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Assessment > Pre-Op Assessment > Flashcards

Pre-Op Assessment Flashcards

1
Q

What is the BMI cutoff to be considered underweight?

A

less than 18.5

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2
Q

What is the BMI cutoff to be considered normal weight?

A

18.5-24.9

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3
Q

What is the BMI cutoff to be considered overweight?

A

25-29.9

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4
Q

What is the BMI cutoff to be considered obese?

A

30 and above

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5
Q

What is the BMI formula for metric scale?

A

Weight in kgs divided by m squared

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6
Q

What is the BMI formula for imperial scale?

A

Weight in lbs divided by inches squared

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7
Q

If you have an emergent case how are you going to do an emergent physical exam?

A

AMPLE
Allergies
Meds
Past Mhx
Last meal eaten
Events leading up to the need for sx

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8
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is Ortho sx?

A

Low

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9
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is urology sx?

A

Low

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10
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is skin sx?

A

Low

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11
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is cataract sx?

A

Low

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12
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is Endoscopic procedures?

A

Low

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13
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is Breast sx?

A

Low

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14
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is ambulatory sx?

A

Low

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15
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is head/neck sx?

A

Intermediate

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16
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is carotid endardectomy?

A

Intermediate

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17
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is intrathoracic sx?

A

Intermediate

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18
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
Which category is Intraabdominal sx?

A

Intermediate

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19
Q

There are 3 categories of riskiness of procedures.
High greater than 5%
Intermediate 1-5%
Low < 1 %
What are the two high risk procedures?

A

Aortic and major vascular
Peripheral vascular

20
Q

What are the SIX components of the revised cardiac risk index?

A

High risk sx (intra peritoneal or thoracic or suprainguinal vascular procedure)
Ischemic heart dz
Hx of CHF
Hx of cerebrovascular dz
DM requiring insulin
Scr > 2.0

21
Q

Even with an RCRI of 0 what is your risk of major cardiac events?

A

Still 0.4%

22
Q

What is your risk of major cardiac events with an RCRI of 1?

A

1%

23
Q

What is your risk of major cardiac events with an RCRI of 2?

A

2.4 %

24
Q

What is your risk of major cardiac events with an RCRI of 3 or greater?

A

5.4 %

25
Q

What does a MET stand for?

A

Metabolic equivalent of task

26
Q

You measure functional capacity by __

A

METs

27
Q

METs give us an idea of energy consumption at rest T or F

A

T

28
Q

1 MET =

A

3.5 mL/kg/min

29
Q

This is a definition and example or ASA. State which ASA described. A normal healthy pt.
Ex: Healthy, nonsmoking, none or minimal alcohol use

A

ASA 1

30
Q

This is a definition and example or ASA. State which ASA described. A pt with mild systemic dz

Ex: current smoker
Social alcohol drinker
pregancy
BMI greater than 30
Well controlled DM/HTN
mild lung dz

A

ASA 2

31
Q

This is a definition and example or ASA. State which ASA described. A pt with severe systemmic dz

Ex: One or more moderate to severe dz’s
Pt has functional limitations
Poorly controlled DM, HTTN, COPD morbid obesity greater than 40.
Active hepatitis, alcohol dependence or abuse
Implanted PM
Moderate reduction of EF
ESRD undergoing regular scheduled HD
Premature infant postconceptual age < 60 weeks
Hx of (more than 3 moths ago) MI, CVA, TIA, or CAD/stents
Peritoneal dialysis

A

ASA 3

32
Q

This is a definition and example or ASA. State which ASA described. A pt with sever systemic dz that is a constant threat to life

Ex: RECENT hx (less than 3 months ago) of MI, CVA, TIA, or CAD/stents, ongoing cardiac ischemia, or severe valve dysFXN, SEVERE reduction of EF, sepsis, DIC, ARDS, ESRD not getting regularly scheduled HD!!!!

A

ASA 4

33
Q

This is a definition and example or ASA. State which ASA described. A moribund pt who is not expected to survive without the operation

Ex: Ruptured abdominal or thoracic aneurysm
Massive trauma
Intracranial bleed with mass effect
Ischemic bowel in the face of significant cardiac pathology or multiple organ/system dysFXN.
Pt needing a PM or will die due to arrhythmia

A

ASA 5

34
Q

This is a definition and example or ASA. State which ASA described. A declared brain dead pt whose organs are being removed for donor purposes

A

ASA 6

35
Q

List the 5 most common allergies in order from most common to least.

A

Muscle relaxants
Latex
CHG
ABX
Opioids

36
Q

P2Y12 inhibitor Clopidogrel (Plavix) and Ticagrelor (Brilinta) should be D/C’s how many days before sx?

A

5-7 days

37
Q

P2Y12 inhibitor Prasugrel should be D/C’d how many days before sx?

A

7-10 days

38
Q

P2Y12 Inhibitor Ticlopidin (Ticlid) should be D/C’d how many days before sx?

A

10 days

39
Q

Apfel score of _ means you are high risk for PONV

A

3

40
Q

What are the 4 criteria of Apfel?

A

Female gender
Hx of PONV/motion sickness
Nonsmoking status
Post-op opioids

41
Q

What are the 2 criteria to meet for Mendelson syndrome?

A

Greater than 25 cc of residual volume
Ph of stomach content less than 2.5

42
Q

Pt can have a full meal how many hours before sx and stilll be considered NPO status at sx? What could they eat?

A

Fatty foods, full meal, enteral tube feeds

43
Q

Pt can have a light meal how many hours before sx and still be considered NPO status? What could they eat?

A

6

Toast and liquids, instant formula, nonhuman milk, coffee with milk

44
Q

Pt can have breast milk how many hours before sx and still be considered NPO status?

A

4

45
Q

Pt can have clear liquids how many hours before sx and still be considered NPO? What could they drink?

A

2
Water, sports drink, carbonated beverages, coffee, tea, juice without pulp

46
Q

Why does diabetes cause delayed gastric emptying?

A

Gastroparesis is the result of damage to the vagus nerve, which controls the movement of food through the digestive system. Instead of the food moving through the digestive tract normally, it is retained in the stomach.

Assessment (3 decks)

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