Patient Evaluation and Monitoring Flashcards

(46 cards)

1
Q

what are the two standard formats for medical history questionnaire

A

short and long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the patient interview should be conducted by who

A

the person planning and administering the anesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the purpose of the medical history questionnaire

A
  • a tool to gather written information about the patients health
  • completed by the pt or guardian
  • simple format which is easy to understand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the purposes of the patient interview

A
  • an opportunity to review the responses made on the written medical questionnaire
  • gain greater insight to the magnitude of the problem - identifies the treatment risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the physical exam starts when:

A

the patient walks in the room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the purpose of the physical exam

A
  • check for signs of underlying illness
  • assesses patient general appearance
  • vital signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the components of the upper airway

A
  • nasopharynx
  • oropharynx
  • laryngopharynx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is a consultation

A

request to the PCP or specialist for assistance/information that you will use to manage your patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the consult needs to be:

A
  • concise
  • specific regarding what you want done
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the assistance/information with consultations may include:

A
  • providing a specific piece of information needed to move forward with treatment
  • information pertaining to the patients medical consition
  • patients ability to tolerate treatment
  • requests further information about patients medical condition
  • determine optimal condition for treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the assistance may include:

A
  • request that patient be optimized prior to treatment: HTN pt
  • request assistance in management of patient during perioperative period as necessary (insulin regimen for diabetic patient)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the purpose of recognition and assessment

A

to determine the level of illness the provider must be able to interpret the signs and symptoms that indicate an existing or pending emergent situation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the early signs of serious illness arise from the CNS

A
  • anxiety
  • fear
  • nausea
  • inadequate blood supply or vital nutrients: oxygen and glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the progression of process

A
  • confusion
  • agitation
  • combative behavior
  • lethargy
  • coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the skin changes

A
  • diaphoresis (especially of the brow)
  • pallor or grayness of face and limbs: signs of extreme sympathetic nervous system activation, attempt to conserve core circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is capillary refill

A

the time it takes for the pink to return after blanching the palm or a nail bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

capillary refill is prolonged if peripheral circulation is:

A

compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

color should return in the time it takes to say:

A

“capillary refill”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the vital signs for

A
  • baseline vital signs when patient is seated
  • changes can be used to judge the seriousness of the patients condition
  • correlate to clinical situation
  • continue monitoring throughout the case
20
Q

what are the symptoms that may represent early signs of an emergent situation

A
  • difficulty breathing
  • shortness of breath
  • nausea
  • chest pain or pressure
  • lightheadedness
  • dizziness
  • headache
  • abdominal pain
21
Q

the most important part of IV sedation is:

22
Q

what is the suction equipment

A
  • central suction
  • portable suction
  • suction powered by an non electrical source in event of electrical failure
23
Q

what is the yankaur suction tip

A

rigid smooth plastic anatomically shaped
multiple suction ports
controlled suction

24
Q

what is the purpose of monitoring equipment

A
  • device to measure blood pressure and heart rate with multiple size cuffs
  • to auscultate the heart and lungs
  • pulse oximetry with appropriate probes
  • electrocardiogram
  • temperature monitor
  • ideal that monitor can print
25
what is capnography
- monitoring of concentration or partial pressure of CO2 - graph of expiratory CO2 by expired volume
26
what is an advantage of capnography
- breath to breath ventilation data - respiratory effort - real time feedback on treatment
27
what does the pulse oximeter do
- measures oxygen saturation of arterial blood - determine percentage of oxyhemoglobin in capillaries
28
what wavelength does a pulse oximeter use
650nm and 950nm
29
describe the nasal canula
- no airtight seal - significant air dilution - cannot be scavenged - no N2O, inhalation agents - no reservoir bag - often uncomfortable
30
describe nasal hood
- commonplace in office - less air dilution - less volume needed - reservoir bag - may be scavenged
31
what are the etiology of airway obstruction
- poor airway classification - relaxation of soft tissues - retraction of the tongue - depressing the mandible - inadequate airway support
32
what does the head tilt chin lift
displaces the prolapsed tongue from the posterior pharyngeal wall - eliminates obstruction - can be used for conscious or unconscious patient
33
describe the combitube
- double lumen airway - blindly inserted - ventilate patient regardless of tracheal or esophageal placement
34
what are the indications for combitube
- difficult airway - cant ventilate - failed intubation - cant move head/neck - no laryngoscope - significant upper airway bleeding
35
the king laryngeal tube is a versatile airway tool offering:
-ease of insertion: quick insertion requiring no laryngoscopy - low incidence of sore throat and trauma - minimizes gastric insufflation - does protect from aspiration
36
what is the laryngeal mask airway for
- intended as an improved alternative to the traditional face mask - minimizes trauma - simplifies securing the airway
37
what are the LMA advantages
- minimal training - shortest placement time - can use in pediatric patients - least amount of tissue trauma - ACLS class 2B airway control - can use to intubate
38
what are the LMA contraindications
- intact gag reflex - patients at high risk for aspiration - laryngeal foreign bodies or pathology - patients with decreased pulmonary compliance
39
describe LMA vs king tube
- quick establishment of the airway - effective ventilation - better ventilation than OPA/NPA - does not protect from aspiration
40
describe king tube vs LMA
- rapid establishment of the airway - effective ventilation - protects from aspiration - easy to use and train - can be used to facilitate intubation
41
what is definitive airway control
endotracheal intubation
42
what is the surgical airway procedure
cricothyroidotomy
43
what is the procedure for the cricothyroidotomy
- palpate the cricothyroid membrane - skin incision over the cricothyroid membrane - insert scalpel handle and rotate 90 degrees - insert endotracheal tube - inflate cuff and ventilate
44
what are the emergency airway management tools
- laryngeal mask airway - combitube - cricothyroidotomy - kingtube
45
what is the oral pharyngeal partition
- should be used with each patient - prevents teeth/debrid from entering oropharynx - helps absorb excess irrigation fluid - provides additional reaction time
46