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NRNP 6560 Midterm Exam

HEAL100 Health Care — exam and revision material · Other

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Health Care study guide material, 62 pages. Originally published on StudyMerit.

Pages
62
Academic year
2025/2026
Language
English

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NRNP 6560 MIDTERM EXAM Surgery risk classes - Class 1: benefits outweigh risk, should be done Class 2a: reasonable to perform Class 2b: should be considered Class 3: rarely appropriate General rules for surgery: testing - ECG before surgery only if coronary disease, except when low risk surgery Stress test not indicated before surgery Do not do prophylactic coronary revascularization Meds before surgery - Diabetic agents: Use insulin therapy to maintain glycemic goals(iii) Discontinue biguanides, alpha glucosidase inhibitors, thiazolidinediones, sulfonylureas, and GLP - 1 agonists - Do not start aspirin before surgery - Stop Warfarin 5 days before surgery. May be bridged with Lovenox. - Do not stop statin before surgery - Do not start beta - blocker on day of surgery, but may continue Assessment of surgical risk - Unstable cardiac condition (recent MI, active angina, active HF, uncontrolled HTN, severe valvular disease), concern with CAD, CHF. arrhythmia, CVD - patient stable or unstable? - urgency of the procedure (oncology will be time sensitive) - risk of procedure - nutritional status - immune competence - determine functional capacity (need to be more than 4 METS, more than 10 METs makes low risk)

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Low risk surgeries - catarcts breast biopsy cystoscopy, vasectomy laporascopic procedures Plastic surgery Intermediate risk surgeries - Head/ neck surgery thyroidectomy Intraperitoneal Prostate Laminectomy Hip/ knee Hysterectomy cholecystectomy nephrectomy non majot intrathoracic High risk surgeries - aortic/ cabg transplants spinal reconstruction peripheral vascular surgery Lee's revised cardiac risk index - 6 points: High risk surgery = 1 CAD = 1 CHF = 1 Cerebrovascular disease = 1 DM 1 on insulin = 1 Creat greater than 2 = 1

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1 = low risk 2 = moderate risk 3 = high risk SCIP pre - operative infection measures - Prophylactic antibiotics should be received within 1 h prior to surgical incision - be selected for activity against the most probable antimicrobial contaminants - be discontinued within 24 h after the surgery end - time Postoperative infection reduction methods - pre - op hair removal (clippers) - wash hands - normothermia - maintain euglycemia - urinary catheters are to be removed within the first two postoperative days Osteoarthritis: what, incidence - Slow destruction of bones/ joint followed by production of replacement collagen which causes inflammatory changes - older than 60 - more female after 55 - more black than white women - men and women equal risk between 45 - 55 - abnormal height or weight (obesity) - repetitive movement - prior trauma (sprains/ dislocations) - diabetic neuropathy - genetic Osteoarthritis findings and diagnostics - Pain in weight bearing joints - stiffness after sitting, gets better when arising

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