Pre Op Flashcards
Should we continue or hold beta-blockers and statins?
continue
What does ASA classification 3 mean?
The pt has a systemic disease but it’s not incapacitating
How would a low serum albumin level affect a pt? When would a pt have a low serum albumin levels?
increase their risk of pulmonary complications
Pts with malnutrition
If asthma a risk factor for post-op complications?
NO
If a smoker wants to undergo elective surgery, when should they stop smoking?
Well ASAP, but at least 6 weeks before surgery
Why does COPD increase perioperative risks?
Increased secretions with inefficient clearing
Small airway obstruction
Lack of pulmonary reserves (high risk for atelectasis & superimposed infections)
If a pt has an FEV <1L, PaO2 <50mmHg, and PaCO2 >45, this puts that an increased risk for after surgery?
High risk of death via pneumonia or long-term vent dependence
High risk of death via pneumonia or long-term vent dependence
Serum Cr, BUN, and urinary electrolytes
What does liver disease put a pt at high risk of for surgery?
Increased risk of bleeding
What score can we use to evaluate a pt’s cirrhotic liver? What is it made up of?
MELD score
Cr (most important), bili, albumin, INR
What are contraindications for elective surgery?
- acute liver failure
- AKI
- Acute viral Hep
- Cardiomyopathy
- Hypoxemia
- Severe coagulopathy
If a pt has diabetes what does it put them at an increased risk for?
Substantially higher risk of infection
Hyperglycemia = decreased immune function
Reduced blood flow = delayed wound healing
what are the pre-operative instructions for surgery in diabetics?
Stop long-acting 48-72 hours before
Hold short-acting the before/day of
What are the sxs of DKA?
N/V/abdominal distention , polyuria
What are the biggest risks for a DVT?
being immobile, congestive HF, pelvic or joint operations, vertebral/pelvic/long bone fractures
