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Preop Care
| Question | Answer |
|---|---|
| a condition that includes DVT & pulmonary embolism; a concern for any surgical patient | postoperative venous thromboembolism (VTE) |
| patients at HIGH risk for VTE include those with a history of | blood-clotting disorders, cancer, obesity, smoking, variscosities, HF, or COPD |
| Echinacea | may cause inflammation of the liver |
| herbs that may increase bleeding (perioperative) | garlic, ginger, ginkgo biloba, ginseng |
| ginseng | may cause increased heart rate, or elevated BP |
| goldenseal | may cause increased BP; may increase swelling |
| kava kava (kava) | may prolong effects of certain anesthetics or antiseizure medications; may cause liver injury |
| licorice | may cause elevated BP, swelling, or electrolyte imbalance |
| saw palmetto | additive effects with other hormone therapies |
| st. john's wort | may prolong the effects of anesthetic agents |
| vitamin E | may increase bleeding; may effect thyroid function; in high doses may increase BP in patients already contraindicated with high BP |
| tranquilizers | may potentiate the effect of opioids and barbituates, which are agents that can be used for anesthesia |
| antihypertensives | may predispose the patient to shock from the combined effect of the drug and the vasodilator effect of some anesthetics |
| insulin or oral hypoglycemics | may require dose or agent adjustments due to increased body metabolism, decreased caloric intake, stress, and anesthesia |
| medications that inhibit platelet aggregation | NSAIDS, aspirin, clopidogrel (Plavix) |
| three types of preop teaching | sensory, process (general overview), & procedural (detailed explanation) |
| common perioperative complications for diabetics | hypo- & hyperglycemia, ketosis, CV alterations, delayed wound healing, infection, high risk for anesthesia adverse effects |
| serum or capillary glucose tests for diabetics should be completed | the morning of surgery to determine baseline levels; meds will be administerd or witheld according to test results |
| patient with hepatic dysfunction | may have increased perioperative risk for clotting abnormalities and adverse responses to medications |
| the liver is involved in | glucose homeostasis, fat metabolism, protein synthesis, drug & hormone metabolism, bilirubin formation & excretion |
| respiratory adversities to report to the ACP and/or surgeon are | history of dyspnea at rest or with exertion; coughing (dry or productive); hemoptysis |
| a preop upper airway infection may result in cancellation or postponement of the surgery or procedure because of | increase risk of bronchospasm, laryngospasm, decreased O2 saturation, & problems with respiratory secretions |
| preop neurologic assessment of the older adult is crucial in intraop and postop evaluation because | they are more prone to adverse effects of the additional stressors of the surgical procedure, dehydration, hypothermia, & anesthesia |
| common fears to be assessed and addressed | death, pain & discomfort, anesthesia, mutilation or body image alteration, & disruption of life functioning or patterns |
| anxiety | normal and inherent survival mechanism; if level is too high, cognition, decision making, and coping abilities diminish |
| a lack of knowledge can create and/or raise | anxiety and fear; important that patient's concerns and needs are addressed |
Created by:
ashanti20
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