Preop

Question 1

When should a pre-op assessment be performed

Answer 1

30 days prior to surgery

Question 2

What are the aspects of a per-op cardiac assessment

Answer 2

cardiac conditions, associated diseases, changes in sx, medications, EtOH, drug use, DOE

Question 3

What are the major risk factors in cardiovascular assessment

Answer 3

unstable coronary syndromes, Recent MI, severe valvular disease, ventricular arrhythmias

Question 4

when is the risk of post-op MI the highest

Answer 4

within 6 mos of previous MI

Question 5

What are the aspects of revised cardiac risk index

Answer 5

Cerebrovascular disease, CHF, Cr level > 2, DM requiring insulin, ischemic CVD, high risk surgery

Question 6

When is a cxr necessary

Answer 6

COPD, >60 yo, functional dependence, hypoalbuminemia, CHF, emergency surgery, prolonged surgery, ASA score >2

Question 7

What are the risk factors in a pulmonary assessment

Answer 7

smoking, poor general health, older age, obesity, COPD, asthma

Question 8

What are pre-op indicators of malnutrition

Answer 8

anorexia, dysphagia, N/V/D, malignancy, GI disorders, drug dependency, dental difficulties, low SES

Question 9

At what level should blood glucose be maintained in a diabetic

Answer 9

150-200

Question 10

How often should BG be monitored in a diabetic after surgery

Answer 10

q6hours

Question 11

What disorders are considered metabolic considerations

Answer 11

hepatic dysfunction, adrenal insufficiency, hyperthyroidism, hypothyroidism, alcohol abuse

Question 12

what are the characteristics of DTs

Answer 12

restlessness, anxiety, hallucinations, fever, disorientation, rarely death

Question 13

what is the treatment of DTs

Answer 13

Lorazepam (Ativan), Versed

Question 14

How should Wernicke encephlopathy be treated

Answer 14

100mg thiamine

Question 15

How old can an informed consent be to be considered legal

Answer 15

30 days

Question 16

When is surgical prophylactic medication appropriate

Answer 16

GI bleeding, tetanus, DVT, fungal infections, endocarditis, EtOH

Question 17

What are medications for GI bleeding surgical prophylactic

Answer 17

H2 agonist, PPI, sucralfate

Question 18

When is the Td booster or TIG utilized

Answer 18

in a patient with unknown vac history

Question 19

When should a TdAP be administered

Answer 19

every 10 years

Question 20

What is considered a tetanus prone wound

Answer 20

> 6hours, stellate or avulsion, >1cm deep, missile/crush/burn/frostbite wound, devitalized tissue

Question 21

What is considered a non-tetanus prone wound

Question 22

What is the most common pulm complication

Answer 22

atelectasis

Question 23

what are the 5 Ws of post op fever

Answer 23

Water, Wind, Walk, Wound, Weird drugs

Question 24

What does water mean in the 5 Ws

Answer 24

UTI

Question 25

What does wind mean in the 5 Ws

Answer 25

atelecasis or pneumonia

Question 26

What does walk mean in the 5 Ws

Answer 26

DVT or PE

Question 27

What does wound mean in th 5Ws

Answer 27

incision infection

Question 28

What does weird drugs mean in 5Ws

Answer 28

drug induced fever

Question 29

What medicines can be taken up to the day before surgery

Answer 29

ACEi, diruretics, MVI, oral hypoglycemic

Question 30

What medicines should you stop 5 days before surgery

Answer 30

coumadin, NSAIDs

Question 31

What medicines should be stoped 1 week before surgery

Answer 31

ASA, plavix, Vit E, herbals