Chapter 16 personal flash cards part 2

Question 1

Why is it important to ask the patient about a history of cardiac disease?

Answer 1

Cardiac problems can increase surgical risks. They impair the patient’s ability to withstand hemodynamic changes and alter the response to anesthesia.

Question 2

What type of drugs would be used for a patient who is about to have MI surgery and has a history of cardiac disease?

Answer 2

Beta-blocking drugs

Question 3

What complications can occur with smoking?

Answer 3

Increased chest rigidity and loss of lung elasticity. This reduces anesthetic excretion. Action of cilia decreases and leads to retained secretions and predisposes patient to infection. It also collapses alveoli.

Question 4

What is atelectasis?

Answer 4

The collapsing of alveoli. Can be caused by smoking.

Question 5

When can patients give an autologous donation?

Answer 5

Up to 5 weeks before surgery, infection free, hemoglobin greater than 11. THE LAST DONATION CANNOT BE MADE WITHIN 72 HOURS OF SURGERY.

Question 6

A blood donation from a family member or friend is called:

Answer 6

Directed blood donation.

Question 7

Patients with religious or medical restrictions to blood transfusions might benefit from:

Answer 7

“bloodless surgery” or minimally invasive surgery.

Question 8

What things might you give to a patient to stimulate his own production of blood?

Answer 8

epoetin alpha (procrit, epogen), supplemental iron, folic acid, B12 and vitamin C

Question 9

Key Point

Answer 9

All PATIENTS ARE REQUIRED TO HAVE DISCHARGE PLANNING, NO MATTER WHAT.

Question 10

The number of serious problems during surgery is called:

Answer 10

Morbidity

Question 11

The number of deaths during surgeries is called:

Answer 11

Mortality

Question 12

Why is it important to assess kidney function?

Answer 12

Kidney function affects the excretion of drugs and waste products, including anesthetic and analgesic agents. Any problems urinating can indicate reduced kidney function.

Question 13

What can indicate a poor fluid status?

Answer 13

• Brittle Nails
• Dry, flaky skin, decreased skin turgor, hair changes
• Orthostatic Hypotension
• Decreased serum protein levels and abnormal serum electrolytes

Question 14

What drugs can alter lab values?

Answer 14

Warfarin (Coumadin), Aspirin, duretics

Question 15

Key Point

Answer 15

Report any electrolyte imbalance to the anesthesia team and surgeon before surgery.

Question 16

Hypokalemia can cause what problem for a patient going into surgery?

Answer 16

It increases the risk for toxicity if the patient is taking digoxin, slows recovery from anesthesia and increases cardiac irritability

Question 17

What problems can Hyperkalemia cause for a patient going into surgery?

Answer 17

It increases the risk for dysrhythmias especially with the use of anesthesia.

Question 18

Key Point

Answer 18

ANY POTASSIUM IMBALANCE SHOULD BE CORRECTED BEFORE THE SURGERY.

Question 19

What are the normal lab values for Potassium?

Answer 19

3.5 - 5.0

Question 20

Key Point

Answer 20

If you believe that the patient has not been adequately informed, contact the surgeon and request that he or she see the patient for further clarification. Document this action.

Question 21

Key Point

Answer 21

At a minimum, the patient’s identity, correct side and site, correct position and agreement on the proposed procedure must be verified by all members of the team.

Question 22

Key Point

Answer 22

Emphasize the importance of adherence to the prescribed NPO restriction. Failure to adhere can result in cancellation of surgery or increase the risk for aspiration during or after the surgery.

Question 23

What factors that can predispose a wound to contamination or surgical site infection?

Answer 23

• Bacteria found in hair follicles
• Disruption of the normal protective mechanisms of skin
• nicks in the skin

Question 24

How do you remove hair from a patient?

Answer 24

Electrical clippers or depilatory creams.

Question 25

What kind of catheter is usually used for an IV in the arm?

Answer 25

Large Bore, Short Catheter (i.e. 18 gauge, 1 inch catheter)

Question 26

Who is at the greatest risk for dehydration?

Answer 26

Older adults.

Question 27

A patient feels a dull ache in the calf that gets worse with ambulation. What do they have?

Answer 27

Venous Thromboembolism (VTE) which can lead to a pulmonary embolism.

Question 28

These drugs are sedatives:

Answer 28

Hydroxyzine (Atarax, Vistaril)

Question 29

What is an example of a hypnotic drug?

Answer 29

Lorazepam (Ativan)

Question 30

What is an example of an anxiolytic?

Answer 30

Midazolam (versed)

Question 31

What is an example of opioid analgesics?

Answer 31

Morphine, hydromorphone

Question 32

What is an example of an anticholinergic agent?

Answer 32

Atropine