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NRNP 6560 Midterm exam With Questions And 100% CORRECT ANSWERS
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JACKLINENRNP 6560 Midterm exam With Questions And 100% CORRECT ANSWERS
Terms in this set (196)
Class 1: benefits outweigh risk, should be done
Class 2a: reasonable to perform
Surgery risk classes
Class 2b: should be considered
Class 3: rarely appropriate
ECG before surgery only if coronary disease, except when low risk surgery
General rules for surgery: testing Stress test not indicated before surgery
Do not do prophylactic coronary revascularization
NRNP 6560 Midterm exam
1/25
, - Diabetic agents: Use insulin therapy to maintain glycemic goals(iii) Discontinue biguanides,
alpha glucosidase inhibitors, thiazolidinediones, sulfonylureas, and GLP-1 agonists
- Do not start aspirin before surgery
Meds before surgery
- Stop Warfarin 5 days before surgery. May be bridged with Lovenox.
- Do not stop statin before surgery
- Do not start beta-blocker on day of surgery, but may continue
NRNP 6560 Midterm exam
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, 10/11/24, 6:29 PM
- Unstable cardiac condition (recent MI, active angina, active HF, uncontrolled HTN, severe
valvular disease), concern with CAD, CHF. arrhythmia, CVD
- patient stable or unstable?
- urgency of the procedure (oncology will be time sensitive)
Assessment of surgical risk - risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to be more than 4 METS, more than 10 METs makes low
risk)
catarcts
breast biopsy
Low risk surgeries cystoscopy, vasectomy
laporascopic procedures
Plastic surgery
Head/ neck surgery
thyroidectomy
Intraperitoneal
Prostate
Laminectomy
intermediate risk surgeries
Hip/ knee
Hysterectomy
cholecystectomy
nephrectomy
non majot intrathoracic
aortic/ cabg
transplants
High risk surgeries
spinal reconstruction
peripheral vascular surgery
6 points:
High risk surgery = 1
CAD = 1
CHF = 1
Cerebrovascular disease = 1
Lee's revised cardiac risk index DM 1 on insulin = 1
Creat greater than 2 = 1
1 = low risk
2 = moderate risk
NRNP 6560 Midterm exam
3 = high risk
3/25
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