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Med Surg > Chapter 17 - Preoperative Care > Flashcards

Chapter 17 - Preoperative Care Flashcards

1
Q

PERIoperative Surgery

A

total surgical episode

-includes PREoperative, INTRAoperative, POSToperative periods

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2
Q

PREoperative

A

time before surgery

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3
Q

INTRAoperative

A

time during actual surgical procedure

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4
Q

POSToperative

A

period after surgery is over

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5
Q

reasons for surgery

A
  • diagnosis
  • cure
  • palliation (alleviate sympt w/o cure)
  • prevention
  • cosmetic imprvmt
  • exploration (determine nature/extent of disease) (less common)
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6
Q

-ectomy

A

excision or removal of

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7
Q

-lysis

A

destruction of

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8
Q

-orrhaphy

A

repair or suture of

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9
Q

-oscopy

A

looking into

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10
Q

-ostomy

A

creation of opening into

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11
Q

-otomy

A

cutting into or incision of

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12
Q

-plasty

A

repair or reconstruction of

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13
Q

elective surgery

A

carefully planned event

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14
Q

emergency surgery

A

arise w unexpected urgency

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15
Q

ambulatory surgery is aka

A

same-day or outpatient surgery

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16
Q

ambulatory surgery

A

minimally invasive techniques

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17
Q

6 Reasons for surgery

A 
1 dx
2 cure
3 palliation
4 prevention
5 cosmetic
6 exploration
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18
Q

Fear in patients

A
  • decrease some anxiety by giving patients info about what to expect
  • reassure that drugs are avail for pain
  • -teach patients to ask for med BEFORE pain becomes severe
  • listen to patient’s concern w accepting attitude
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19
Q

antidepressants + opioids

A

antideps can POTENTIATE effect of opiods

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20
Q

Hx antihypertensive drugs predispose patients to ____

A

shock

-fr combined effect of drug (lowering BP) +vasodilating effects of anesthetics

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21
Q

insulin/oral hypoglycemic drugs needs to be adjusted bc ___

A
  • incr body metab
  • decr oral intake
  • stress
  • anesthesia
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22
Q

NSAIDs stands for

A

non steroidal anti inflammatory drugs

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23
Q

NSAID + anti platelet drugs can ___

A

inhibit platelet aggregation > incr postop bleeding

24
Q

options for patients w long-term anti-coag therapy

A

1 cont therapy
2 withhold therapy for a time before + after surgery
3 withhold therapy + start subQ or IV heparin during periop

25
Q

herbal products that can incr BP before + during surgery

A

astralagus + ginseng

26
Q

herbal products that can incr bleeding

A

cinnamon, vit E, fish oils, 4G (ginger, garlic, ginseng, gingko)

27
Q

herbal products that can cause excessive sedation

A

kava + valerian

28
Q

allergy/anaphylactic rxn effects

A
  • hives
  • hypotension
  • tachycardia
  • bronchospasms
29
Q

diuretic therapy will require…

A

serum K levels drawn before surgery

30
Q

hypertensive patients may require ___

A

vasoactive drugs to maintain adequate BP

31
Q

patient w prosthetic heart may require ____

A

antibiotic prophylaxis

-decr the risk for endocarditis

32
Q

upper airway infection may increase risk for

A
  • bronchospasm
  • laryngospasm
  • decreased O2 sat
  • problems w resp secretion
33
Q

Hx of COPD is at high risk for

A

pulm complications like HYPOXEMIA + ATELACTASIS

34
Q

Smoking

A
  • stop w/in 6 weeks before

- incr risk for for pulm complication during + after surgery

35
Q

Renal dysfunction

A
  • fluid + electrolyte imbalance
  • coagulopathies
  • incr risk for infections
  • impaired wound healing
  • altered response to drugs
  • unpredictable drug elimination
36
Q

testing for renal functions

A

BUN
serum creatinine
urinalysis?

37
Q

what are normal liver functions?

A
  • glucose homeostasis
  • fat metab
  • protein synth
  • drug + hormone metab
  • bilirubin formation + excretion
38
Q

hepatic dysfunction

A

incr risk for clotting abnormalities

adverse response to drugs

39
Q

common diabetes complications

A

hypo/hyperglycemia
delayed wound healing
infection

40
Q

Addisonian crisis/shock

A

occurs if patient ABRUPTLY stops taking corticosteroid

41
Q

Corticosteroid

A

used in immunosuppressive doses may be TAPERED before surgery

42
Q

high albumin

A

protein makes drugs less active

-interferes w distribution

43
Q

obesity

A
  • stresses heart + resp
  • makes access site more difficult
  • predisposed to wound dehiscence
  • high risk for wound infection
  • high risk incisional herniation
  • slower to recover fr anesthesia bs fat absorbs + stores inhalation agents
44
Q

important substances for wound healing

A

protein, vit A B C

45
Q

American Society of Anesthesiologists [ASA] Physical Classification System

A

physical status rating for anesthesia admin

46
Q

P1 (ASA I)

A

normal healthy person

47
Q

P5 (ASA V)

A

moribund patient - NOT expected to survive without surgery

48
Q

P6 (ASA VI)

A

declared brain dead

-organs being removed for donor purposes

49
Q

importance of teaching

A
  • incr patient satisfaction
  • reduce anxiety
  • decr dvlpt of complications
  • decr length of hospitalization
  • decr recovery time
50
Q

3 types of info in teachings

A

1 sensory (hear, smell, feel)
2 process info (general flow of info)
3 procedural info (detailed info)

51
Q

all patients should receive instructions about _____

A
  • deep breathing
  • coughing
  • ambulation
52
Q

why do we restrict fluid + food intake

A

reduce risk for aspiration, nausea, + vomiting

53
Q

why do we encourage patients to void before preop drugs?

A

empty bladder prevents involuntary elimination during op

-reduce risk for urinary retention during early post op

54
Q

preop med + purpose

A 
1 benzo> sedative + amnesic
2 anticholinergic> reduce secretion
3 opioid> analgesic/pain
4 antiemetics> decr n/v
5 B-adrenergic blockers> control BP, prevent MI/cardiac arrest
55
Q

patients w known hypertension or coronary artery disease (CAD) may receive ___

A

B-adrenergic blockers

  • controls BP
  • reduce chance of MI or cardiac arrest

Med Surg (18 decks)

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