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Surgery EOR: Preoperative/Postoperative Care Exam 2024/2025 Questions With Completed & Verified Solutions. €12,77
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Surgery EOR: Preoperative/Postoperative Care Exam 2024/2025 Questions With Completed & Verified Solutions.
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Surgery EOR: Preoperative/Postoperative Care Exam 2024/2025 Questions With Completed & Verified Solutions.

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Document informatie

  • 25 mei 2024
  • 20
  • 2023/2024
  • Tentamen (uitwerkingen)
  • Vragen en antwoorden

Onderwerpen

  • when can a patient eat prior to a major surgery
  • what electrolyte must you check preoperatively if
  • describe the asa classification system ans asa 1

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  • PAEA GENERAL SURGERY
  • PAEA GENERAL SURGERY

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Voorbeeld van de inhoud

Surgery EOR: Preoperative/Postoperative
Care

When can a patient eat prior to a major surgery? - ANS NPO after midnight or at least 8 hours

What risks should be discussed with all patients and documented on the consent form for a
surgical procedure? - ANS Risk: Bleeding, infection, anesthesia, scars

If a patient is on anti-HTN meds should the patient take them on the day of the procedure? -
ANS Yes

Should a patient who smokes cigarettes stop before an operation? - ANS Yes - improvement is
seen in just 2-4 weeks of smoking cessation

What lab test must all women of childbearing age have before entering the OR? - ANS B-Hcg
and CBC

What is a preop colon surgery "bowel prep"? - ANS Bowel prep with a colon cathartic
(GoLYTELY), oral abx (neomycin, erythromycin), IV antibiotic before incidsion

What must you always order preoperatively for you patient undergoing a major surgery? - ANS
1. NPO/IVF
2. Preop abx
3. Type and cross blood (PRBCs)

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

Who gets a preop EKG? - ANS Patients over 40 or undergoing cardiac procedure

What is the most important preoperative eval performed by the surgical team? - ANS H&P - no
documentation exists linking a reduction in mortality and morbidity to routine lab testing in
otherwise healthy patients undergoing elective procedures

Detailed H&P prior to surgery including special attention to... - ANS Hx of CVA, heart dz, pulm
dz, renal dz, liver dz, GI d/o, DM, prior surgeries, bleeding problems, clotting problems, difficulty
w/ anesthesia, nutrition, etoh, illicit drugs

What is an ASA score? - ANS American Society of Anesthesiologists (ASA) classification
system which stratifies the degree of perioperative risk for patients

,Describe the ASA classification system - ANS ASA 1: Normal healthy patient
ASA 2: Patient with mild systemic disease
ASA 3: Patient with severe systemic disease
ASA 4: Patient with severe systemic disease with a constant threat to life
ASA 5: Moribound patient who are not expected to survive without an operation
ASA 6: Brain dead patient

Mouth PE important to note - ANS Teeth - if loose worry about intubation
Tongue - think sleep apnea if large
Jaw - TMJ could be difficult intubation
Mallampati score

Airway concerns with surgery - ANS Tracheal deviation - can be issue for maintaining airway
during surgery

Neck concerns with surgery - ANS If >17in there is concern for sleep apnea, masses,
deformities, ROM

Mallampati score - ANS Classifies how open the airway is
1 - Can see the uvula, no prob w/ intubation
IV- No uvula, hard intubation

Routine preop labs/tests for patients with cardiac disease/vascular disease? - ANS CBC
EKG

What are major cardiac risk factors for surgery? - ANS Unstable coronary syndromes
Recent MI
Severe valvular disease
Ventricular arrhythmias

What are minor cardiac risk factors for surgery? - ANS Hx of CVA
Uncontrolled HTN

What is the Goldman Criteria for Cardiac Risk? - ANS Assesses risk of perioperative fatal and
nonfatal cardiac events. Another used is Detsky's

What are moderate cardiac risk factors for surgery? - ANS Asymptomatic MI
DM
Compensated CHF

What is Lee's revised cardiac risk index? - ANS Validated way to predict risk in patients who
undergo elective noncardiac procedures. There are 6 predictors (each get one point):
History of ischemic heart disease
CHF

, Hx of CVA
High-risk operation
Preoperative treatment with insulin
Preoperative SCr >2.0 mg/dL

Goldman criteria points - ANS 0-5 = Class I
6-12 = Class 2
13-25 = Class 3
>25 = Class 4

Preop lab assessment for cardiac disease? - ANS Resting LV function
Ambulatory EKG monitoring
Exercise stress test or nuclear stress test
Stress echo

Patients with an EF <___% are at greatest risk for complications during surgery - ANS <35%

What are indications for preop coronary angiography? - ANS Patients with suspected left main
disease, triple vessel coronary occlusive disease, or unstable coronary syndromes (high risk
patients)

What is appropriate medical therapy for CAD prior to surgery? - ANS BB, CCBs, nitrates to
ensure myocardial oxygen demand does not exceed supply

What do patients with a history of rheumatic heart disease require prior to surgery? - ANS
Prophylactic antibiotics to prevent endocarditis

What should you do if you find your patient to have carotid artery disease? - ANS
Endorterectomy prior to surgery - wait 6 months before operation if possible

What are the 2 big things to worry about in surgery w/ a cardiac patient - ANS 1. Catecholamine
surge which causes an increase in myocardial o2 demand
2. Suppression in the fibrinolytic system which leads to thrombosis

What kind of murmurs are usually benign? - ANS Short, soft, systolic murmurs that are
asymptomatic often don't require further investigation

What are risk factors for postop pulmonary complications (PPC)? - ANS Advanced age
Elevated ASA class
CHF
Functional dependence
COPD
Sleep apnea
Smoking status

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