Surgery Patient Lecture

Question 1

What is a pre op OMT consideration for anesthesia?

Answer 1

Optime c spine for intubation

Question 2

What are 2 cardiac risk factors we need to consider for surgery?

Answer 2

CHF (ejection fraction less than 35) and recent MI

Question 3

What are two pulmonary risk factors to consider for surgery patients?

Answer 3

Smoking and COPD

Question 4

4 hepatic risk factors for a surgery patient?

Answer 4

Ascites
Bilirubin greater than 2 mg/dl
PTT greater than 16 seconds
Albumin less than 3

Question 5

2 nutritional risk factors for surgery patient?

Answer 5

Loss of 20% body weight over 6 months

BMI over 40

Question 6

1 metabolic risk factors for surgery patient to consider?

Answer 6

Diabetes

Question 7

Behavioral risk factor for surgery patients?

Answer 7

Drug and alcohol use

Question 8

How many treatments a day is max for hospital patients and what frequency is usually administered?

Answer 8

3 a day is max

Everyday or every other day

Question 9

What is sympathetic level of upper extremities and lower extremities?

Answer 9

Upper is t2-8 and lower is t11-l2

Question 10

What is the sympathetic level of GU?

Answer 10

T10-l2

Question 11

What are 4 factors during surgery that increase risk of having SD after?

Answer 11

Long surgery, position during surgery, being inactive, and prolonged bed rest

Question 12

What is a good rule of thumb for treating SDs in orthopedic patients?

Answer 12

Treat SDs below and above the joint to give greater mobility to joint

Question 13

What is the temperature that is considered a fever?

Answer 13

100.4 or 38

Question 14

What is the rules of W’s for post op fever and what is causing the fever?

Answer 14

Wind days 1-2: atelectasis then pneumonia 
Water day 3: UTI
Walking 5-7 DVT/PE
Wound 7-10 wound infection
Wonder Drugs: drugs causing fever

Question 15

3 contributing factors in the hospital to atelectasis?

Answer 15

Pain, anesthesia and mechanical ventilation, and bed rest

Question 16

Sympathetics and parasympathetics for atelectasis patients? What other neuro are we thinking about?

Answer 16

T1-6
Vagus
C3-5 for phrenic

Question 17

What is the sympathetic level and parasympathetic level for pre tibial edema patient?

Answer 17

T10-l2

S2-s4

Question 18

What 2 electrolyte abnormalities lead to constipation?

Answer 18

Hypokalemia and hypercalcemia

Question 19

When does peristalsis usually return to small intestine, right colon and left colon?

Answer 19

24 hours, 48 hours and 72 hours

Question 20

What is the med of choice for post op pain?

Answer 20

Morphine

Question 21

Pain is a powerful stimulant for what?

Answer 21

It is a powerful respiratory stimulant so respiratory depression is rare

Question 22

What is the relationship between SNS and pain?

Answer 22

Hyperactive SNS lowers pain tolerance