SR Chapter 13: Preoperative 101

Question 1

When can a patient eat prior to major surgery?

Answer 1

NPO after midnight (8 hours before surgery)

Question 2

What risks should be discussed with all patients and documented on the consent for before surgery?

Answer 2

Anesthesia, Bleeding, Infection, Scar; other risks, i.e. MI, CVA, death with CV disease

Question 3

Should a patient take anti-HTN meds the day of the procedure?

Answer 3

Yes; clonidine “rebound”

Question 4

Should a patient take an oral hypoglycemic agent on the day of surgery?

Answer 4

No: not if patient is NPO

Question 5

If a patient is taking insulin, should it be taken on the day of surgery?

Answer 5

No, only half of a long-acting insulin and start D5 NS IV; check glucose pre/intra/post op

Question 6

When should a patient who smokes cigarettes stop before an operation?

Answer 6

2-4 weeks

Question 7

What lab tests must all women of childbearing age have before entering the OR?

Answer 7

B-HCG & CBC / pregnancy & anemia of menses

Question 8

What is a pre-op colon “bowel prep”?

Answer 8

Bowel prep with colon cathartic (i.e. GoLYTELY), oral ABX (neomycin and erythromycin base) & IV ABX before incision

Question 9

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

Answer 9

No

Question 10

What preoperative medication can decrease postop cardiac events and death?

Answer 10

Beta-blockers

Question 11

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

Answer 11

1. NPO/IVF
2. Pre-op ABX
3. Type & cross

Question 12

What electrolyte must you check pre-operatively if a patient is on HD?

Answer 12

K

Question 13

Who gets a preoperative ECG?

Answer 13

Patients >40 years old