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Outpt Surgery Week 3 Flashcards

1
Q

How much less is the cost for outpt surgery than inpatient?

A

five times less

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2
Q

Ex premature infants younger than how many weeks old is a contraindication to outpt surgery?

A

60 weeks post conceptual age

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3
Q

How many vials of dantrolene should be available?

A

> 36

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4
Q

Single greatest cause of unanticipated hospital admission?

A

surgical complications

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5
Q

mL amt of liposuction that can qualify a pt to go home?

A
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6
Q

Amt of liposuction where pt should consider staying over night?

A

3,000-5,000

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7
Q

Amt of liposuction that requires pt to stay overnight?

A

> 5,000

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8
Q

Solution used in liposuction that is infiltrating saline or LR mixture with dilute amounts of epi and lidocaine solution prior to suctioning?

A

tumescent

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9
Q

Safe levels of lidocaine?

A

35 mg/kg- 55mg/kg

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10
Q

3 functions of tumescent?

A

analgesia, hydro dissection, improve hemostasis

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11
Q

What volume liposuction can be done under local anesthesia?

A

small volume

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12
Q

Highest dose of lidocaine may not be safe in pts with what issue?

A

low protein or other conditions where metabolic byproducts of lido break down and reach toxic levels

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13
Q

Why are pts undergoing liposuction at a more increased risk of hypothermia?

A

less surface area to put Bair Hugger on

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14
Q

What is the intraoperative fluid ratio for liposuction?

A

(IV fluid + infiltrate)/aspirate 2:1 for the small volume group

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15
Q

Is anesthesia involved with only local is done by the surgeon for liposuction?

A

no

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16
Q

A peripheral nerve block would be done w what type of anesthesia?

A

general or MAC

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17
Q

What type of anesthesia is Exparel?

A

local wound infiltration

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18
Q

What type of anesthesia is not done in outpatient bc of lack of predictability?

A

regional= spinal or epidural

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19
Q

To be eligible for outpatient surgery, disease status should be well controlled for how long?

A

3 months

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20
Q

4 types of pts who should be scheduled earlier on in the day?

A

pediatrics, elderly, diabetics, longer surgeries

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21
Q

Is there a relationship between OSA and unplanned hospital admission?

A

no

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22
Q

Pts with OSA have a greater risk for what 3 things?

A

difficult intubation, needing more pressors, and needing more O2 in PACU

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23
Q

Is a pt at high risk for ambulatory surgery if MI was

A

yes

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24
Q

A pt is at high risk for ambulatory surgery if a BMS was placed

A

ASA must be d/c preop

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25
3 absolute contraindications to outpt surgery?
no caregiver for 24 hours, delayed recovery anticipated, severe uncorrectable CV disease
26
Infant >__ months has less risk of respiratory complications and apnea?
6
27
How long does a URI delay surgery for adults?
6 weeks
28
Pt with RTI may be more likely to...?
hold breath, bronchospasm, cough, laryngospasm, be hypoxic, have atelectasis, pneumonia, stridor, or croup
29
H&P should be done w/in how many days from surgery?
30
30
When should a pregnancy test be done on a pt?
DOS if >13 years old until year after last menses or hysterectomy
31
When should an EKG be done on outpt pts?
METs50 years old or history of cardiac issues
32
Potassium should be obtained when and for whom?
7 days before surgery, those on diuretics or dig
33
How soon before surgery should Coumadin be d/c?
5 days
34
What is the 8, 6, 4, 2 rule?
8 hours before surgery if heavy meal, 6 hours for light meal, 4 hours for breast milk, and 2 hours for clear liquids
35
What is pt supposed to do w insulin pump?
just keep the basal rate
36
What is pt supposed to do about long acting insulin dose?
1/2 the dose the night before and hold AM dose
37
How undiagnosed is OSA?
80%
38
A pt in a surgery lasting > how many hours should receive a catheter?
3
39
In what type of surgery should you decrease fluid?
cataract
40
In those patients undergoing surgery of limited scope and who are low risk, which fluid therapy is better tolerated-liberal or restricted?
liberal
41
Are COX2 inhibitors effective in ambulatory surgery?
no
42
What ages have less PONV?
infants and elderly
43
Risk factors for PONV?
woman, nonsmoker, motion sickness, age, anxiety, opioids/pain, neostigmine >2.5 mg, hydration status, length of surgery, type of surgery
44
Weight based dose of Decadron?
0.1mg/kg
45
Dexamethasone decreases what 3 things?
N, pain, opioid consumption
46
What type of anesthesia is rarely used in outpt surgery bc of delay discharge?
spinal
47
What type of anesthesia is not an airway irritant?
Propofol/TIVA
48
3 benefits of propofol TIVA?
decreased PONV, not airway irritant, rapid recovery-clear head
49
Which IA transiently increases hr and and bp?
sevo
50
Which IA is associated with emergence delirum?
sevo
51
3 meds to reduce agitation from sevo?
prop, fent, and midazolam
52
This IA improves quality and safety of induction of anesthesia, facilitates faster recovery, and reduces overall costs?
N20
53
Which NMB does Suggamedex reverse?
Roc and Vec
54
4 benefits to using LMA?
decreased sore throat, hoarseness, coughing, and laryngospasm
55
3 reasons why ProSeal is used for outpt surgery?
modified to provide increased seal pressure, reduces gastric inflation, provides gastric drainage
56
High seal pressure can get up to what amt with the ProSeal?
up to 30 cm
57
Regular LMAs can withhold pressure or what amt?
15 cm
58
Stage of PACU that includes awakening, management of pain and nausea, and monitoring of HD stability?
Phase I
59
Stage of PACU that includes stable vital signs, minimal pain, minimal nausea, and ability to sit with minimal dizziness?
Phase II
60
Phase of PACU that includes being at home?
Phase III
61
What score determines if pt can be moved from Phase I to Phase II?
Aldrette
62
Complete recovery of pyschomotor skills requires how much time after surgery?
24-48 hours
63
All outpt centers should have what 3 things?
at least 36 vials of Dantrolene, surgeon have admitting privileges at hospital, and IV lipid emulsion 20%
64
Aldrete score consists of what 5 parameters?
activity, respiration, circulation, consciousness, oxygenation
65
Maximum score for Aldrete score?
10
66
Aldrete score of what makes the pt ok for d/c from Phase I/
9

6901 (18 decks)

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