Principles of assessment Flashcards
1
Q
6 steps to come to diagnosis
A
- provisional diagnosis
- important aspects of history
- findings on examination
- results of investigation
- tissue diagnosis
- further investigations
2
Q
5 steps once diagnosis is reached
A
- establish diagnosis
- exclude extent/ severity of disease
- evaluate whole system
- exclude external disease
3
Q
what to consider for operation 5
A
- what is planned operation
- changes since op planned
- new diagnostic info
- special risks
- routine procedures eg bloods
4
Q
ASA status types
A
- healthy
- mild systemic disease: no functional limitations
- severe systemic disease: definite functional limitation
- severe systemic disease that is a constant threat to life
- moribund pt not expected to survive 24 hrs with or without surgery
5
Q
5qs for fitness of operation
A
- is pt fit for op
- incurrent diseases
- do these require invesigation
- does surgical condition give rise to problems eg fluids and electrolytes
- is pt taking drugs which could interfere with anaesthesia/ operation
6
Q
7 common concurrent diseases
A
- ischaemic heart disease
- congestive heart failure
- arterial hypertension
- chronic resp disease
- diabetes mellitus
- cardiac arrythmias
- anaemia
7
Q
3 aims of management
A
- diagnose pre-existing disease to make accurate assessment of degree of problem
- ensure pt medical condiiton is optimised before surgery
- consider drug interactions
8
Q
6 high risk groups for perioperative complications
A
babies over 60 yo elderly smokers obese intercurrent disease
9
Q
how to manage babies 3
A
monitor fluids/ electrolytes
check drugs
heat loss
10
Q
complications with
a. over 60s
b. elderly
A
a. cardiovascular disease –> chest x ray, pre op ECG, monitoring
b. elderly: confusion, hyponatraemia, immobility
11
Q
2 risks of smokers and measures to control this
A
- post op chest infection/ atelectasis: stop smoking 4 weeks before op, pre op chest x ray, physio
- inc risk of myocardial infarction: pre op ECG, avoid hypoxia
12
Q
2 consideratios of obese pts
A
increased risk of DVT
reduced mobility
13
Q
considerations of after op
A
anticipate special probs eg living alone
14
Q
9 essential preop assessment stages
A
history taking physical exam collate info about diagnosis arrange for further investigation discuss op, obtain consent mark op site inform theatre prophylactic medication plan rehab and convalescence
15
Q
6 principles of assessment
A
- diagnosis
- operation
- anaesthesia
- fitness for operation
- high risk
- after operation
