SCIP CORRECT ANSWER--surgical care improvement act
-specific interventions prior to surgery -(pre-screening for MRSA, antibiotics to incision) -not a popular
Pre-operative assessment CORRECT ANSWER--before surgery
-on phone or in office -ask a lot of questions (get an idea of potential problems that could occur) -history, med rec, H&P on the chart, labs, diag.
History CORRECT ANSWER--their current problem -chronic illnesses, allergies
-medications include OTC, herbals -diet -pain, culture, et. -chronic pain? : long term pain meds, will not work
Some issues that may impact the outcome on surgery CORRECT ANSWER--high cholesterol
-HTN
-high blood sugar -airway problems
Physical exam CORRECT ANSWER--baseline head to toe -VS -pain -psychosocial history -alert & orientated X3? -martial partner?
Labs & Diagnostic Exams CORRECT ANSWER--electrolytes, glucose, BUN -CPK & liver -protein & albumin
-PT, platelets -disease specific Xray -they do not need all these lab, only ones that are specific to surgery
Nutrition CORRECT ANSWER--protein & albumin levels -can they repair properly? are they malnourished?
Infection CORRECT ANSWER--MRSA screenings, keeping them clean before and after surgery
Heme CORRECT ANSWER--are they already anemic? -most are after surgery
-need to be aware of how much they loose
Education CORRECT ANSWER--did they get adequate education? -classes, deep breathing, getting them up Pain CORRECT ANSWER--sometimes we will get them to a 0 but we need to find out what is tolerable for the patient, what are they comfortable with?
Risk vs. Benefit CORRECT ANSWER--is this surgery worth it? -do the benefits outweigh the risks
Anesthetic risk CORRECT ANSWER--how do they react to anesthesia? -cardiac patients: spinal anesthesia instead
American Society of Anesthesia CORRECT ANSWER--scored I through V -higher the score the higher the risk -cardiac anesthesia risk evaluation -cardiac disease stable/unstable -how may medical conditions? -emergency or non emergency
Immediate Pre-op Care CORRECT ANSWER--consent -lab work and diagnostics -skin preparation -GI tract -patient education -assess for anxiety -surgical site (void, VS, meds)
Components of Pre-op teaching CORRECT ANSWER--timing (not the day of)