Anesthesia Plan Flashcards

1
Q

What are the 5 Basic components to developing a good anesthesia plan?

A
  • History and Physical
  • Review co-existing diseases
  • Review ASA Classification
  • ASA monitoring standards
  • Developing and Anesthetic plan
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2
Q

What are the 3 major things that we examine ourselves as anthesia providers. Meaning, we don’t just read the chart and take someone else’s word for it?

A
  • Airway evaluation
  • Respiratory system- recent cough, auscultate, etc
  • Cardiovascular- listen to heart, feel pulses, etc.
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3
Q

What are the 4 major things we are looking for when we do a pre-op assessment?

A
  • Previous anesthetic complications
  • Medication History
  • Difficult Airway
  • Patient of family history of malignant hyperthermia
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4
Q

When reviewing a patient’s medication history it is important to ask about which 4 groups of medications that could complicate our anesthesia plan?

A
  • MAOi’s
  • Anticoagulants
  • Supplements/ Herbals
  • Substance abuse
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5
Q

What are the 11 components of the pre-op evaluation?

A
  1. Pt. history
  2. Daily medications
  3. Physical exam
  4. Lab testing/ diagnostics
  5. ASA physical status class
  6. Fasting status and aspiration risk
  7. Formulation of plan
  8. Discussion of plan
  9. Informed Consent
  10. Documentation
  11. Medical consultation if needed
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6
Q

A normal, healthy patient with no systemic disease would be an ASA class _____

A

1

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7
Q

A pt. with mild to moderate systemic disease, well controlled, with no functional limitation would be an ASA class_____

A

2

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8
Q

A patient with severe systemic disease that causes functional limitation would be an ASA class ______

A

3

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9
Q

A patient with severe systemic disease that is a constant threat to life would be an ASA ____

A

4

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10
Q

A moribund pt, not expected to survive with or without the surgical procedure would be an ASA class ____

A

5

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11
Q

A patient declared brain dead whose organs are being harvested for donation would be an ASA class _____

A

6

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12
Q

Any patient with an emergency surgery would have what additional ASA class?

A

E

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13
Q

When instructing patients on NPO status and number of hours they should remain NPO, it is important to balance what two things?

A

the risk factors of fasting vs. the risk factors of being NPO

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14
Q

What are the fasting guidelines for “healthy” patients?

A
  • NO chewing gum or candy after midnight
  • Clear liquids up to 2 hours before OR
  • Breast milk up to 4 hours before OR
  • Light meal, milk or formula up to 6 hours before OR
  • Sip of water or liquid pre-med up to 1 hour before OR
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15
Q

The risk of aspiration increases when pH falls to ______ and stomach contents exceed _______mL.

A

pH- 2.5

volume 25 mL

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16
Q

When giving reglan IVP for your pt. at risk for aspiration, should you push it fast or slow?

A

Do not push reglan fast. It will cause major GI cramping.

17
Q

What are the 5 components of the airway exam?

A
  1. Mallampati classification
  2. Thyromental/ hyoid-mental distance
  3. Cerival ROM
  4. Dentition
  5. Size and shape of mandible
18
Q

Should you stick to your inital anesthesia plan?

A

Not necessarily. You should formulate your specific plan but then be prepared to adjust based on the patient’s physiological response

19
Q

Name 4 ways you can monitor how well your patient is tolerating your anesthesia plan?

A
  1. Reassess VS
  2. Airways status
  3. Response to pre-procedure meds
  4. Make sure all anesthesia equipment, supplies, and medications are checked and immediately available in case the pt. needs a change in anesthetic plan
20
Q

The anesthesia plan should take what 5 things about the patient into consideration?

A
  1. Demographics (age, gender)
  2. Past medical history
  3. Previous surgeries
  4. Past anesthesia complications
  5. Proposed surgical procedure and its impact on anesthesia delivery
21
Q
A