UC Adv Health Assessment - Quiz 1 questions and answers

Define Prejudice Opinion formed beforehand: a preformed opinion, usually an unfavorable one, based on insufficient knowledge, irrational feelings, or inaccurate stereotypes Components of a Patient Interview (1) Medical/Surgical/Anesthetic Hx including familial anesthetic reactions (2) Drug/Medication Hx (3) Drug Allergies (4) Latex Sensitivity (5) Social Hx - tobacco, alcohol, illicit drugs, synthetic androgens, herbal supplements 0:00 / 0:15 What component of the patient interview increased patient compliance? Showing respect Considerations for patients taking ACE inhibitors, Beta-blockers & Calcium Channel Blockers (1) Optimize hydration (2) Continue morning of surgery Considerations for patients taking diuretics (1) Monitor pre-op K+ levels (2) Monitor hydration (3) May need foley catheter (4) May discontinue day of surgery except for CHF & CRF patients When to stop drugs affecting hemostasis (1) NSAIDS: stop 1-2 days prior (2) Aspirin 8-12 days prior (3) Plavix: 8-12 days prior Considerations for patients taking hypoglycemic agents (1) Monitor serum glucose (2) Either withhold or decrease dose on day of surgery Drugs affecting CNS (1) MAOIs (2) tricyclic antidepressants (3) SSRI (4) Lithium (5) Antiparkinsonian agents What drug should be avoided in concurrent use with MAOIs? Demerol Consideration for patients on steroid therapy (including inhalers and nasal sprays) (1) May have adrenal insufficiency (2) Continue steroids day of surgery (3) May need "stress dose" of corticosteroids during surgery to prevent vascular collapse A steroid dose greater than ____ daily would indicate that an intraoperative stress dose would be needed 5 mg All of the following statements regarding ASA classification are true except: A.) Often results in misclassification, over classification, or improper classification B.) Provides consistent communication about the physical status of the patient C.) Represents an estimate of anesthesia risk D.) Classifies the physical condition of a patient requiring anesthesia and surgery C. Represents an estimate of anesthesia risk Define ASA Class 1 No organic, physiologic, biochemical, or psychiatric disturbance Examples of ASA Class 1 Healthy patient or otherwise healthy pregnant patent for labor epidural Define ASA Class 2 Mild to moderate systemic disturbance Examples of ASA Class 2 Heart disease that slightly limits physical activity, essential HTN, DM, chronic bronchitis, anemia, morbid obesity (>40), age extremes (<1 yr or >70 years), smokers Define ASA Class 3 Severe systemic disturbance that limits activity Examples of ASA Class 3 Chronic heart or pulmonary dx that limits activity, Poorly controlled HTN, DM with vascular complications, angina pectoris, Hx of previous MI Define ASA Class 4 Severe systemic disturbance that is life threatening Examples of ASA Class 4 CHF, persistent angina, advanced pulmonary, renal dysfunction (ESRD on dialysis), hepatic dysfunction, hemorrhagic stroke 24 hours ago Define ASA Class 5 Moribund patient undergoing surgery as a resuscitative effort, despite minimal chance for survival Examples of ASA Class 5 Uncontrolled hemorrhage from a ruptured AAA ASA 6 Classification Either postmortem patients undergoing organ procurement or alive patient deemed brain dead who are donating organs