Pre-op/post-op Flashcards

1
Q

Some important PMH questions in a pre-op assessment

A

Cardiovascular disease - increased risk of cardiac event during anaesthesia, HF (lying flat), exercise tolerance

Respiratory disease - planning oxygenation

Renal disease - surgical complications (anaemia, coagulopathy, biochemical disturbances)

Endocrine disease - diabetes and thyroid(medication changes)

GORD

Falls/blackouts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Questions in post anaesthetic history

A

Previous anaesthesia? - Post op complications? Airway difficulties? Drug reactions?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is malignant hyperpyrexia?

A

An autosomal dominant condition that leads initially to muscle rigidity despite neuromuscular blockade, followed by a rise in temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Whats the 2-4-6 rule?

A

Fasting rules:
2 hours clear fluids/tea/coffee,
4 hours breast milk
6 hours food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What score is used to describe how easy intubation will be?

A

Mallampati score

- degree of mouth opening, teeth, oropharynx, neck movement, thryomental distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What score is used to assess the physical state of a patient before surgery?

A

The ASA score (1-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should oxygen be given post op?

A

Until patient is fully awake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reasons for ongoing oxygen therapy

A

Patient factors - obesity, age, cardiorespiratory
Physiological factors - anaemia, hypovolemia
Surgical factors - abdominal surgery, thoracic surgery
Analgesia - intrathecal opiods, PCS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 2 variable performance devices for oxygen

A

Non-rebreathe mask

Nasal cannulae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How many ml/min does a non-rebreathe mask give?

A

Up to 15l/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How many ml/min does a nasal cannulas give?

A

1-4L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name a fixed performance devices for oxygen

A

Venturi device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Contraindication to a nasopharyngeal airway

A

Significant facial and basilar skull fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Post op complications

A

Hypoxaemia, hypotension, arrhthmias, AKI, delerium, post op nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Possible causes of post op hypoxaemia

A

Atelecatasia, bronchopneumonia, aspiration, pulmonary oedema, pneumothorax, PE, hypoventilation secondary to opiods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Possible causes of post op hypotension

A

Transient/benign related to drugs, hypovolemia, sepsis, anaphylaxis, rewarming

17
Q

Possible causes of post op arrhythmia

A

Hypercapnia, hypoxaemia, acid/base disturbance, pain, underlying cardiac disease, PE, sepsis

18
Q

Possible causes of post op AKI

A

Predisposition, haemodynamic disturbance, nephrotoxic insults and inflammatory response

19
Q

Risk factors for post op nausea

A

Patient factors: female, non smokers, young age, motion sickness
Anaesthetics: opiods, NO
Surgical: emergency surgery, ENT surgery, GI surgery, gyn surgery