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Pre, Peri and Post-Operative Care > Pre-Operative Assessment > Flashcards

Pre-Operative Assessment Flashcards

(52 cards)

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1
Q

What examinations are performed prior to surgery

A
  • General examination to determine health of patient

- Airway exam be anaesthetists

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2
Q

What grading system is used to determine someones risk with intubation

A

ASA (American society of anesthesiologists)

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3
Q

what is ASA I

A

Healthy Patient

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4
Q

what is ASA 2

A

Mild Systemic Disease

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5
Q

what is ASA 3

A

Severe Systemic Disease

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6
Q

what is ASA 4

A

Severe Systemic Disease that is a constant threat to life

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7
Q

what is ASA 5

A

Would not survive without the operation

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8
Q

what is ASA E

A

Emergency Procedure

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9
Q

give examples of a minor surgery

A

Skin lesion excision

Incision and drainage or abscess

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10
Q

what two investigations may be ordered in minor surgery

A

ECG

U+E

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11
Q

when is U+Es required for minor surgery

A

Risk of AKI

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12
Q

when is ECG required for minor surgery

A

Not had an ECG in past 12-months

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13
Q

Give examples of intermediate surgery

A
  • Inguinal hernia repair
  • Tonsillectomy
  • Excision varicose veins
  • Knee arthroscopy
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14
Q

What investigations may be ordered for ASA 2 in intermediate surgery

A

ECG

U+E

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15
Q

When are U+Es ordered for intermediate surgery

A

CKD, Risk AKI

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16
Q

When is an ECG ordered in intermediate surgery

A

CVD

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17
Q

What tests may be ordered for ASA 3 or 4 in intermediate surgery

A
  • FBC
  • Coagulation studies
  • ABG and Lung Function Tests
  • U+E. always
  • ECG = always
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18
Q

When is FBC ordered

A

ASA 3/4 and CVD or Renal Disease

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19
Q

When are coagulation studies ordered

A

ASA 3/4 and chronic liver disease or taking anti-coagulants

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20
Q

When are ABG or LFTs ordered

A

ASA 3/4 and rest disease

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21
Q

What counts as a major surgery

Study These Flashcards
A

TURP
Hysterectomy
Thyroidectomy
Joint replacement

22
Q

what is ordered if blood loss is expected in the surgery

Study These Flashcards
A

Group and Save, Cross-Match

23
Q

what tests are ordered in all female patients prior to surgery

Study These Flashcards
A

Pregnancy Test

24
Q

when is a sickle cell test ordered pre-operatively

Study These Flashcards
A

Afro-Carribean Patients with a History of Sickle Cell

25
when are MRSA swabs ordered
All patients
26
how long should patients stop eating prior to surgery
6 hours
27
how long should patients stop the intake of clear fluids
2 hours
28
what is a mnemonic to remember drugs to stop prior to surgery
CHOW
29
what drugs should be stopped prior to surgery
Clopidogrel Hypoglycaemic Oral contraceptive Warfarin
30
how long before surgery is clopidogrel stopped
7-days
31
how long is COCP and HRT stopped prior to surgery
4 Weeks
32
why is COCP stopped prior to surgery
Due to increased VTE risk
33
how long is warfarin stopped prior to surgery
5-days
34
if warfarin is stopped what is it bridged with
LMWH
35
how long prior to surgery is LMWH stopped
24h
36
what INR is required for surgery to proceed
< 1.5
37
what should SC insulin regimens be changed to prior to surgery
Variable rate infusion insulin
38
if a patient is on long-term steroids, should these be stopped and why
Continue steroids as otherwise on stopping can cause addisonian crisis
39
what should all patients have prior to surgery
VTE Risk assessment
40
how long following surgery are individuals given LMWH for
28 days
41
what are individuals given in addition to LMWH
TED Stockings
42
in addition to VTE, what else may be prescribed in surgery
Antibiotic prophylaxis
43
how long should patients be advised to stop smoking prior to the operation
2 months
44
explain corticosteroids during surgery
Continue corticosteroids - as stopping corticosteroids can risk addisonian crisis
45
in diabetic patients what should be measured prior to surgery
HbA1C
46
in what HbA1c should the surgery be delayed
>69
47
where should diabetic patients be put on the surgery list
First patients - as they are kept NBM overnight
48
in T1DM, what is done the night before surgery
Given 1/3 of their SC dose of insulin
49
in T1DM, what should be done the morning of surgery
SC insulin is switched to IV variable infusion rate insulin
50
what is a sliding scale of insulin
50 Units actarapid in 49.5 ml Saline
51
how much dextrose should be given if NBM
5% Dextrose at a rate of 125ml/h
52
how often are BM's checked
Every 2-hours

Pre, Peri and Post-Operative Care (4 decks)

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