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My Foundations 2 > Quiz 6 > Flashcards

Quiz 6 Flashcards

1
Q

No age limit in outpatient with the exception of premature babies

A

.

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2
Q

1st and second most common surgery center procedures

A
  • Opthalmologic

- 2nd are gynecological surgeries

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3
Q

Healthy former premature infants should be greater than ______ weeks postconceptual age

A

50-60

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4
Q

Infants displaying ___________________________ should NOT be considered for surgery

A

bronchopulmonary dysplasia

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5
Q

Increased risk of SIDS

A
  • Children with history of apnea/bradycardic events
  • Siblings with SIDS (4-5X greater risk)
  • Should not be considered until 6mo. – 1yr
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6
Q

Children with prior history should be free of apnea/bradycardia for ____ prior to surgery

A

6 months

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7
Q

Healthy full-term infant: If free of any complications can be considered case by case at _______ weeks of age

A

2 to 4

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8
Q

Those aged ___ years or greater are at greater risk for hospital admission and death within the week following surgery

A

85

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9
Q

Convulsive disorders

A

-If Controlled: Schedule procedures very early in the day to provide for optimal observation, minimum of 4 to 8 hours postoperatively

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10
Q

Malignant HyperthermiaSusceptibility

A

Must have at least 1 of the following criteria:

  • Previous MH episode
  • Masseter rigidity with previous anesthesia
  • Relative (1st degree) with MH episode or positive muscle biopsy

Can do in outpatient, must watch 4 hours post-op.

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11
Q

Have a minimum of ____ vials of dantrolene available

A

36

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12
Q

Morbid obesity

A
  • ASA class I, II only
  • Co-morbidities such as cardiac, endocrine, hepatic, renal or pulmonary should be inpatient
  • Bring CPAP
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13
Q

BMI greater than ___ considered very high risk/unacceptable

A

50

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14
Q

Sickle Cell Criteria for outpatient:

A
  • No major organ disease (as a result)
  • No sickle crisis for minimum of 1 year
  • Compliant medical care
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15
Q

UNACCEPTABLEPatient Conditions for SDS

A
  • Unstable ASA III or IV
  • Newly diagnosed or untreated OSA
  • Uncontrolled diabetes
  • Isolation necessary (sepsis/infectious dz)
  • Post-op pain not controlled with oral meds
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16
Q

H & P: For stable patient should be within __ days or within __ hours for the high risk patient

A

30

72

17
Q

Lab values good within __ days of surgery if patient status is stable

A

60

unless on diuretic, digitalis - K+ within 7 days

18
Q

If coumadin held, should be held for

A

4-5 days

19
Q

Symptoms of URTI

A
  • WBCs >12-15,000
  • Mucopurulent nasal secretions
  • Inflamed/reddened mucosa
  • Positive chest findings
  • Temperature 38C or>
  • Tonsilitis
  • Viral ulcers in oropharynx
  • Conjunctivitis
  • Coughing (nonproductive)
  • Fatigue
  • Itching
  • Laryngitis
  • Malaise/myalgias
  • Sneezing
  • Sore throat
  • *throat/nasal cultures
20
Q

URTI: Asymptomatic can be done if following are met

A
  • Child older than 1yr, otherwise healthy and surgery is not on thorax or abdomen
  • ETT intubation is not planned (11-fold increase risk of adverse respiratory complications)
21
Q

Risk factors for increased respiratory airway problems with URTI:

A
  • ETT
  • <5yrs
  • hx of prematurity
  • hx RAD(reactive airway dz)
  • 2nd hand smoke
  • copious secretions
  • nasal congestion
  • ENT sx
22
Q

Fluid Management

A
  • Surgical procedure greater than 30 min.
  • Increased hypothermia, increased analgesics, prolonged resumption of normal diet
  • Procedures with increased PONV
  • Procedures with increased post-op pain
  • Prolonged fasting, particularly children
  • Intra- or post-op bleeding
  • Need for antibiotics
23
Q

Top 2 reasons for inpatient admission

A
  • N/V

- uncontrolled pain

24
Q

Contributors to PONV

A
  • Ambulation
  • postural hypotension
  • uncontrolled pain
  • post-op pain meds
  • oral intake
  • low inspired O2 concentration
  • reversal agents
25
Q

Monitoring Standards MAC

A

Pulse Oximetry
ECG
BP

26
Q

Droperidol

A
  • Avoid in patients with pre-existing ECG abnormalities

- Recommend 2-3hrs monitoring and 12-lead ECG following administration

My Foundations 2 (10 decks)

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