Intro to Surgical Care Quiz

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Questions and Answers

What does the 'E' in AMPLE history represent?

Emergent procedures performed previously

Events leading to the current condition (correct)

Emergency contact information

Examination findings of the patient

Which of the following formulas is used to calculate the maintenance fluid requirements using the Holliday-Segar Method for a 70 kg patient?

100 ml + 50 ml + 40 ml

500 ml + 200 ml + 100 ml

100 ml/kg + 50 ml/kg + 20 ml/kg

1000 ml + 500 ml + 200 ml (correct)

In the context of fluid resuscitation, what is the initial bolus volume for a 70 kg patient showing signs of severe dehydration?

1000 ml

1400 ml (correct)

500 ml

2000 ml

What is the main purpose of collecting an AMPLE history in an urgent situation?

To gather critical information quickly. Signup and view all the answers

Which vital sign would indicate a significant concern in a patient presenting with acute dehydration?

Increased heart rate Signup and view all the answers

How is fever taken into account when calculating fluid requirements?

Add 2.5 ml/kg/day for each degree C above 37.5 oral. Signup and view all the answers

What is a crucial step after administering the initial fluid bolus to a patient?

Continue monitoring vital signs and urine output. Signup and view all the answers

What does the abbreviation 'BUN' stand for in the context of laboratory assessments?

Blood Urea Nitrogen Signup and view all the answers

Which type of solution is recommended for the initial fluid bolus in a hypotensive patient?

Isotonic crystalloid solution Signup and view all the answers

What is one of the key components of the Universal Protocol aimed at preventing medical errors in surgery?

Preoperative verification process Signup and view all the answers

Which technology can be utilized to track surgical instruments and reduce the risk of retained items?

Radio-frequency identification (RFID) tags Signup and view all the answers

What potential error can occur due to confusion related to medication during surgery?

Administering the wrong medication or dosage Signup and view all the answers

Which strategy is essential for preventing surgical site infections (SSIs)?

Aseptic techniques adherence Signup and view all the answers

What method should be used to verify the correct dosage and type of anesthesia during surgery?

Protocols and checklists Signup and view all the answers

Which of the following is a key mitigation strategy for preventing pressure ulcers in patients during surgery?

Regular repositioning of patients Signup and view all the answers

What specific patient assessment is crucial to prevent postoperative falls?

Fall risk assessment tools Signup and view all the answers

Which part of a Comprehensive History and Physical (H&P) provides insights into current health issues of the patient?

History of Present Illness (HPI) Signup and view all the answers

What is an effective strategy to ensure proper labeling of medications during surgical procedures?

Utilization of computerized systems Signup and view all the answers

Which of the following factors can lead to inadequate preoperative verification?

Miscommunication among surgical team members Signup and view all the answers

Which of the following is NOT a key role of the Physician Assistant in the surgical environment?

Optimization of anesthesia Signup and view all the answers

What is the primary purpose of a Mayo stand in surgery?

To hold instruments and supplies needed during surgery Signup and view all the answers

Which surgical term indicates the procedure of removing the gallbladder?

Cholecystectomy Signup and view all the answers

Which scenario represents a 'never event' in the surgical setting?

A patient undergoing surgery on the incorrect limb Signup and view all the answers

What is the significance of maintaining a sterile field during surgery?

To prevent infection and maintain patient safety Signup and view all the answers

Which of the following personnel is typically responsible for post-anesthesia care?

Postanesthesia Care Unit nurse Signup and view all the answers

What does the suffix '-otomy' signify in surgical terminology?

Creation of an opening Signup and view all the answers

In the context of surgical risk mitigation, what is meant by 'homeostasis'?

Maintaining stable internal conditions in the patient Signup and view all the answers

Which fluid is preferred for initial fluid resuscitation?

Lactated Ringer’s (LR) Signup and view all the answers

Which type of procedure is classified as higher risk?

Major thoracic procedures Signup and view all the answers

What is the primary focus of pre-op screening for intermediate and high-risk procedures?

Cardiopulmonary evaluation Signup and view all the answers

Which patient characteristic would likely necessitate additional screening before elective surgery?

Patients with a history of malignant hyperthermia Signup and view all the answers

Which lab test is commonly required for women of child-bearing age before elective surgery?

Pregnancy test Signup and view all the answers

Which of the following is NOT a typical indicator for requiring detailed screening for peri-op complications?

Normal EKG readings Signup and view all the answers

Which fluid type is utilized primarily for maintenance rather than initial resuscitation?

Dextrose 5% in water (D5W) Signup and view all the answers

Which risk category does a carotid procedure fall into?

Intermediate Risk Signup and view all the answers

Which factor is NOT a minor predictor of complications during surgery?

History of major abdominal surgery Signup and view all the answers

Which of these fluids is considered less commonly used in initial resuscitation?

Albumin Signup and view all the answers

Study Notes

Surgical Care Overview

Pre-operative activities focus on optimization, safety, risk mitigation, informed consent, patient/family education, and care coordination.
Intra-operative procedures prioritize safety and risk mitigation, including intubation and extubation.
Post-operative care emphasizes safety, homeostasis, and vital monitoring including airway management.

Key Surgical Equipment

MAYO stand, surgical light, back table, operating table, anesthesia cart, BOVIE (electrocautery) essential for procedures.
Maintenance of a sterile surgical field involves using sterile drapes, towels, and eye protection.

Key Personnel in Surgical Care

Attending surgeon, fellows, residents (5th year chief, junior), interns, students crucial for surgical teams.
Anesthesia team includes anesthesiologist, CRNA, anesthesiologist assistants.
Operating room staff: circulating RN, scrub RN/first assist, certified surgical tech, operating room director, recovery room nurse.

Role of the PA

Pre-operative: handles risk mitigation, optimization, informed consent, patient education, documentation, and care coordination.
Intra-operative: assists in safety and optimization, acts as first assist, may participate in closure.
Post-operative: manages risk mitigation, post-op orders, documentation, education, wound care, care coordination.

Surgical Terminology

Terms provide insight into procedures:
- CHOLE: gallbladder
- MAST: tumor removal
- THORO: thorax
- PLEURO: lung
- SPLEN: spleen
- NEPH: kidney
- LAPARO: abdominal
- ENDO: esophagus
Suffixes indicate procedure types:
- -ECTOMY: surgical removal
- -OTOMY: creating an opening
- -OSCOPY: using a scope
- -CENTESIS: draining fluid
- -PEXY: fixating
- -PLASTY: repairing or reorganizing
- -STOMY: opening with a pouch.

Never Events in Surgery

Defined as serious, preventable adverse events that should never occur:
- Wrong site, patient, or procedure surgeries.
- Retained instruments or foreign bodies.
- Death of a previously healthy patient post-operatively.
Mitigation strategies include implementing Universal Protocol, strict counting protocols, and robust communication methods.

Fluid Resuscitation

Maintenance fluid requirements calculated using the Holliday-Segar method.
Initial bolus of isotonic solutions is crucial for severe dehydration cases.
Continuous monitoring and adjustments based on vital signs and urine output are essential for patient safety.

Preoperative Testing and Evaluation

Lower Risk Procedures: Require thorough medical histories; routine testing often unnecessary.
Intermediate and High Risk Procedures: Require additional screening focused mainly on cardiopulmonary health.
Key considerations include history of cardiopulmonary disease, significant medical history, anesthetic history, and potential drug interactions.

Identifying Additional Tests

Elective surgical candidates may require further assessments based on their health, especially those exhibiting risk factors including advanced age and abnormal EKG patterns.
Pre-operative testing typically includes a resting 12-lead EKG for specific demographics and conditions, with lab tests tailored to the patient's background.

Summary of Patient Preparation

Optimal outcomes in elective surgeries depend on assessing patient health and mitigating risks associated with surgical stress.
Continuous assessment of the patient's condition before surgery can lead to improved recovery and surgical efficiency.

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Description

Test your knowledge on key equipment, personnel, and activities associated with surgical care. This quiz covers the critical aspects of pre-operative, intra-operative, and post-operative settings, focusing on safety and risk mitigation. Perfect for students in healthcare fields.