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Preop Care

QuestionAnswer
a condition that includes DVT & pulmonary embolism; a concern for any surgical patient postoperative venous thromboembolism (VTE)
patients at HIGH risk for VTE include those with a history of blood-clotting disorders, cancer, obesity, smoking, variscosities, HF, or COPD
Echinacea may cause inflammation of the liver
herbs that may increase bleeding (perioperative) garlic, ginger, ginkgo biloba, ginseng
ginseng may cause increased heart rate, or elevated BP
goldenseal may cause increased BP; may increase swelling
kava kava (kava) may prolong effects of certain anesthetics or antiseizure medications; may cause liver injury
licorice may cause elevated BP, swelling, or electrolyte imbalance
saw palmetto additive effects with other hormone therapies
st. john's wort may prolong the effects of anesthetic agents
vitamin E may increase bleeding; may effect thyroid function; in high doses may increase BP in patients already contraindicated with high BP
tranquilizers may potentiate the effect of opioids and barbituates, which are agents that can be used for anesthesia
antihypertensives may predispose the patient to shock from the combined effect of the drug and the vasodilator effect of some anesthetics
insulin or oral hypoglycemics may require dose or agent adjustments due to increased body metabolism, decreased caloric intake, stress, and anesthesia
medications that inhibit platelet aggregation NSAIDS, aspirin, clopidogrel (Plavix)
three types of preop teaching sensory, process (general overview), & procedural (detailed explanation)
common perioperative complications for diabetics hypo- & hyperglycemia, ketosis, CV alterations, delayed wound healing, infection, high risk for anesthesia adverse effects
serum or capillary glucose tests for diabetics should be completed the morning of surgery to determine baseline levels; meds will be administerd or witheld according to test results
patient with hepatic dysfunction may have increased perioperative risk for clotting abnormalities and adverse responses to medications
the liver is involved in glucose homeostasis, fat metabolism, protein synthesis, drug & hormone metabolism, bilirubin formation & excretion
respiratory adversities to report to the ACP and/or surgeon are history of dyspnea at rest or with exertion; coughing (dry or productive); hemoptysis
a preop upper airway infection may result in cancellation or postponement of the surgery or procedure because of increase risk of bronchospasm, laryngospasm, decreased O2 saturation, & problems with respiratory secretions
preop neurologic assessment of the older adult is crucial in intraop and postop evaluation because they are more prone to adverse effects of the additional stressors of the surgical procedure, dehydration, hypothermia, & anesthesia
common fears to be assessed and addressed death, pain & discomfort, anesthesia, mutilation or body image alteration, & disruption of life functioning or patterns
anxiety normal and inherent survival mechanism; if level is too high, cognition, decision making, and coping abilities diminish
a lack of knowledge can create and/or raise anxiety and fear; important that patient's concerns and needs are addressed
Created by: ashanti20
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