Pre Op Eval

Question 1

What are the Pre op evaluations?

Answer 1

Cardiac 
Pulmonary 
Liver 
Nutrition 
Metabolic status

Question 2

What are pts that need to be checked for cardiac pre op Evals? How is it Dx and Tx?

Answer 2

Heart failure with EF < 35 %
Myocardial infarction within the last 6 mos

Dx: ECG, Echo, Cath

Thx: Stenting, plavix, CABG, Medical Managment

Question 3

What is more of a issue in Pulmonary pre op eval?

Answer 3

Ventilation more than oxygen

Question 4

What pts need to be checked for pulmonary pre op eval?

Answer 4

Smokers
COPD
Asthma
ILD

Question 5

How are pts with pulmonary issues in pre op evals Dx? What will ABGs show? Which is worse low O2 or high CO2?

Answer 5

Dx: PFTs

ABG: will low O2 (Bad), High CO2 (worse)

Question 6

What must smokers do before surgery in pre op evals?

Answer 6

Smoking cessation at least 8 weeks before

Question 7

What does Child Pugh for Liver asses?

Answer 7

How well a pt can process anesthesia

Question 8

What is checked for child Pugh class A,B,C?

Answer 8

Low albumin 
Elevated Pt/PTT 
Elevated billirubin 
Ascites 
Encephalopathy

Question 9

How are pts dx in pre op evals for liver (child Pugh)? When are surgeries contraindicated? What is the treatment?

Answer 9

Dx: MELD score (use equation, don’t memorize)

Contraindicated in cirrhosis
Tx: Liver transplant

Question 10

Why is adequate nutrition needed before surgery?

Answer 10

Adequate surgery needed for healing

Question 11

Which pts are at risk for nutrition in pro op evals?

Answer 11

People who lost 20% of body weight in last 3 months

Albumin < 3

Failed a nervy test

Question 12

How are people with nutrition dx in pre op eval?

Answer 12

DX: CRP, check prealbumin to ensure albumin is from nutrition

Skin a anergy test

Question 13

What is the treatment for pts in nutrition?

Answer 13

Tx: PO>IV

10 days> 5 days

Question 14

Which metabolic status pts don’t you don’t do surgery on?

Answer 14

Pts in DKA don’t do surgery