SR 13 - Preoperative 101

Question 1

When can a patient eat prior to major surgery?

Answer 1

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

Question 2

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

Answer 2

Bleeding
Infection
Anesthesia
Scar
Other risk are specific to individual procedures and patient risk factors

Question 3

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

Answer 3

Yes

Question 4

If the patient is on an oral hypoglycemic agent, should they take it on the day of surgery?

Answer 4

No, due to being NPO

Question 5

If that patient is taking insulin, do they take it on the day of surgery?

Answer 5

No - only half a dose of long-acting insulin and start D5NS IV
Check glucose levels often, pre, intra and post-op

Question 6

Should a patient who smokes stop before an operation?

Answer 6

Yes - improvement is seen within 2-4 weeks (best at 6 weeks)

Question 7

What lab tests must be done on all women of childbearing age before entering an OR?

Answer 7

bHCG and CBC

For pregnancy and anemia secondary to menstruation

Question 8

Does preop bowel prep conclusively decrease postop infections in colon surgery?

Answer 8

No, there is no data to support its use

Question 9

What preoperative medication can decrease postop cardiac events and death?

Answer 9

B-blockers

Question 10

What must you always order pre-op for your patient undergoing a major operation?

Answer 10

NPO/IVF
Preoperative antibiotics
Type and cross blood (PRBCs)

Question 11

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

Answer 11

Potassium

Question 12

Who gets a preop ECG?

Answer 12

Patients older than 40yo