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6901 > Outpt Surgery Week 3 > Flashcards

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
Q

3 absolute contraindications to outpt surgery?

A

no caregiver for 24 hours, delayed recovery anticipated, severe uncorrectable CV disease

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26
Q

Infant >__ months has less risk of respiratory complications and apnea?

A

6

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27
Q

How long does a URI delay surgery for adults?

A

6 weeks

28
Q

Pt with RTI may be more likely to…?

A

hold breath, bronchospasm, cough, laryngospasm, be hypoxic, have atelectasis, pneumonia, stridor, or croup

29
Q

H&P should be done w/in how many days from surgery?

A

30

30
Q

When should a pregnancy test be done on a pt?

A

DOS if >13 years old until year after last menses or hysterectomy

31
Q

When should an EKG be done on outpt pts?

A

METs50 years old or history of cardiac issues

32
Q

Potassium should be obtained when and for whom?

A

7 days before surgery, those on diuretics or dig

33
Q

How soon before surgery should Coumadin be d/c?

A

5 days

34
Q

What is the 8, 6, 4, 2 rule?

A

8 hours before surgery if heavy meal, 6 hours for light meal, 4 hours for breast milk, and 2 hours for clear liquids

35
Q

What is pt supposed to do w insulin pump?

A

just keep the basal rate

36
Q

What is pt supposed to do about long acting insulin dose?

A

1/2 the dose the night before and hold AM dose

37
Q

How undiagnosed is OSA?

A

80%

38
Q

A pt in a surgery lasting > how many hours should receive a catheter?

A

3

39
Q

In what type of surgery should you decrease fluid?

A

cataract

40
Q

In those patients undergoing surgery of limited scope and who are low risk, which fluid therapy is better tolerated-liberal or restricted?

A

liberal

41
Q

Are COX2 inhibitors effective in ambulatory surgery?

A

no

42
Q

What ages have less PONV?

A

infants and elderly

43
Q

Risk factors for PONV?

A

woman, nonsmoker, motion sickness, age, anxiety, opioids/pain, neostigmine >2.5 mg, hydration status, length of surgery, type of surgery

44
Q

Weight based dose of Decadron?

A

0.1mg/kg

45
Q

Dexamethasone decreases what 3 things?

A

N, pain, opioid consumption

46
Q

What type of anesthesia is rarely used in outpt surgery bc of delay discharge?

A

spinal

47
Q

What type of anesthesia is not an airway irritant?

A

Propofol/TIVA

48
Q

3 benefits of propofol TIVA?

A

decreased PONV, not airway irritant, rapid recovery-clear head

49
Q

Which IA transiently increases hr and and bp?

A

sevo

50
Q

Which IA is associated with emergence delirum?

A

sevo

51
Q

3 meds to reduce agitation from sevo?

A

prop, fent, and midazolam

52
Q

This IA improves quality and safety of induction of anesthesia, facilitates faster recovery, and reduces overall costs?

A

N20

53
Q

Which NMB does Suggamedex reverse?

A

Roc and Vec

54
Q

4 benefits to using LMA?

A

decreased sore throat, hoarseness, coughing, and laryngospasm

55
Q

3 reasons why ProSeal is used for outpt surgery?

A

modified to provide increased seal pressure, reduces gastric inflation, provides gastric drainage

56
Q

High seal pressure can get up to what amt with the ProSeal?

A

up to 30 cm

57
Q

Regular LMAs can withhold pressure or what amt?

A

15 cm

58
Q

Stage of PACU that includes awakening, management of pain and nausea, and monitoring of HD stability?

A

Phase I

59
Q

Stage of PACU that includes stable vital signs, minimal pain, minimal nausea, and ability to sit with minimal dizziness?

A

Phase II

60
Q

Phase of PACU that includes being at home?

A

Phase III

61
Q

What score determines if pt can be moved from Phase I to Phase II?

A

Aldrette

62
Q

Complete recovery of pyschomotor skills requires how much time after surgery?

A

24-48 hours

63
Q

All outpt centers should have what 3 things?

A

at least 36 vials of Dantrolene, surgeon have admitting privileges at hospital, and IV lipid emulsion 20%

64
Q

Aldrete score consists of what 5 parameters?

A

activity, respiration, circulation, consciousness, oxygenation

65
Q

Maximum score for Aldrete score?

A

10

66
Q

Aldrete score of what makes the pt ok for d/c from Phase I/

A

9

6901 (18 decks)

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