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Surgery I > Preoperative Evaluation of Patient > Flashcards

Preoperative Evaluation of Patient Flashcards

1
Q

What are the six key factors that are looked at in determining the operative risk?

A 
Age  
Benefits vs Outcome of surgery 
Urgency 
Nature of problem 
Duration of procedure 
Concurrent medical problems
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2
Q

For a smaller patient, like on going under for a PDA repair, what are four things that should be set aside or used?

A

Warmed fluids
Glucose
Atropine
Nerve block

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3
Q

What are the five levels of anesthetic risk?

A

Excellent - Good - Fair - Poor - Guarded

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4
Q

What does a classification of risk of Good mean?

A

Slight chance for complications but highly likely there will be a good outcome

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5
Q

What does a classification of risk of Fair mean?

A

Serious complications are possible but uncommon
Prolonged recovery possible
May not return to pre surgical function

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6
Q

What does a classification of risk of Poor mean?

A

Underlying disease/Procedure itself is associated with severe complications
Recovery will be prolonged
Unlikely to return to pre surgical function

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7
Q

What does a classification of risk of Guarded mean?

A

Outcome unknown

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8
Q

What three things should you ask when focusing in on a complaint?

A

When
What did it look like when it first began
Better or Worse

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9
Q

What is the most important part of a pre surgical work up?

A

PE

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10
Q

What are the levels in rating the physical status of a surgical patient?

A

I to V

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11
Q

What is a physical status of II mean?

A

Localized disease or mild systemic disease but otherwise healthy

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12
Q

What is a physical status of III mean?

A

Severe systemic disease

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13
Q

What is a physical status of IV mean?

A

Severe systemic disease that is life threatening

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14
Q

What is a physical status of V mean?

A

Moribund, not expected to live 24 hours with or without surgery

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15
Q

What is part of the intraoperative plan?

A

Surgical approach
Material/Equipment needed
Personnel you will need on staff
(How - Who - What)

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16
Q

What are the examples of a postoperative plan?

A

Further testing
Wound care
Support (nutritional, fluid, oxygen, etc)

17
Q

What is the normal blood volume for a dog?

A

90 ml/kg

18
Q

What is the normal blood volume for a cat?

A

70 ml/kg

19
Q

What is the rate for the shock dosage of fluids?

A

30 ml/lb

20
Q

What do you have to be careful of when giving shock rate of fluids?

A

Can cause more problems then good if patient has:

Pulmonary + Cardio + Renal issues

21
Q

When do you know if you need to treat ventricular arrhythmias?

A

Interfere with CO
Multiform
R on T
Ventricular rate is > 160 rpm

22
Q

What are the two methods of suppling nutrition?

A

Enteral + Parenteral

23
Q

What are the possible complications/problems with total parenteral nutrition?

A

Expensive formulas

Sepsis

24
Q

What are the four types of tubes you can place for enteral feeding?

A

Nasogastric
Pharyngostomy
Gastrostomy
Enterostomy

25
Q

What are the three clinical methods of using antibiotics?

A

Therapeutic
Prophylactic
Nosocomial

26
Q

What is prophylactic antibiotic administration responsible for?

A

Antibiotic resistance in bacteria

27
Q

What are the four major reasons given for resistant bacteria?

A

Prolonged, extensive surgical procedures
Increased invasiveness of supportive measures
Long hospital stays
Inappropriate use of AB’s
Immunosuppressive drugs

28
Q

What is infection dependent on?

A

Number/Virulence of bacteria
Competence of host defense
Amount of tissue damage
Dead space resulting from procedure

29
Q

What four things can be done to decrease infections?

A

Good wound lavage
Closure of dead space
Appropriate AB prophylaxis
Meticulous surgical technique

30
Q

Where is the most common place that bacteria come from that cause infection?

A

Endogenous to patient

31
Q

How much does the risk increase per person in the surgical suite?

A

1.3 times

32
Q

What are the two most common nosocomial infections?

A

Urinary tract + Surgical site infection

33
Q

When would you need to use prophylactic AB’s?

A

Surgery longer than 90 minutes
Prothesis implantation
Prothesis that was there pre-surgery
Severely infected wounds

34
Q

What are the four types of surgery that need prophylactic AB’s?

A

Orthopedic + Respiratory + Gastrointestinal + Urogenital

Surgery I (17 decks)

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