Pre-Operative Flashcards
Types of Surgery
1) Elective
2) Urgent
3) Emergent
Surgery planned for correction of a non-acute problem. It is planned in advance.
Ex: Cataract removal, Total Joint Replacement
Hernia repair, Hemmorrhoidectomy
Elective
Requires prompt intervention; may be life threatening if treatment is delayed more than 24-48 hours.
Ex: Intestinal Obstruction, Bladder Obstruction, Kidney or Ureteral Stones, Bone Fracture, Eye Injury, Acute Cholecystitis
Urgent
Requires immediate intervention because of life threatening consequences.
Ex: Gunshot/Stab Wound, Severe Bleeding, Abdominal Aortic Aneurysm, Compound Fracture, Appendectomy
Emergent
Removal of (Excision)
ectomy
ex: Tonsilectomy
Surgical repair of (Suturing of)
orrhaphy
ex: Herniaorrhaphy
Creation of an opening (Surgical Opening)
ostomy
ex: Colostomy
Process of cutting into
otomy
ex: Lobotomy
Reconstructive ( Surgical Repair of)
plasty
ex: Rhinoplasty
Direct visual examination using some type of scope.
scopy
ex: Colposcopy
Reasons for Surgery:
1) Diagnostic
2) Curative
3) Restorative
4) Palliative
5) Cosmetic
Performed to detemine the origin and cause of a problem:
Diagnostic
ex: Breast Biopsy, Exploratory Laparotomy, Arthroscopy
Performed to solve a health problem by repairing or removing the cause:
Curative
ex: Cholcystectomy, Appendectomy, Hysterectomy
Performed to improve a patient’s functional ability:
Restorative
ex: Total Knee Repacement, Finger Reimplantation
Performed to relieve symptoms of a disease process, but does not cure:
Palliative
ex: Colostomy, Nerve Root Resection, Tumor Debulking, Ilestomy
Performed primarily to alter or repair personal appearance:
Cosmetic
ex: Liposuction, Revision of Scars, Rhinoplasty
Explains what the physician will be doing:
Detailed Consent
PAT
Pre-Admission Testing; performed from 24 hours to 28 days before the scheduled surgery.
Most Common PAT’s:
1) Urinalysis (protein, glucose, blood & bacteria)
2) Blood Type & Screen
3) CBC or H&H (Complete Blood Count)
(Hemoglobin Level & Hematocrit)
4) Clotting Studies:
- PT: Prothrombin Time
- INR: International Normalized Ratio
- aPTT: Activated Partial Thromboplastin Time
- Platelet Count
5) Electrolyte Levels
6) Serum Creatinine & Blood Urea Nitrogen levels
7) Pregnancy Test (depending on age & nature of procedure)
NSAID’s in relation to Surgery:
Blood thinners stopped 1-2 weeks prior to surgery.
The Physical Assessment:
1) Provides baseline health status
2) Review pre-operative labs/diagnostic studies
3) First assess part of body to be operated on
4) Extent of examination will depend on setting
Reason for Cognitive/Neuro Status Review:
1) Specify what patient is oriented to: time, place, etc
2) Adverse reactions to anesthesia
3) Any Neuro or Cognitive history (co-morbidities) such as: AMS, Dementia, Alzheimers, Seizures, Unsteady Gait, Parkinsons
4) Ability to follow directions
Reason for Cardiovascular Review:
1) Past Cardiac History including: HTN, MI, Arrythmias, Heart Failure
2) Cardiac Diseases result in 30% more deaths related to administration of anesthesia
3) Decreased tissue perfusion impeding wound healing
Smoking in relation to Surgeries:
Cessation of smoking should occur 3-4 weeks prior to surgery