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SP15 Oral Surgery > Perioperative Management > Flashcards

Perioperative Management Flashcards

1
Q

What are four attributes to reducing peri-op morbidity

A

have awareness of the patients physical and medical state
allows the provider to make adjustments to the care plan based on the patients presentation
allows the provider to anticipate and prepare for adverse events
eliminate or minimize surprises

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2
Q

What does ASA II mean

A

mild systemic controlled disease

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3
Q

What does ASA III mean

A

severe disease but not incapacitating

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4
Q

What does ASA IV mean

A

severe disease, that is a constant threat to life

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5
Q

What does ASA V mean

A

moribund, not excessive to lived 24hrs

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6
Q

What seven things make up the patient presenation

A 
CC
history of present illness
medical history
review of systems
physical exam
impressions/diagnosis
treatment plan
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7
Q

Don’t forget this regarding the med history

A

herbals and OTC medications

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8
Q

When reviewing the systems what is there to look for regarding the head

A

headaches
nausea/vomiting
swelling/asymmetry

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9
Q

When reviewing the systems what is there to look for regarding the eyes

A

changes to vision
redness
excessive tearing/watering

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10
Q

When reviewing the systems what is there to look for regarding the ears

A

hearing loss
tinnitus
vertigo

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11
Q

When reviewing the systems what is there to look for regarding the nose

A

stuffiness/difficulty moving air
sneezing
epistaxis

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12
Q

When reviewing the systems what is there to look for regarding the throat

A

pain
hoarseness
sore throat

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13
Q

When reviewing the systems what is there to look for regarding the neck

A

impaired mobility

pain

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14
Q

When reviewing the systems what is there to look for regarding the heart

A 
angina
syncope
paroxysmal nocturnal dyspnea
palpitations
hypertension
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15
Q

When reviewing the systems what is there to look for regarding the pulmonary system

A 
dyspnea
orthopena
wheezing
cough
hemoptysis
sputum
asthma
bronchitis
URI
smoking
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16
Q

When reviewing the systems what is there to look for regarding the GI

A 
dysphagia
dyspepsia
pain
nausea/vomitting
diarrhea
hematochezia; bloody stool
steatorrhea; fatty stool
puritis 
fatigue
melena
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17
Q

When reviewing the systems what is there to look for regarding the genitourinary system

A

urgency to void
frequent voiding
pain upon voiding
fluid overload

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18
Q

When reviewing the systems what is there to look for regarding the hematopoietic system

A

petechiae
spontaneous bleeding
bleeding inappropriate to the injury
easy bruisabiliy

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19
Q

When reviewing the systems what is there to look for regarding the endocrine system

A 
diabetes; hypoglycemia is worse
thyroid
adrenal
paraythroid
Cushing's
pheochromatoma
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20
Q

When reviewing the systems what is there to look for regarding the neurologic system

A 
headaches
diplopia
seizures
weakness
memory loss
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21
Q

When reviewing the systems what is there to look for regarding the MS system

A

pain impaired mobility
joint swelling
aching
cramping/numbness

22
Q

At the time of procedure, a note stating what should be made

A

that there are no changes to the pre-op evaluation should be made

23
Q

This is a request to a specialist for assisting in the management of a patient

A

consultation

24
Q

What may a consultation entail

A

information
recommendations
opinions
request for treatment by the consult

25
Q

True or False

The fact that you don’t know something can’t be an excuse for a negative outcome

A

True

26
Q

What are the four purposes of post-op instruction

A

prepare patient for expected course
identify potential complications
provide reference and point of contact
make no assumptions

27
Q

What kind of pain is expected post-op

A

mild to moderate pain, which increases with flap and bone removal

28
Q

How do you manage post-op pain

A

with OTC analgesics and appropriate drugs

29
Q

Can the asthmatic patient take ibuprofen

A

No, its an NSAID

30
Q

How much swelling is expected post-op simple extraction

A

little or none

31
Q

How much swelling is expected post-op flaps or bone removal

A

little to substantial

32
Q

What are the directions for icing swelling post-op

A

15 mins on 15 mins off for 24 hours

33
Q

How long should you keep your head eleven post-op

A

24 hours

34
Q

How much bleeding is expected post-op

A

minimal

35
Q

When should bleeding stop post-op

A

24-48 hours

36
Q

What can be used if bleeding persists

A

gauze pressure to surgery site for 20 minutes

37
Q

The key to bleeding management is what

A

to have it stopped before the patient leaves the office

38
Q

Are post-op antibiotics warranted in a healthy patient

A

No

39
Q

True or false

In some patient prophylactic and continuing antibiotics are appropriate

A

True

40
Q

Which instances are indicative of prophylaxis

A 
heart valves
cyanitis heart disease
transplants
joint replacement
metallic implants
41
Q

Avoid doing the the first day post-op

A

rinsing

42
Q

How should you brush around the surgical site

A

gently, rinsing gently the first day

good oral hygiene will help healing

43
Q

Rinse the mouth with this several times a day beginning the DAY AFTER SURGERY

A

warm saltwater

44
Q

What is the diet post-op

A

soft, cool, foods for the first day

chewing gently in the area afterwards

45
Q

Do not do these after surgery regarding diet

A

use straws

suck on food, candy or wound

46
Q

What is the recommendation about exercising after surgery

A

avoid vigorous exercise on the day of surgery

may resume usual activity as tolerated after (few days for simple, several days+ for surgical)

47
Q

This condition is when there is an increase in pain 3-5 days post-op and no improvements 3-5 days post-op

A

dry socket

48
Q

What is the hallmark of dry socket

A

worsening taste or odor in mouth

49
Q

True or False

you can diagnose dry socket over the phone

A

False; they must come in for a consult

50
Q

The patient MUST be able to do this

A

contact someone

SP15 Oral Surgery (7 decks)

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