI
age
neck circumference
gender
24
upper airway sounds
upper airway - croup, stridor d/t epiglotitis, obstruction, upper resp infection
25
lower airway sounds
lower airway - asthma, pneumonia, chf, pulm edema
26
BMI
BMI - KG / meters squared | or pounds / inches squared x 703
27
teens and smoking
3x more likely to use alcohol 8x marijuana 22x cocaine increased fighting and unprotected sex
28
number one cause of death from anesthesia
malignant hyperthermia
29
Humphrey Davey used this for his personal use, recreation
nitrous oxide
30
risk factors for surgery
``` greater than 85 years old ASA class greater than 2 CHF functionally dependent COPD ```
31
cardiac risk factors / does your patient need an echo?
``` class 1- class 2- class 3- ```
32
if your patient has a murmur...
is it symptomatic?
33
insulin rec's
Nagelhout pg. 368
34
James Simpson - obstetrician
chloroform
35
three A's of anesthesia
analgesia amnesia anesthesia
36
surgeon's requirements
``` immobile patient positioning requirements muscle relaxation ability to post op test pain control go home same day to remain intubated ```