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Flashcards in Preoperative Evaluation of Patient Deck (34):
1

What are the six key factors that are looked at in determining the operative risk?

Age
Benefits vs Outcome of surgery
Urgency
Nature of problem
Duration of procedure
Concurrent medical problems

2

For a smaller patient, like on going under for a PDA repair, what are four things that should be set aside or used?

Warmed fluids
Glucose
Atropine
Nerve block

3

What are the five levels of anesthetic risk?

Excellent - Good - Fair - Poor - Guarded

4

What does a classification of risk of Good mean?

Slight chance for complications but highly likely there will be a good outcome

5

What does a classification of risk of Fair mean?

Serious complications are possible but uncommon
Prolonged recovery possible
May not return to pre surgical function

6

What does a classification of risk of Poor mean?

Underlying disease/Procedure itself is associated with severe complications
Recovery will be prolonged
Unlikely to return to pre surgical function

7

What does a classification of risk of Guarded mean?

Outcome unknown

8

What three things should you ask when focusing in on a complaint?

When
What did it look like when it first began
Better or Worse

9

What is the most important part of a pre surgical work up?

PE

10

What are the levels in rating the physical status of a surgical patient?

I to V

11

What is a physical status of II mean?

Localized disease or mild systemic disease but otherwise healthy

12

What is a physical status of III mean?

Severe systemic disease

13

What is a physical status of IV mean?

Severe systemic disease that is life threatening

14

What is a physical status of V mean?

Moribund, not expected to live 24 hours with or without surgery

15

What is part of the intraoperative plan?

Surgical approach
Material/Equipment needed
Personnel you will need on staff
(How - Who - What)

16

What are the examples of a postoperative plan?

Further testing
Wound care
Support (nutritional, fluid, oxygen, etc)

17

What is the normal blood volume for a dog?

90 ml/kg

18

What is the normal blood volume for a cat?

70 ml/kg

19

What is the rate for the shock dosage of fluids?

30 ml/lb

20

What do you have to be careful of when giving shock rate of fluids?

Can cause more problems then good if patient has:
Pulmonary + Cardio + Renal issues

21

When do you know if you need to treat ventricular arrhythmias?

Interfere with CO
Multiform
R on T
Ventricular rate is > 160 rpm

22

What are the two methods of suppling nutrition?

Enteral + Parenteral

23

What are the possible complications/problems with total parenteral nutrition?

Expensive formulas
Sepsis

24

What are the four types of tubes you can place for enteral feeding?

Nasogastric
Pharyngostomy
Gastrostomy
Enterostomy

25

What are the three clinical methods of using antibiotics?

Therapeutic
Prophylactic
Nosocomial

26

What is prophylactic antibiotic administration responsible for?

Antibiotic resistance in bacteria

27

What are the four major reasons given for resistant bacteria?

Prolonged, extensive surgical procedures
Increased invasiveness of supportive measures
Long hospital stays
Inappropriate use of AB's
Immunosuppressive drugs

28

What is infection dependent on?

Number/Virulence of bacteria
Competence of host defense
Amount of tissue damage
Dead space resulting from procedure

29

What four things can be done to decrease infections?

Good wound lavage
Closure of dead space
Appropriate AB prophylaxis
Meticulous surgical technique

30

Where is the most common place that bacteria come from that cause infection?

Endogenous to patient

31

How much does the risk increase per person in the surgical suite?

1.3 times

32

What are the two most common nosocomial infections?

Urinary tract + Surgical site infection

33

When would you need to use prophylactic AB's?

Surgery longer than 90 minutes
Prothesis implantation
Prothesis that was there pre-surgery
Severely infected wounds

34

What are the four types of surgery that need prophylactic AB's?

Orthopedic + Respiratory + Gastrointestinal + Urogenital