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16 Cards in this Set
- Front
- Back
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list the 8 components of the preop eval.
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1. pt dx/procedure being done
2. hx-cardio, pulm, hepatic/renal, endocrine, neuro 3. prior surgery/anesthetics w/ complications 4. fam hx - looking for MH 5. allergies - allergy or drug intolerance/side effects 6. meds- including herbals/OTCs 7 social 8. NPO status - last oral intake |
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what are the major perioperative cardiac complications?
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1. MI
2. CHF 3. Pulmonary Edema 4. arrythmias |
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which complication occurs frequently in patients with a hx of CAD? when?
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-myocardial ischemia
-post op |
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what are the risk factors for post-op cardiac complications?
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1. hx of CHF
2. hx of CAD 3. advanced age |
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what are the procedures at "high-risk" for post op cardiac complications?
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1. emergency procedures
2. major vascular surgery 3. peripheral vascular surgery 4. prolonged surgical procedures with large fluid shifts and/or blood loss |
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which pulmonary complication may occur during induction of anasthesia, any time during anesthesia or post op?
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bronchospasm- always a concern
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which complications result from bronchospasm?
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inability to ventilate
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what are the major risk factors for developing bronchospasm?
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1. reactive airway disease
2. recent URI 3. prior smoking hx (>20 yrs) |
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what are patients with a hx of obstructive lung disease at risk for?
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hypoxemia
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what are the major pulmonary complication?
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1. atelectasis
2. infection 3. respiratory failure with prolonged mech ventilation |
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what causes pulm. complications?
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1. reduction of lung defense mechanisms
2. alteration in diaphragmatic fxn 3. alterations in lung volumes 4. alterations in gas exchange |
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(T/F) pulmonary function tests are predictive of postoperative morbidity
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False. EXCEPT in lung resectional surgery
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(T/F) A good H & P is the most imp. pre-op pulm eval.
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True
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(T/F) ONLY pts with obstructive lung disease have been shown to be at increased risk post-op
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TRUE. association with restrictive lung disease and pulmonary HTN remains unknown
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what are some significant physical findings?
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1. wheezing (sign of acute airflow obstruction)
2. rhonchi (sign of increased secretions) |
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(T/F) screening chest x-rays are an important screening tool.
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False. they are rarely of benefit in the absence of abnormal H&P findings.
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