Exam 1 Reading (N.Ch20) Flashcards
CHAPTER 20
Which of the following are characteristics of unstable angina?
Pain that began when?
Severity / duration?
Changes on ECG?
Bubsternal chest pain that began less than 2 months ago, has progressively increased in severity, duration, or frequency, is less responsive to pharmacologic therapy, occurs at rest, lasts longer than half an hour, or exhibits transient T-wave or ST segment changes.
Associated with cigarette smoking
carboxyhemoglobin in the blood, dysfunction of the mucociliary escalator, and an increase in elastase activity in the alveoli that leads to emphysema.
Sarcoidosis is a disorder of the
immune system.
What is the overall risk for a perioperative MI in the general population undergoing general anesthesia?
0.3%.
the best predictor of silent coronary artery disease in diabetic patients,
Autonomic neuropathy
A normal intercisor distance is
at least 4 cm.
MAC and a history of chronic alcohol abuse would result in
an increased inhalational anesthetic requirement
Alcoholic hepatic insufficiency and Albumin
Alcoholic hepatic insufficiency can lead to decreased albumin concentrations.
Which medication should be withheld the morning of surgery for all patients
Oral hypoglycemics
How long should a patient refrain from smoking before the ability of the lungs to respond to pulmonary infection returns to normal?
8 weeks
What improves significantly at about 8 weeks of smoking cessation?
Mucociliary and immune function
Airway management may be made even more difficult prior to that amount of time as there is an
increase in pulmonary secretions during the first month of smoking cessation.
Elective surgery should be cancelled in patients with chronic bronchitis if they exhibit (select two)
Elective surgery should be postponed in these patients if they exhibit severe dyspnea, wheezing, pulmonary congestion, or a PaCO2 greater than 50 mmHg.
Metabolic equivalents (METs) help identify the
quantity of cardiovascular exercise a patient can tolerate.
4 METs indicate what?
indicates good functional capacity.
Strenuous exercise, such as swimming or playing basketball, represents about
10 METs.
Self-care and walking around the house represents____ MET.
1
You explain to a patient who smokes cigarettes that in order to minimize the effects of carbon monoxide on oxygen-carrying capacity, he/she should refrain from smoking for at least
12-18 hours
The elimination half-life of carbon monoxide is about 4 to 6 hours which means that a smoke free interval of 12 to 18 hours results in marked decreases in carboxyhemoglobin levels and a corresponding increase in oxygen carrying capacity.
Which of the following disorders would be most likely to exhibit evidence of its presence on chest x-ray?
COPD
COPD shows those characteristics on XRAY
hyperlucency
bullae, and diaphragmatic flattening.
A preoperative finding of nystagmus would be consistent with potential abuse of which drug?
Phencyclidine (PCP)
Fentanyl abuse and pupils
Constricted
Cocaine abuse and pupils
Midriasis
During the perioperative evaluation, you discover that a patient with a pacemaker occasionally experiences dizziness while exercising his chest muscles. Based on this finding, which of the following would you avoid during his anesthetic?
Avoid succinylcholine
This indicates that myopotentials may be inhibiting the pacemaker. From this information, you know that muscle fasciculations from succinylcholine should be avoided to prevent inadvertent pacemaker inhibition.
How long after a myocardial infarction is the risk for reinfarction the greatest?
one month ; 30 days; The mortality rate with reinfarction is 50%. Because of these statistics, it is recommended that no patient undergo elective surgery until at least 60 days after the MI.
hich herbal medication lowers blood glucose and has the potential to increase bleeding?
Ginseng lowers blood glucose and has the potential to increase bleeding.
Which of the following findings would warrant postponement of an elective procedure for further diagnostic evaluation?
Symptomatic mitral stenosis
mitral stenosis, new onset ventricular tachycardia, symptomatic ventricular arrhythmias, unstable angina, MI within the past 30 days, severe aortic stenosis, symptomatic bradycardia, and high-grade heart block.
