Preoperative Care : Review of systems

Preoperative Care : Review of systems 150 150 Tony Guo
  • Review of systems
    • Body systems review
      • Confirms the presence or absence of diseases
      • Alerts to areas to closely examine
      • Provide essential data to determine specific preoperative tests
    • Cardiovascular system
      • Report
        • Any cardiac problems so they can be monitored during the intraoperative period
        • Use of cardiac drugs
        • Presence of pacemaker/ICD
      • 12-lead electrocardiogram (ECG)
      • Coagulation studies
      • Possible prophylactic antibiotics
      • Venous thromboembolism (VTE) prophylaxis
    • Respiratory system
      • Inquire about recent airway infections
        • Procedure could be cancelled because of increased risk of laryngo/bronchospasm or decreased SaO2
      • History of dyspnea, coughing, or hemoptysis reported to operative team
      • COPD or asthma
        • High risk for atelectasis and hypoxemia
      • Smoking history, sleep apnea, obesity, airway deformities
    • Nervous system
      • Evaluation of neurologic functioning
        • Vision or hearing loss can influence results
        • Cognitive deficits can affect informed consent and cause adverse outcomes during and after surgery
    • Genitourinary system
      • Impaired renal function
      • Renal function tests
      • Note problems voiding, and inform operative team
      • Assess women for possibility of pregnancy
    • Hepatic system
      • Liver detoxifies many anesthetics and adjunctive drugs
      • Hepatic dysfunction may increase risk of postoperative complications
    • Integumentary system
      • History of skin and musculoskeletal problems
      • History of pressure ulcers
        • Extra padding during procedure
        • Affects postoperative healing
      • Body art such as tattoos, piercings
    • Musculoskeletal system
      • Identify joints affected with arthritis
      • Mobility restrictions may affect positioning and ambulation
    • Endocrine system
      • Patients with diabetes mellitus
        • Serum or capillary glucose tests morning of surgery (baseline)
        • Clarify with physician or ACP regarding insulin dose
      • Patients with thyroid dysfunction
        • Hyper/hypothyroidism poses surgical risks because of altered metabolic rate
        • Verify with ACP about giving thyroid medications
      • Patients with Addison’s disease
        • Abruptly stopping replacement corticosteroids could cause addisonian crisis
        • Stress of surgery may require increased dose of IV corticosteroids
    • Immune system
      • Patients with history of compromised immune system or use of immunosuppressive drugs can have
        • Delayed wound healing
        • Increased risk for infection

Leave a Reply

Your email address will not be published.