Preop Evaluation Flashcards
(39 cards)
what is one of the most important features of a surgical history?
pain
what is one of the most important aspects of pain?
the patient’s reaction to it
what is a common complaint that is often of no significance?
change in bowel habits
what should be suspecting if a patient presents with intermittent alterations of constipation and diarrhea?
colon cancer
what is the most common error in hematemesis or hematochezia?
assuming hemorrhoids
what is the most frequently acquired nosocomial infection?
UTI
what are 3 pre-op precautions regarding home medications?
continue critical meds with sip of water
do not take ACEI on day of sx
withhold diuretic on morning of sx
when should prophylactic antibiotics be given?
within 1 hour of incision
when are prophylactic antibiotics normally discontinued?
< 24 hours after surgery
in which 4 operative conditions are prophylactic antibiotics continued for longer in?
GI tract
implantation of foreign body
contaminated wounds
immunocompromised patients
in which operative case is a cephalosporin usually given as a pre-op antibiotic and discontinued within 24 hours post-operatively?
elective hernia repair
right-sided colectomy
left-sided hemi-colectomy
pulmonary repair d/t thoracic stab wound
bilateral mastectomy with overlying cellulitis
elective hernia repair
classify: healthy patient with no systemic disorder
class I
classify: mild to moderate systemic disorder that need not be associated with the surgical problem
class II
what is a major cause of morbidity and mortality in surgical patients?
cardiovascular complications
what are 6 independent predictors of cardiac complications?
hx of ischemic heart disease
CHF
cerebrovascular disease
high risk operation
preop treatment with insulin
preop serum Cr > 2
findings suggestive of ischemic heart disease should be screened by what?
stress test
how long after an MI should surgery be postponed?
> 6 months
patients undergoing which surgery would be best evaluated by the Revised Cardiac Risk Index for risk of perioperative major adverse cardiac event (MACE)?
aortic valve replacement
hip surgery
coronary stent placement
coronary artery bypass grafting
hip surgery
to minimize retained gastric volume and maximize gastric pH before general anesthesia, refrain from drinking clear liquids for at least?
2 hours
before receiving anesthetics or sedatives, avoid eating light meals for at least ____ hours and fatty meals for ____ hours
6
8
what increases the risk for multiple complications after elective surgeries?
hepatic dysfunction
what are the 3 signs of liver failure?
spider telangiectasias
jaundice
prolonged bleeding
what are 2 things used to treat hepatic/liver dysfunction?
vitamin K
fresh frozen plasma
what are the two scoring systems used to assess liver function?
child-turcotte-pugh (CTP) score
Model for end-stage liver disease (MELD)
