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28 Cards in this Set
- Front
- Back
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The preop assessment of "respiratory function in the thoracic surgery patient should include: (choose 3)
a. Mechanical fx of airways & lung b. Cardiopulmonary reserve c. Metabolic effects d. pulmonary parenchymal fx |
a,b,d
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What is the term used to describe the respiratory assessment that includes:
-mechanical function of the airways and lungs -pulmonary parenchymal fx -cardiopulmonary reserve |
"three-legged-stool"
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Preop assessment of ________ is critical b/c at least three times the Vt is necessary for an effective cough
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vital capacity
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_______ increases airway irritability, decreases mucociliary transport, and increases secretions. It also decreases FVC & FEF 25-75
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Smoking
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What patient population is at high risk for cardiac complication, particularly arrhythmias, after large pulmonary resections
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Geriatric patients
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**Interventions that have been shown to decrease the incidence of respiratory complications in high-risk patients undergoing thoracic surgery include? (list 3)
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1. cessation of smoking
2. physiotherapy 3. thoracic epidural analgesia |
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What are the "4 M's" of anesthetic considerations in lung CA patients:
a. Mass effects b. metabolic effects c. MP <3 d. metastasis e. medications |
all but "c" are true
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Why is the need for one lung ventilation (OLV) much higher with a Video-Assisted Thoracoscopic Surgery (VATS) than with an open-thoracotomy?
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because it is not possible to retract the lung.
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After lung resection surgery, it is usually possible to wean and extubate pt's with adequate predicted postop respiratory fx in the operating room provided they are?
"AWaC" |
"AWaC" alert, warm, and comfortable
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What % of patients with Lung CA will die from their disease
1. 25% 2. 45% 3. 55% 4. 87% |
87%
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removes a small portion of a lobe?
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wedge resection
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removes a larger portion of a lobe
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segment resection
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removes an entire lobe
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lobectomy
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removes the entire lung
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pneumonectomy
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What is the average decrease in FEV1 for:
-Lobectomy -Pneumonectomy |
Lobectomy = 10%
Pneumonectomy = 33% |
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slow/deep respirations =
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obstructive
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Rapid/shallow respirations =
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Restrictive
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________could indicate tumor invading the airway
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hemoptysis
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**Treatable components of thoracic surgery complications**
(how would you manage them) a. Bronchospasm b. Atelectasis c. Infection d. Pulmonary Edema |
a. bronchodilators
b. chest PT c. antibiotics d. heart failure/fluid management |
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What is used to calculate the predicted postoperative pulmonary function status in thoracic surgery patients?
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The # of subsegments of each lobe
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How many total lung subsegments are there?
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42
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What is the ppoFEV1 equation
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FEV1% x (1-%functional lung tissue removed/100)
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How is a lung parenchymal function test done?
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DLco
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What % FEV1 is needed to extubate a thoracic surgery patient in the O.R
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>40% & AWaC
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What % FEV1 score would require further examination of:
exercise tolerance, DLco, V/Q scan...before extubation would be considered in thoracic surgery patients |
30-40%
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If a thoracic surgery patient has an FEV1 _____% you would do staged weaning from mech. ventilation
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<30%
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Initial preanesthetic assessment for thoracic surgery patients (all of them) should include what test?
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Exercise tolerance
PPO FEV1 Discuss smoking cessation and postop analgesia |
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Initial preanesthetic assessment of thoracic surgery pt's with a PPO FEV1 < 40% should include what?
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DLco
V/Q scan VO2 max |
