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Questions and Answers
What is one significant aim of the pre-operative assessment?
Which of the following is NOT a complication that can arise from anesthesia?
What is a common risk during the induction phase of anesthesia?
Which of the following are important factors in evaluating a patient's cardiovascular system?
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What does the airway inspection primarily assess?
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Which intervention may lead to hypertensive episodes during anesthesia?
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What is an important part of the physical examination before surgery?
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Which laboratory test is significant for assessing renal function before surgery?
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Study Notes
Aim of Evaluation
- Anesthesia and surgery can worsen existing conditions or reveal new ones.
- Pre-operative evaluation helps minimize risks for the patient.
Risks of Anesthesia
- Airway: Difficulty establishing a secure airway can impair oxygenation and ventilation.
- Induction: Induction agents can cause hypotension, while laryngoscopy and intubation can lead to hypertension
- Blood administration: Potential complications of blood transfusions.
- Maintenance: Fluctuations in stimulation levels and blood loss during surgery.
- Emergence: Hypothermia, hypoglycemia, bronchospasm, and allergic reactions to medications can occur.
- Positioning: Nerve damage from prolonged positioning.
Pre-operative Evaluation
- History of Present Illness: Determine if the patient is fasting or not and if there are any current medical issues.
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Past Medical History: Document past medical conditions such as:
- IDH (Idiopathic Dilated Cardiomyopathy)
- HT (Hypertension)
- DM (Diabetes Mellitus)
- Thyroid Disorders
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Drug History: Identify medications taken such as:
- Aspirin
- Plavix
- Levothyroxine
- Hypertension and Diabetes Medications
- Past Surgical History (PSH): Identify previous surgeries.
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Vital Signs:
- Blood Pressure
- Pulse Rate
- SpO2 (Oxygen Saturation)
Common Anesthesia Problems
- Malignant Hyperthermia: A rare but potentially life-threatening reaction to certain anesthetic agents.
- Post-operative Nausea and Vomiting (PONV): A common complication.
- Difficulty with Intubation: A letter from the anesthesiologist may be required if intubation is anticipated to be challenging.
- Allergies: Identify allergies, especially to antibiotics and latex.
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Smoking:
- Pack Years: Determine the number of packs smoked per day and for how long.
- Quitting Smoking: If the patient has quit smoking, document the duration of abstinence.
Physical Examination
- Airway Examination: Assess the airway for potential problems.
- Lungs: Evaluate lung function through auscultation.
- Neurological Examination: Assess neurological function.
Laboratory Tests
- Complete Blood Count (CBC): Measure hemoglobin (HB) and platelet count.
- Renal Function Tests: Evaluate kidney function.
- Serum Electrolytes: Measure electrolytes, including sodium, potassium, chloride, and bicarbonate.
- Virology Testing: May be performed if indicated.
Imaging
- Chest X-ray: Can detect chest infections and cardiomegaly.
Cardiac Evaluation
- Electrocardiogram (ECG): Assess heart rhythm and electrical activity.
- Echocardiogram (ECHO): Visualize the heart's structure and function.
Important Questions for Cardiovascular System
- Smoking History: Evaluate smoking history as it impacts cardiovascular health.
- Hypertension: Assess if there is any history of hypertension.
- Age: Consider the patient's age as cardiovascular risk increases with age.
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Description
Test your knowledge on the risks associated with anesthesia and the importance of pre-operative evaluation. Explore various complications that may arise during different stages of surgery, as well as crucial patient history factors that influence surgical outcomes. This quiz will help you understand how to minimize risks effectively.
