Lecture 2: Preoperative Assessment of the Patient with Cancer AL Flashcards
TEST BANK ?s
TEST BANK ?s
Treatments:
surgery
chemotherapy
radiation therapy
Toxicities and adverse effects that have the potential to affect nearly every ?
Treatments:
surgery
chemotherapy
radiation therapy
Toxicities and adverse effects that have the potential to affect nearly every organ system.
Adverse effects: Bleomycin***
Pulm. HTN, pulm. fibrosis
Adverse effects: Cisplatin***
Dysrhythmias mg wasting mucositis ototoxicity p. neuropathy SIADH renal tubular necrosis thromboembolism
Adverse effects: Cyclophosphamide (Cytoxan)***
Encephalopathy/delirium hemorrhagic cystitis myelosuppression pericarditis pericardial effusion SIADH pulm. fibrosis
Adverse effects: Doxorubicin (Adriamycin)***
Cardiomyopathy
myelosuppression
Adverse effects: Fluorouracil***
Acute cerebellar ataxia ischemic and nonischemic EKG changes Chest pain gastritis myelosuppression
Adverse effects: Methotrexate***
Encephalopathy hepatic dysfunction mucositis platelet dysfunction hypersensitivity pneumonitis renal failure myelosuppression
Adverse effects: Tamoxifen***
Thromboembolism
Adverse effects: Vincristine***
autonomic dysfunction myocardial ischemia p. neuropathy bronchospasm SIADH
Adverse effects: Radiation therapy
**Review Table 28.3, Slide 10!
Sinusoidal obstruction syndrome -> severe liver failure
Review Table 28.3, Slide 10!
Preoperative Assessment: History and comorbidities
malignancy in the head or neck ->?
mediastinal masses obstructing great vessels
• dyspnea, dysphagia, stridor, wheezing, coughing→?
• compression of SVC→?
Preop testing: a lot of tests
Anesthestic concerns:
Preoperative Assessment: History and comorbidities
malignancy in the head or neck
• airway exam and possible need for tracheostomy
• Recurrent laryngeal n. damage
mediastinal masses obstructing great vessels
• dyspnea, dysphagia, stridor, wheezing, coughing→ recumbent pos.
• compression of SVC→JVD, facial, chest, neck, upper ext edema
Airway Assessment:
- tracheal deviation or compression
- SOB
- difficulty breathing (sign of airway obstruction)
- dysphagia
- Preop airway assessment, cervical ROM, cervical X-ray, ENT consult
***SVC Comp Syndrome + Tracheal Comp = ?
***SVC Comp Syndrome + Tracheal Comp = Superior Mediastinal Syndrome
Airway: radiation to head and neck→ ?
radiation to head and neck→ permanent tissue fibrosis • carotid artery ds • hypothyroidism • difficult ventilation • difficult intubation *May not be recognized on physical exam
Slide 16: just read through
Slide 16: just read through
Preoperative Assessment: Functional status
chemo and radiation take a toll on patient
• Assess __________ status→ ________ tolerance
Preoperative Assessment: Functional status
chemo and radiation take a toll on patient
• Assess functional status→ exercise tolerance
Preoperative Assessment: Geriatrics
Greater comorbidities, frailty, polypharmacy
• risk of ?
• “Chemobrain” = ?
Preoperative Assessment: Geriatrics
Greater comorbidities, frailty, polypharmacy
• risk of delirium
• “Chemobrain”—chemo-induced cognitive dysfunction
- doc preop!