Lecture 20: Pre-Op Patient Assessment & Prep (Exam 2) Flashcards
Why is pre-op important
Allows for comparison of the animal’s status before & after surgery
What is included in the px history
- Signalment
- Presenting complaint
- Diet
- Exercise
- Environment
- Past medical problems
- Recent tx
- Evidence consistent w/ infection
What three questions should be asked when given the presenting complaint
- When did the current problem start?
- What did the problem look like when it first began
- Has the problem gotten better or worse, and if so how much & what is the associated therapy w/ that?
How should questions be asked to avoid vague responses & obtain specific information
Frame the questions (ask open ended questions)
What is one of the best determinants of the likelihood of cardiopulmonary emergencies during or after surgery
Eval of preanesthetic physical status
What lab data should young healthy animals undergoing elective procedures get before surgery
- PCV (hematocrit)
- Total protein (TP)
- Blood Glucose
- BUN
AKA the “Big 4” or “Quats”
What lab data should animals older than 5 to 7 years or having systemic signs should get before surgery
- CBC & Differential
- Serum Biochemical Profile
- Urinalysis
AKA “Minimum Data Base”
T/F: Age-related differences in hematologic & serum biochemical values have NOT been noted in dogs
False they have been noted
T/F: Growth & maturation of pups influence some of these lab values greatly from those for adults
True
Describe a #1 on the anesthesiologist physical status scale
- Healthy w/ no discernable disease
- Px comes in for an elective procedure
Describe a #2 on the anesthesiologist physical status scale
Px is healthy w/ a localized disease or mild systemic disease
What are some examples of a localized disease or mild systemic disease
- patellar luxation
- Skin tumor
- Cleft palate w/ pneumonia
Describe a #3 on the anesthesiologist physical status scale
Px has a severe systemic disease
What are some examples of a severe systemic disease
- Pneumonia
- Fever
- Dehydration
- Heart murmur
- Anemia
Describe a #4 on the anesthesiologist physical status scale
Px severe systemic disease that is life threatening (like heart or renal failure)
Describe a #5 on the anesthesiologist physical status scale
Px is moribund
Define moribund
Patient is not expected to live more than 24 hours w/ or without surgery
T/F: Risk of the surgical procedure may outweigh its potential benefits
True
What should always be considered for veterinary px
Quality of life
Describe an excellent surgical prognosis
- Potential for complaints is min
- High prob that the px will return to norm
Describe an Good surgical prognosis
- Some potential for complications
- High prob of a good outcome
Describe an fair surgical prognosis
- Serious complications are possible but uncommon
- Recovery my be prolonged
- May not return to its presurgical fxn
Describe an poor surgical prognosis
- Many, severe, or both complications
- Recovery is expected to be prolonged
- Death during or after is high
- Unlikely to return to its presurgical fxn
Describe an guarded surgical prognosis
Given when the outcome is highly variable or unknown