Preop Flashcards
When should a pre-op assessment be performed
30 days prior to surgery
What are the aspects of a per-op cardiac assessment
cardiac conditions, associated diseases, changes in sx, medications, EtOH, drug use, DOE
What are the major risk factors in cardiovascular assessment
unstable coronary syndromes, Recent MI, severe valvular disease, ventricular arrhythmias
when is the risk of post-op MI the highest
within 6 mos of previous MI
What are the aspects of revised cardiac risk index
Cerebrovascular disease, CHF, Cr level > 2, DM requiring insulin, ischemic CVD, high risk surgery
When is a cxr necessary
COPD, >60 yo, functional dependence, hypoalbuminemia, CHF, emergency surgery, prolonged surgery, ASA score >2
What are the risk factors in a pulmonary assessment
smoking, poor general health, older age, obesity, COPD, asthma
What are pre-op indicators of malnutrition
anorexia, dysphagia, N/V/D, malignancy, GI disorders, drug dependency, dental difficulties, low SES
At what level should blood glucose be maintained in a diabetic
150-200
How often should BG be monitored in a diabetic after surgery
q6hours
What disorders are considered metabolic considerations
hepatic dysfunction, adrenal insufficiency, hyperthyroidism, hypothyroidism, alcohol abuse
what are the characteristics of DTs
restlessness, anxiety, hallucinations, fever, disorientation, rarely death
what is the treatment of DTs
Lorazepam (Ativan), Versed
How should Wernicke encephlopathy be treated
100mg thiamine
How old can an informed consent be to be considered legal
30 days
When is surgical prophylactic medication appropriate
GI bleeding, tetanus, DVT, fungal infections, endocarditis, EtOH
What are medications for GI bleeding surgical prophylactic
H2 agonist, PPI, sucralfate
When is the Td booster or TIG utilized
in a patient with unknown vac history
When should a TdAP be administered
every 10 years
What is considered a tetanus prone wound
> 6hours, stellate or avulsion, >1cm deep, missile/crush/burn/frostbite wound, devitalized tissue
What is considered a non-tetanus prone wound
What is the most common pulm complication
atelectasis
what are the 5 Ws of post op fever
Water, Wind, Walk, Wound, Weird drugs
What does water mean in the 5 Ws
UTI
What does wind mean in the 5 Ws
atelecasis or pneumonia
What does walk mean in the 5 Ws
DVT or PE
What does wound mean in th 5Ws
incision infection
What does weird drugs mean in 5Ws
drug induced fever
What medicines can be taken up to the day before surgery
ACEi, diruretics, MVI, oral hypoglycemic
What medicines should you stop 5 days before surgery
coumadin, NSAIDs
What medicines should be stoped 1 week before surgery
ASA, plavix, Vit E, herbals
