MED SURG FINAL EXAM 1

Preoperative Care a. Surgical Risk Factors, Current Medications, Data to Obtain in Health History, & Physical/Psychosocial Assessment i. Health History: Past surgical history and reactions, medications the patient is taking. RED FLAG medications include: Anticoagulants: Coumadin, Warfarin, Plavix, Aspirin, Heparin, Herbal Medications that can thin your blood, and corticosteroids because they delay wound healing. ii. Psychosocial Assessment: You want your patient to feel as good as possible. It is a fact supported by evidence that patients that enter surgery with poorer attitudes experience poorer outcomes. iii. Cultural/Spiritual Assessment: “Is there anything about your cultural or spiritual background that I should know that could affect your surgery and care?” iv. Physical Assessment: This will give us a baseline of information with which to compare during and after surgery. v. Labs: Hgb & Hct (H & H), platelets, PTT, aPTT, PT/INR, Blood Type & Cross, BUN, and CR. vi. Diagnostic Tests b. Pre-operative Care i. What medications are commonly used pre-op and why? 1. To reduce anxiety, pain, and the amount of anesthesia needed, i.e. sedatives: atarax/vistaril (hydroxyzine), hypnotics: Ativan (lorazepam), anxiolytics: versed(midazolam), analgesics: morphine, Demerol (merperidine), fentanyl, dilaudid (hydromorphone)