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Summer 2020 - APA Foundations 2 - Other > Outpatient - Quiz 5 > Flashcards

Outpatient - Quiz 5 Flashcards

1
Q

What are some disadvantages to Outpatient Surgeries?

A

Privacy

Multiple trips for Screenings

Need of Home Care

Pt. Compliance

Less time for Orientation

Less Post-Op Observation

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2
Q

What is the only age restriction for outpatient surgery?

A

Pre-Term Babies d/t Anemia, Apnea, Immature Gag & Temp Control

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3
Q

What are some considerations that should be taken for surgery in a pt w/ substance abuse?

A

Pt. eval & pain management talk the day before surgery

&

Regional Technique

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4
Q

What should be done if a patient comes in intoxicated or on drugs the day of surgery?

A

Cancel surgery

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5
Q

What should be done for a Pre-Term baby needing surgery w/ a Hematocrit less than 30%?

A

Further Eval d/t Increased Apnea Episodes

&

Give Iron Therapy

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6
Q

What is the normal drop in Hgb in the first three months for a Premature Baby?

A

Hgb 7-8 g/dL

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7
Q

When might a Preterm Baby be considered for Outpatient Surgery?

A

50-60 weeks Postconceptual Age w/ special considerations regarding other problems

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8
Q

What increases the risk of SIDS?

A

Kids w/ hx of Apnea/Bradycardic Events

Siblings w/ SIDS

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9
Q

When is it ok for kids w/ SIDS risk be considered for surgery?

A

6 months - 1 yr w/o Apnea/Bradycardic Events

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10
Q

At what age are Geriatric patients at a greater risk for Hospital Admission & Death a week after surgery?

A

85 years or older

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11
Q

How should pts w/ Convulsive Disorders be scheduled and managed for Outpatient Surgery?

A

First or Early Case for optimal observation w/ 4-8 hrs Post-Op

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12
Q

What should be evaluated for pts w/ Cystic Fibrosis needing Outpatient Surgery?

A

Pulmonary Function

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13
Q

Pts w/ Morbid Obesity are acceptable candidates for Outpatient Surgery if they are which ASA Class?

A

ASA I & II - all others should be inpatient

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14
Q

What makes a pt w/ Sickle Cell Disease a candidate for Same Day Surgery?

A

No Major Organ Disease

No crisis in the last year

Compliant

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15
Q

What conditions make pts unacceptable for Same Day Surgery?

A

ASA III or IV

Active Drug/ETOH Abuse

Psych Problems

Uncontrolled Disease

New/Untreated OSA

Isolation

Need for IV Post-Op Pain Control

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16
Q

For Same Day Surgery, how recent should the documented H&P be?

A

Within 30 days or 72 hrs for High Risk Patients

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17
Q

For SDS, Lab values are good within 60 days of surgery, but the potassium level should aat least be within ____ days

A

For SDS, Lab values are good within 60 days of surgery, but the potassium level should aat least be within 7 days

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18
Q

How should a pt on Coumadin be managed for SDS?

A

If Held - 4-5 day minimum

Draw PT Morning of Surgery

Restart 1-7 Days Post-Op

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19
Q

What should be done if a child comes in for SDS w/ symptoms of an Upper Respiratory Tract Infection?

A

Reschedule surgery 4 weeks later

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20
Q

When is surgery appropriate for a child w/ an Upper Respiratory Tract Infection?

A

If kid is older than 1, Asymptomatic with no other problems, and the surgery is not in the Thorax or Abdomen

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21
Q

What are the top 2 Post-Op complications that would result in Inpatient Admission?

A

N/V & Excessive Pain

22
Q

What is Phase I Post-OP?

A

Stable VS

No Resp. Problems

Can Protect Airway

Alert & Oriented

23
Q

What is Phase II Post-Op?

A

Ambulation

Caregiver Present

Min. Bleed

Pain Controlled

Min. N/V

Voiding

Oral Intake

24
Q

When does a MAC become a General?

A

Prolonged Airway Manipulation

25
Q

Which type of Anesthesia carries a higher incidence of Brain Damage or Death?

A

MAC

26
Q

What is considered Deep Sedation?

A

Unable to be easily aroused

Responds to Painful Stimuli

May need help maintaining patent airway

CV Function unaltered

27
Q

What is consdered Minimal Sedation?

A

Cognitively impaired, but can respond verbally

Resp. & CV Unaltered

28
Q

What is Moderate Sedation?

A

Can be directed to an RN by MD performing procedure, but depth should not cause loss of protective reflexes

29
Q

What can be the cause of Delayed Awakening in the PACU?

A

Prolonged Anesthetics

Metabolic Causes

Neuro Injury

30
Q

What are causes of Hypotension in the PACU?

A

Hypovolemia - most common

Hypothermia - vasoconstriction

Sepsis, Acidosis, Hypoxemia

LV Dysfunction

31
Q

What can cause PACs and PVCs in the PACU?

A

Hypomagnesemia

Hypokalemia

↑Sympathetic Tone

Myocardial Ischemia

32
Q

What is used to treat Post-Op Laryngospasms?

A

Positive Pressure

&

Succinylcholine 0.1mg/kg

33
Q

What is the Positioning for a D&C?

A

Dorsal Lithotomy w/ < 40 degree Abduction

34
Q

What meds can be given to limit blood loss during a D&C?

A

Methylergonogvine (Merthergine) 0.2mg IM

&

Oxytocin 10-20u IV

35
Q

What are some causes of Severe Post-Op Bleeding from a D&C?

A

Cervical Injury

Uterine Atony

Uterine Perf

Retained Conception Products

36
Q

How is a Hysteroscopy done?

A

Tenaculum secures Cervix for Hysterscope

Distend w/ NS, Sorbitol, Mannitol, or CO2

37
Q

What are some considerations when using CO2 for Distension?

A

Use < 1200 mL/min flow

Keep Intrauterine Pressures < 200 mmHg

Expect Shoulder Pain

38
Q

What’s an adequate level of block for a Hysteroscopy?

A

T10 Sensory

39
Q

What kind of airway should be used for Dental Surgeries?

A

Nasotracheal Tube

40
Q

What happens if the Lingual Nerve is damaged during a tooth extraction?

A

Tongue Numbness

41
Q

What happens if the Inferior Alveolar Nerve is damaged during a Surgical Tooth Extraction?

A

Lip Numbness

42
Q

What is one of the major concerns w/ Shoulder Arthroscopy?

A

Major Pain

Should use Interscalene Block w/ GA, which can cause Horner’s Syndrome

43
Q

What are the concerns when positioning a pt in a Sitting Beach Chair position for Should Arthroscopy?

A

Air Embolism

&

Severe Postural Hypotension

44
Q

What should be avoided w/ Tonsilectomies & Adenoidectomies?

A

Avoid Nasal Airways to decrease bleeding risk

45
Q

When should Tonsielectomies & Adenoidectomies be postponed or rescheduled?

A

If pt comes has symptoms of Upper Respiratory Infection - fever, nasal secretions, purulent sputum

46
Q

What are problems associated with using a GAG?

A

ETT Kinks, Obstructions, BBS, or Dislodgement

47
Q

What should the Post-Op positioning be after a Tonsillectomy or Adenoidectomy?

A

Lateral w/ Head Down - Tonsilar Position

48
Q

What is the positioning for a T&A?

A

Supine w/ Shoulder Roll & Arms Tucked

Possibly Reverse TBerg

49
Q

What are Post-Op complications of T&As?

A

Laryngospams

Bleeding

Retained Throat Pack

Postobstructive Pulm. Edema

50
Q

What is the most common complications of Knee Arthroscopies?

A

Hemarthrosis

Summer 2020 - APA Foundations 2 - Other (10 decks)

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