Week 4 - Labs, Chest X-Ray Interpretation and Radiation Safety Flashcards
(115 cards)
Who must do the pre-operative assessment on the patient?
A qualified anesthesia practitioner
What has been found to be most predictive of surgical complications?
A thoughtfully executed preoperative history and physical.
What are some conditions that would benefit from early preoperative evaluations?
Poorly controlled HTN, asthma/COPD requiring medicine, morbid obesity, cervical or thoracic spine injuries
What would be suspected if a patient had vague reports of fever and convulsions last time they were under anesthesia?
Malignant hyperthermia, further investigation needs to be done to rule this out before surgery.
How can we prevent adverse drug reactions prior to surgery?
Advise patients to not take unnecessary medications preoperatively.
Most common cause of drug hypersensitivities during anesthesia?
Antibiotics and NMBA
A patient states that they are allergic to oxycodone because it makes them dizzy. What should you next step be?
Further investigate a true allergic reaction opposed to adverse reactions. A true allergic reaction is a absolute contraindication to give a drug, whereas an adverse reaction isn’t.
How long before surgery should patients be advised to not smoke?
12-18 hours
Smoking effects on the body
Hyper coagulability, increased blood viscosity, left shift on oxy-hem curve, COPD, recurrent chest infections…
Perioperative complications in children exposed to smoke
Laryngospasm, coughing on induction/emergence, breath holding, postop O2 desaturations, and hyper secretion
Anesthetic requirements are _________ in alcoholics or illicit drug users
Increased
Important to know prior to surgery (if patient will tell you)
Alcoholics have increased postoperative morbidity and mortality due to
Poor wound healing, infection, bleeding, pneumonia, and further hepatic deterioration
Most common recreational drugs
Marijuana and cocaine
Signs that indicate illicit drug use during physical exam
Evidence of drug injections, ophthalmologic changes, malnourishment, poor dental care/bruxism, and nasal perforation
How do you preform a Mallampati exam?
Ask patient to open mouth as wide as possible and maximally extrude their tongue. DO NOT phonate because this may elevate the soft palate
What does a Class IV Mallampati classification indicate?
Soft palate not visualized, tracheal intubation will be difficult
How far should patient be able to open mouth?
4 cm (2 finger widths). Less than 4 indicates difficult intubation
How would you assess a patient for mandibular mobility?
Have patient protrude the mandible in front of the central incisors. If they can do this, this indicates relative ease with maneuvering the laryngoscope.
Most common reason for anesthesia related legal claims?
Dental injuries
What should you do if you are worried about a patients risk for dental injury?
Talk to them about the risks, if they wish to proceed have them sign informed consent.
What is the ideal body weight for a 5 foot 5 inch man? woman?
Starting at 5 feet
Man = 105 + 6 lbs per per inch –> 135 lbs
Woman = 100 + 5 lbs per inch –> 125 lbs
BMI formula
Weight in kg/(height in meters)^2
What does a BMI of 32.4 indicate?
Moderate obesity
What patients are at risk for adrenal insufficiency?
Those who are/have taken 20 mg of hydrocortisone for longer than 2 weeks DURING the previous year