Anesthesia Consultation II Flashcards
What questions are asked during the HEENT portion of the anesthesia consult?
Any loose teeth?
Broken teeth?
Caps?
Dentures (upper/lower)?
Partials?
If dentures or removable partials
Loose or broken-document tooth #
Contact lenses?
Glasses?
Hearing aids?
Note: Ask the patient to remove anything removeable.
What questions do you ask during the respiratory portion of the consult?
Ever Smoke?
Packs per day?
How many years?
Quit?
COPD?
Bronchitis?
Pneumonia?
TB?
Asthma?
URI? (upper respiratory infection)
What questions do you ask during the cardiovascular portion of the consult?
Chest pain?
Palpitations?
Heart Valve disease?
Murmur?
HTN?
Myocardial infarction?
Shortness of breath?
Exercise tolerance?
What are the adverse effects of smoking relating to cardiovascular and pulmonary systems? (4)
decreases cardiac output
decreases oxygen delivery
increases amount of mucus secreted
small airways narrow and are more prone to collapse
What MET does this describe:
Can you eat, dress, or use the toilet?
1 MET
What MET does this describe:
Can you walk indoors around the house?
2 MET
What MET does this describe:
Walk one or two blocks on level ground at 2 to 3 mph?
3 MET
What MET does this describe:
Do light work around the house, such as dusting or washing dishes?
4 METs
What MET does this describe:
Participate in strenuous sports, such as swimming, singles, tennis, football, basketball, or skiing?
10 METS
What questions do you ask during the GI/GU portion of the consult?
Hiatal hernia?
Reflux?
Ulcers?
Liver Disease?
Bleeding problems? Sickle cell?
Kidney disease?
Menstruating? LMP?
What questions do you ask during the endocrine portion of the consult?
Diabetes:
Type I ?
Type II ?
Insulin dependent ?
Deficits: Nephropathy, Neuropathy?
Retinopathy?
Thyroid Disease:
Hypothyroidism
Hyperthyroidism
Treatments/surgeries
What is the more severe form of arthritis–rheumatoid or osteoarthritis?
rheumatoid arthritis
What form of arthritis is caused by wear and tear on the body–rheumatoid or osteoarthritis?
osteoarthritis
What form of arthritis can affect people of any age, but most commonly affects those between 20-30 y/o–rheumatoid or osteoarthritis?
rheumatoid arthritis
What form of arthritis:
Symptoms can be felt throughout the entire body
Affects more women than men
rheumatoid arthritis
What form of arthritis:
Usually only affects the joints
Commonly found in both men and women
osteoarthritis
What questions do you ask during the neuro portion of the consult?
Seizures?
Stroke?
TIA?
Neuromuscular disease?
Do we ask about psychiatric issues within the anesthesia consult?
Yes
Conditions?
Severity?
Hospitalizations?
Suicide attempts?
Treatments?
What are the specific signs of MH? (5)
Muscle rigidity
Rapidly increasing expired carbon dioxide
Rapidly developing fever (late sign)
Cola-colored urine (myoglobinemia–late sign)
Increased serum creatine phosphate (late sign)
People who have psudocholinesterase deficiency may be sensitive to certain anesthetic drugs, including succinylcholine and what 2 other drugs in particular?
Mivacurium
Ester local anesthetics
What do we document when assessing allergies? (3)
Allergen
Medications the patient is allergic to
Allergic reaction
What do we document pertaining to surgical history? (3)
Type of surgery and year performed
Type of anesthesia
Complications
What does “RRR no m,r,g” mean?
Regular rate and rhythm no murmurs, rubs, or gallops
Within the “Problem List” portion of the anesthesia exam, do you include surgeries?
No, they have their own section.
Do anesthetists assign an ASA status?
No
What does “Plan” mean within the anesthesia consult?
General LMA or ETT, or regional, MAC
