Perioperative Management

Question 1

What are four attributes to reducing peri-op morbidity

Answer 1

have awareness of the patients physical and medical state
allows the provider to make adjustments to the care plan based on the patients presentation
allows the provider to anticipate and prepare for adverse events
eliminate or minimize surprises

Question 2

What does ASA II mean

Answer 2

mild systemic controlled disease

Question 3

What does ASA III mean

Answer 3

severe disease but not incapacitating

Question 4

What does ASA IV mean

Answer 4

severe disease, that is a constant threat to life

Question 5

What does ASA V mean

Answer 5

moribund, not excessive to lived 24hrs

Question 6

What seven things make up the patient presenation

Answer 6

CC
history of present illness
medical history
review of systems
physical exam
impressions/diagnosis
treatment plan

Question 7

Don’t forget this regarding the med history

Answer 7

herbals and OTC medications

Question 8

When reviewing the systems what is there to look for regarding the head

Answer 8

headaches
nausea/vomiting
swelling/asymmetry

Question 9

When reviewing the systems what is there to look for regarding the eyes

Answer 9

changes to vision
redness
excessive tearing/watering

Question 10

When reviewing the systems what is there to look for regarding the ears

Answer 10

hearing loss
tinnitus
vertigo

Question 11

When reviewing the systems what is there to look for regarding the nose

Answer 11

stuffiness/difficulty moving air
sneezing
epistaxis

Question 12

When reviewing the systems what is there to look for regarding the throat

Answer 12

pain
hoarseness
sore throat

Question 13

When reviewing the systems what is there to look for regarding the neck

Answer 13

impaired mobility

pain

Question 14

When reviewing the systems what is there to look for regarding the heart

Answer 14

angina
syncope
paroxysmal nocturnal dyspnea
palpitations
hypertension

Question 15

When reviewing the systems what is there to look for regarding the pulmonary system

Answer 15

dyspnea
orthopena
wheezing
cough
hemoptysis
sputum
asthma
bronchitis
URI
smoking

Question 16

When reviewing the systems what is there to look for regarding the GI

Answer 16

dysphagia
dyspepsia
pain
nausea/vomitting
diarrhea
hematochezia; bloody stool
steatorrhea; fatty stool
puritis 
fatigue
melena

Question 17

When reviewing the systems what is there to look for regarding the genitourinary system

Answer 17

urgency to void
frequent voiding
pain upon voiding
fluid overload

Question 18

When reviewing the systems what is there to look for regarding the hematopoietic system

Answer 18

petechiae
spontaneous bleeding
bleeding inappropriate to the injury
easy bruisabiliy

Question 19

When reviewing the systems what is there to look for regarding the endocrine system

Answer 19

diabetes; hypoglycemia is worse
thyroid
adrenal
paraythroid
Cushing's
pheochromatoma

Question 20

When reviewing the systems what is there to look for regarding the neurologic system

Answer 20

headaches
diplopia
seizures
weakness
memory loss

Question 21

When reviewing the systems what is there to look for regarding the MS system

Answer 21

pain impaired mobility
joint swelling
aching
cramping/numbness

Question 22

At the time of procedure, a note stating what should be made

Answer 22

that there are no changes to the pre-op evaluation should be made

Question 23

This is a request to a specialist for assisting in the management of a patient

Answer 23

consultation

Question 24

What may a consultation entail

Answer 24

information
recommendations
opinions
request for treatment by the consult

Question 25

True or False | The fact that you don't know something can't be an excuse for a negative outcome

Answer 25

True

Question 26

What are the four purposes of post-op instruction

Answer 26

prepare patient for expected course identify potential complications provide reference and point of contact make no assumptions

Question 27

What kind of pain is expected post-op

Answer 27

mild to moderate pain, which increases with flap and bone removal

Question 28

How do you manage post-op pain

Answer 28

with OTC analgesics and appropriate drugs

Question 29

Can the asthmatic patient take ibuprofen

Answer 29

No, its an NSAID

Question 30

How much swelling is expected post-op simple extraction

Answer 30

little or none

Question 31

How much swelling is expected post-op flaps or bone removal

Answer 31

little to substantial

Question 32

What are the directions for icing swelling post-op

Answer 32

15 mins on 15 mins off for 24 hours

Question 33

How long should you keep your head eleven post-op

Answer 33

24 hours

Question 34

How much bleeding is expected post-op

Answer 34

minimal

Question 35

When should bleeding stop post-op

Answer 35

24-48 hours

Question 36

What can be used if bleeding persists

Answer 36

gauze pressure to surgery site for 20 minutes

Question 37

The key to bleeding management is what

Answer 37

to have it stopped before the patient leaves the office

Question 38

Are post-op antibiotics warranted in a healthy patient

Answer 38

No

Question 39

True or false | In some patient prophylactic and continuing antibiotics are appropriate

Answer 39

True

Question 40

Which instances are indicative of prophylaxis

Answer 40

``` heart valves cyanitis heart disease transplants joint replacement metallic implants ```

Question 41

Avoid doing the the first day post-op

Answer 41

rinsing

Question 42

How should you brush around the surgical site

Answer 42

gently, rinsing gently the first day | good oral hygiene will help healing

Question 43

Rinse the mouth with this several times a day beginning the DAY AFTER SURGERY

Answer 43

warm saltwater

Question 44

What is the diet post-op

Answer 44

soft, cool, foods for the first day | chewing gently in the area afterwards

Question 45

Do not do these after surgery regarding diet

Answer 45

use straws | suck on food, candy or wound

Question 46

What is the recommendation about exercising after surgery

Answer 46

avoid vigorous exercise on the day of surgery | may resume usual activity as tolerated after (few days for simple, several days+ for surgical)

Question 47

This condition is when there is an increase in pain 3-5 days post-op and no improvements 3-5 days post-op

Answer 47

dry socket

Question 48

What is the hallmark of dry socket

Answer 48

worsening taste or odor in mouth

Question 49

True or False | you can diagnose dry socket over the phone

Answer 49

False; they must come in for a consult

Question 50

The patient MUST be able to do this

Answer 50

contact someone