Preoperative 101 Chapter13 P80-81

Question 1

When can a patient eat prior to major surgery?

P80

Answer 1

Patient should be NPO after midnight the night before or for at least 8 hours before surgery

Question 2

What risks should be discussed with all patients and
documented on the consent form for a surgical procedure?
P80

Answer 2

Bleeding, infection, anesthesia, scar; other risks are specific to the individual procedure (also MI, CVA, and death if
cardiovascular disease is present)

Question 3

If a patient is on antihypertensive medications, should
the patient take them on the day of the procedure?
P80

Answer 3

Yes, (remember clonidine “rebound”)

Question 4

If a patient is on an oral hypoglycemic agent (OHA),
should the patient take the OHA on the day of surgery?
P81

Answer 4

Not if the patient is to be NPO on the day of surgery

Question 5

If a patient is taking insulin, should the patient take it on
the day of surgery?
P81

Answer 5

No, only half of a long-acting insulin (e.g., lente) and start D5 NS IV; check glucose levels often preoperatively, operatively, and postoperatively

Question 6

Should a patient who smokes cigarettes stop before an operation?
P81

Answer 6

Yes, improvement is seen in just 2 to 4 weeks after smoking cessation

Question 7

What laboratory test must all women of childbearing
age have before entering the O.R.?
P81

Answer 7

ℬ-HCG and CBC because of the possibility of pregnancy and anemia from menses

Question 8

What is a preop colon surgery “bowel prep”?

P81

Answer 8

Bowel prep with colon cathartic (e.g., GoLYTELY), oral antibiotics (neomycin and erythromycin base), and IV antibiotic before incision

Question 9

Has a preop bowel prep been shown conclusively to
decrease postop infections in colon surgery?
P81

Answer 9

No, there is no data to support its use

Question 10

What preoperative medication can decrease
postoperative cardiac events and death?
P81

Answer 10

ℬ-blockers!

Question 11

What must you always order preoperatively for your patient undergoing a major operation?
P81

Answer 11

1. NPO/IVF
2. Preoperative antibiotics
3. Type and cross blood (PRBCs)

Question 12

What electrolyte must you check preoperatively if a
patient is on hemodialysis?
P81

Answer 12

Potassium

Question 13

Who gets a preoperative ECG?

P81

Answer 13

Patients older than 40 years of age