Preoperative 101 Flashcards
When can a patient eat prior to a major surgery?
Patient should be NPO after midnight the night before or for at least 8 hours before surgery
What risks should be discussed with all patients and documented on the consent form for a surgical procedure?
Bleeding, infection, anesthesia, scar.
Other risks are specific to the individual procedure (also MI, CVA and death if cardiovascular disease is present).
If a patient is on antihypertensive medications, should the patient take them on the day of the procedure?
Yes, (remember clonidine rebound)
If a patient is on an oral hypoglycemic agent, should the patient take the OHA on the day of the surgery?
Not if the patient is to be NPO on the day of the surgery
If a patient is taking insulin, should the patient take it on the day of the surgery?
No, only half of a long-acting insulin (e.g. lente) and start D5NS IV.
Check glucose levels often preoperatively, operatively, and postoperatively.
Should a patient who smokes cigarettes stop before an operation?
Yes, improvement is seen in just 2-4 weeks after smoking cessation
What lab test must all women of child-bearing age have before entering the OR?
B-HCG and CBC because of the possibility of pregnancy and anemia from menses
What is a pre-op colon surgery bowel prep?
Bowel prep with colon cathartic (e.g. GoLytely), oral antibiotics (neomycin and erythromycin base), and IV antibiotic before incision
Has a pre-op bowel prep been shown conclusively to decrease post-op infections in colon surgery?
No, there is no data to support its use
What preoperative medication can decrease postoperative cardiac events and death?
Beta-blockers
What must you always order preoperatively for your patient undergoing a major operation?
- NPO/IVF
- Preoperative antibiotics
- T&C blood (PRBCs)
What electrolyte must you check preoperatively if a patient is on hemodialysis?
Potassium
Who gets a preoperative ECG?
Patients older than 40 years
