Health History

Question 0

Where do you collect data from during the pre-op assessment?

Answer 0

patient's medical record
patient interview
diagnostic tests (labs, xrays, etc.)
specialist consultation/report
physical exam

Question 1

Who mandates that a pre-op assessment be completed?

Answer 1

JCAHO, ASA, AANA

Question 2

What is the benefit of having the preop assessment completed a week prior at a clinic?

Answer 2

reduced patient anxiety
consents signed then
allows time to schedule consults and get results of diagnostic tests
promotes patient teaching
allows time to develop anesthetic plan

Question 3

Who requires an early pre-op assessment?

Answer 3

uncontrolled CV disease patients
Home O2
COPD or reactive airway disease
IDDM
adrenal disease
thyroid disease
liver disease
ESRD
massive obesity
symptomatic GERD
spinal cord injury/problems

Question 4

What are the 6 purpose of the pre-op interview?

Answer 4

obtain medical history
obtain informed consent
formulate anesthetic plan of care
patient education
improved efficiency
motivate patients towards better health

Question 5

What are some factors to consider when interviewing the patient?

Answer 5

organized and systematic
use lay-person terminology
use open ended questions
progress from general to specific questions
make it individualized
make attempts to control the environment (quiet, family presence, etc.)

Question 6

What are the goals of pre-operative lab tests?

Answer 6

improve intra-op quality
decrease intra-op costs
return patient to desirable functioning
reduce anesthetic morbidity

Question 7

What is sensitivity?

Answer 7

It will be positive in a patient who does actually have the disease

Question 8

What is specificity?

Answer 8

it will be negative in a patient without the disease

Question 9

For what type of procedures might you consider doing pre-op blood tests?

Answer 9

moderately or highly invasive surgeries

Question 10

What is an ASA Class 1?

Answer 10

healthy patient with no systemic disease

excludes neonates and very old patients

Question 11

What is an ASA Class 2?

Answer 11

mild to moderate systemic disease, well controlled, no functional limitation

Question 12

What is an ASA Class 3?

Answer 12

mild to moderate systemic disease with functional limitation

Question 13

What is an ASA Class 4?

Answer 13

Severe systemic disease that is a constant threat to life

Question 14

What is an ASA Class 5?

Answer 14

moribund patient, not expected to survive with or without the procedure

Question 15

What is an ASA Class 6?

Answer 15

patient who has been declared brain dead whose organs are being harvested for transplant

Question 16

What are the current ASA guidelines for NPO status?

Answer 16

2 hours for clear liquids on all patients
4 hours for breast milk
6 hours formula or solids; light meal
8 hours heavy meal of fried or fatty food, candy, etc.

Question 17

What are some examples of patients who are considered an aspiration risk?

Answer 17

neonates 70
ascites (ESLD)
GERD, hiatal hernia
pyloric stenosis or other mechanical obstruction
prematurity
pregnancy
neurologic disease
metabolic disorders (DM, obesity, ESRD, hypothyroid)

Question 18

What is the “reasonable practitioner standard”?

Answer 18

what a normal practitioner would consider important for consent

Question 19

What is the “reasonable patient standard”?

Answer 19

what a prudent patient would need to know to make an intelligent decision