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DAANCE: Module II
DAANCE: Module II Evaluation & Prep of Patients w/ Systemic Diseases
| Question | Answer |
|---|---|
| What is HIPAA? | Health Insurance Portability and Accountability Act |
| What are some of the key questions for a patient when taking in a new patient? | Currently under physician care? Taking any medications or have taken any in past? Any allergies? |
| What does NPO stand for? | Latin "nil per os" or "nothing by mouth" |
| OMS offices will work with ASA anesthesia risk classes: | I, II, and sometimes III |
| What is ASA risk class I? | The patient has no organic, physiologic, biochemical, or psychiatric disturbance. The operation to be performed does not entail a systemic disturbance |
| What is ASA risk class II? | The patient has mild to moderate systemic disturbance caused by either the condition to be treated surgically or by other pathophysiologic processes. Included in this class are smokers. |
| What is ASA risk class III? | The patient has severe systemic disturbance or disease from whatever cause, even though it may not be possible to define the degree of disability. Usually treated in outpatient surgery center or hospital setting |
| What is ASA risk class IV? | The patient has a severe life-threatening systemic disorder not always improvable |
| What is ASA risk class V? | The patient is moribund with little change of surviving and the operation is performed out of despiration |
| What is the #1 cause of death in the US? | Cardiovascular disease |
| What is angina pectoris? | "Pain in chest" |
| What kind of medications help reduce cholesterol and prevent fatty plaque build-up? | "Statins" like atorvastatin (Lipitor) |
| What kind of medications are used for to help prevent the formation of blood clots? | Aspirin and antiplatelet therapy like clopidogrel (Plavix) |
| What kind of medications help reduce the effects of excessive andrenergic stimulation on the heart? | Beta blockers like metoprolol (Lopressor) |
| How many months must a patient wait for an elective surgery following a MI? | 6 months |
| What is Rheumatic Heart Disease? | A condition where the heart has been damaged secondary to Rheumatic Fever (systemic bacterial infection), heart valves are damaged (most commonly the mitral valve) |
| What is a Mitral Valve Prolapse (MVP)? | Upward prolapse motion of mitral valve into the left atrium. Can be hereditary |
| What is antibiotic prophylaxis? | The use of antibiotics to prevent infection taken before or during procedure |
| Who are the highest risk patients recommended for prophylaxis? | Prosthetic heart valve, history of endocarditis, heart transplant, and certain congenital heart defect patients |
| What is systolic pressure? | Pressure in the arteries when the heart is contracting |
| What is diastolic pressure? | Pressure in the arteries when the heart is at rest or filling up to get ready to contract |
| What kind of medications help control the rate and force of heart contraction in a hypertensive patient? | Beta blockers like Bystolic, propranolol, atenolol, and metropolol |
| What kind of medications help vasodilation in a hypertensive patient? | Amlodipine (Norvasc), diltiazem, hydralazine, lisinopril, and valsartan |
| What kind of diuretic medications help reduce intravascular volume to reduce BP in a hypertensive patient? | Hydrochlorothiazide (HCTZ) and furosemide (Lasix) |
| What heart condition is caused by the heart's inability to handle the blood volume coming back to it either from the lungs or from peripheral circulation? | Congestive Heart Failure (CHF) |
| What is left-sided heart failure? | The heart fails to pump blood back from left side to circulation causing blood to back up into lung tissue |
| What is right-sided heart failure? | The heart fails to pump blood to lungs efficiently causing blood to back up in the peripheral circulation. Fluid leaks into body causing peripheral edema |
| What represents the P wave? | Contraction of atria |
| What represents the QRS complex? | Contraction of the ventricles |
| What represents the T wave? | Ventricular muscle ready for a new contraction |
| What is a sinus arrhythmia? | Similar to normal sinus rhythm except for change in heart rate in each respiratory cycle. Usually normal finding |
| What is sinus bradycardia? | Heart rate of less than 60 BPM. Normal finding in athletes |
| What is sinus tachycardia? | Heart rate of greater than 100 BPM. Frequently seen with anxiety or pain |
| What is premature atrial contraction (PAC)? | A foreshortened beat containing a "compensatory pause" which compensates for the short beat. Usually a reaction to stress or ingestion of stimulating chemicals (caffeine) |
| What is supraventricular tachycardia? | Heart rate of 150-250 BPM, caused by emotional stress, anxiety, COPD, and ingestion of caffeine, alcohol, or nicotine. |
| What is atrial fibrillation (A. fib.)? | An irregular ventricular rate. Can be seen in patients who have ingested caffeine or alcohol, are hypertensive, have valvular disease, coronary artery disease, or heart failure |
| What is atrial flutter? | Has a slower ventricular rate. May be caused by valvular hear disease, acute MI, hypertension, CHF, or pulmonary disease |
| What are junctional rhythms? | Ectopic pacemaker located near the junction between the atria and ventricles |
| What is premature ventricular contraction (PVC)? | Ectopic focus in ventricles fires prematurely before the normal impulse through SA node and atria. |
| What is ventricular tachycardia (V. tach.)? | Wide, blunt, rapid waveform. Can only support life for a short time and occurs with underlying for of heart disease (a form of cardiac arrest) |
| What is ventricular fibrillation (V. fib.)? | A cardiac arrest rhythm, no pumping of blood and often precedes asystole |
| What is asystole? | Ventricular asystole or cessation of all contractions frequently following V. tach. or V. fib. Referred to as "flat line" |
| Normal appearing tracing such as sinus bradycardia but no pulse, representing cessation of all contractions, and similar to asystole: | Pulseless Electrical Activity (PEA) |
| The three essential characteristics when identifying abnormal rhythms: | Rhythm, rate, and regularity |
| Who should be contacted when trying to schedule surgery for a patient who is taking Coumadin or has a pacemaker? | Cardiologist or prescribing physician |
| What kind of medication(s) do post-heart surgery patients typically take? | Anticoagulants and sometimes prophylactic antibiotics |
| What are atrioventricular blocks (AV Blocks) associated with? | Usually slow rates, missed beats, or both |
| What are some symptoms of asthma? | Wheezing (more pronounced during expiration than inspiration), breathlessness, chest tightness, and cough |
| What are some medications taken orally or inhaled to treat respiratory disorders? | Qvar, Flovent, Serevent, Singulair, zafirlukast, cromolyn |
| What does COPD stand for? | Chronic obstructive pulmonary disease |
| What are two components of COPD? | Chronic bronchitis and emphysema |
| Breathlessness or difficulty in breathing with puffing is known as: | Dyspnea |
| How long should a patient wait before having surgical procedure under general anesthesia if experiencing an upper respiratory infection (URI)? | 2-3 weeks |
| What are some symptoms of acute bronchitis and pneumonia? | Fever, cough, dyspnea, chest discomfort, and sweats |
| What are some symptoms of diabetes? | Frequent urination, excessive thirst and hunger, and recent weight change. Also episodes of sweating, mental confusion, and fruity odor in breath in poorly controlled cases |
| Type I diabetes is taken place in which age group? | In children or young adults |
| Type II diabetes is taken place in which age group? | Adults |
| What medications are taken orally or administered IM to treat diabetes? | Glyburide, glipizide, repaglinide, Actos, Avandia, Metformin, Lantus, Humalog |
| What term is used for elevated level of blood glucose? | Hyperglycemia |
| What term is used for abnormally low blood glucose levels? | Hypoglycemia |
| What does a hemoglobin A1c lab test determine? | The average blood glucose level over a span of 1-3 months |
| What hormones are responsible for the "fight or flight" response? | Epinephrine and norepinephrine |
| What blood glucose level is desired when a patient is fasting? | Less than 125mg/dL |
| What is a normal range for a hemoglobin A1c lab test? | 6-7, indicating 125mg/dL range |
| What are some symptoms of hypoglycemia? | Sweating, nervousness, irritability, tremor, confusion, and hunger |
| Excessive secretion of corticosteroid due to administration of high doses of corticosteroid drugs is what disease? | Cushing's Disease |
| Inadequate secretions of cortisol and can be life-threatening is what disease? | Addison's Disease |
| Adrenocorticol insufficiency can be artificially induced by receiving what prior to a procedure? | A "steroid prep" like prednisone or hydrocortisone |
| What are some symptoms of hypothyroidism? | Lethargy, cold intolerance, weight gain, slow pulse, muscle weakness, and coarse dry skin. |
| Chronic long-termed hypothyroidism is termed: | Myxedema |
| Symptoms such as tremors, nervousness, insomnia, weight loss, and heat intolerance decribe: | Grave's Disease |
| During general anesthesia and surgery, what are some signs of a patient experiencing a "thyroid crisis?" | Elevated heart rate and BP, increased metabolic demand, increased utilization in oxygen, and increase in rate and depth of respiration |
| How many types of hepatitis exist? | 6 types |
| Hepatitis A is contracted by: | Contaminated food or water (fecal-oral route) |
| Hepatitis B is contracted by: | Sexual or IV transmission |
| Hepatitis C is contracted by: | Exposure of infected needle (sharing needles) |
| Yellowish discoloration of sclera, oral mucosa, and skin is: | Jaundace |
| What is an International Normalized Ratio (INR) test? | Test for blood clotting time |
| What kind of medications can renal failure patients not take? | Ibuprofen and other NSAIDs |
| What are some of the most common causes for chronic renal failure? | Diabetes, hypertension, and glomerulonephritis (an inflammatory condition of the kidney) |
| Hemodialysis patients typically take which kind of medications? | Anticoagulants like heparin and possibly prophylactic antibiotics |
| When should dialysis patients be scheduled for surgery? | On an "off" dialysis day without taking heparin |
| What is the purpose of dialysis? | To help remove waste and maintain reasonable body fluid functions of kidneys |
| What are the 3 phases of a generalized tonic-clonic (grand mal) seizure? | Prodromal phase, ictal tonic-clonic phase, and post-ictal phase |
| When seizure activity is longer than 5 minutes, what is it classified as? | Grand mal status ("Status Epileptus") |
| Petit mal seizures are also known as: | Absence seizures |
| What causes a cerebrovascular accident (CVA) (also known as stroke)? | A disruption of blood supply to a region of the brain |
| A transient ischemic attack (TIA) is also known as: | A "mini stroke" |
| What are the two types of strokes? | Ischemic and hemorrhagic |
| Hemorrhagic strokes are caused by: | A ruptured artery or aneurysm |
| What are some underlying medical conditions that could cause a stroke? | Hypertension, congenital heart disease, diabetes, and dysryhthmias |
| How many days prior would a TIA/past stroke patient need to hold taking Coumadin before a surgical procedure? | 2-3 days, unless prescribing physician says otherwise |
| When is the best time during a patient's pregnancy to perform surgery when necessary? | During 2nd trimester, but consult patient's OB first |
| During which trimester is the patient's fetus at more risk during a surgical procedure including anesthesia? | 1st trimester |
| What is GERD? | Gastroesophageal reflux disease |
| What are some anticoagulant medications? | Warfarin (Coumadin), dibigatran (Pradaxa), clopidogrel (Plavix), ticlopidine (Ticlid), Eliquis, Xarelto, and Aspirin |
| What are the 3 basic stages of hemostasis? | Formation of platelet plug, vascular spasms, and establishment of definitive clot |
| The platelet plug has this characteristic: | Sticky |
| What are some common characteristics when identifying a drug abuser? | Slurred speech, appear sedated (nodding), pinpoint pupils (miosis), and fresh injection sights (especially on non-dominant side) |
| A chronic, multi-system inflammatory disorder with an unknown cause, and affects women predominantly than men, is known as: | Rheumatoid Arthritis |
Created by:
K_Wheeler94
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