cardio clearance if needed- ausculate heart and lung.
Chest X-ray (>50 y/o or with cariopulmonary disease)
Pre-op eval - Answer: -if you are asked to do a pre-op eval than do entire exam. than do a focused
Lower extremity (make sure to describe area of surgery)
Head: atruamatic, normocephalic
Cardiovascular: regular rate and rhythm, no abnormal heart sounds (murmurs, bruit)
Lungs: no abnormal lung sounds (crackles or wheeze)
Skin: no rash or open lesions
Abdomen: normal bowel sounds, soft and tender
Neuro: Achilles and patellar reflex grossly intact, order: cbc, bmp, gfr, liver enzyme. get ekg, chest x-ray,
npo after midnight, crutches surgical shoe, dressings CDI
Questions to ask pre-op - Answer: 1. Chest pain?
2. PMH (Kidney disease, thyroid conditions, liver disease, heart failure- no surgery within 6 months of
MI, asthma, diabetes, bronchitis)
3. Allergies (family history with anesthtics)
4. Have you ever had a stroke
5. Anesthesia questions
6. Pain, stiffness or arthritis in your neck
What to tell periop patients about medications? - Answer: 1. No eating 8 hours before surgery
2. T2DM- stop hypoglycimics and noninsulin injectibles morning of surgery
3. stop smoking 3 days before surgery, ideally 4-6 weeks.
4. tell them pre, peri and post op plan.
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