*NURSING > STUDY GUIDE > NRNP 6560 Week 1 to 6 Key Concepts (Week 1 to 5 covered on midterm exam) Study Guide Latest 2023 (All)

NRNP 6560 Week 1 to 6 Key Concepts (Week 1 to 5 covered on midterm exam) Study Guide Latest 2023

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NRNP 6560 Week 1 to 6 Key Concepts (Week 1 to 5 covered on midterm exam) Study Guide Latest 2023 Week 1 1. Discuss recommended preoperative testing based on patient age and co-morbid conditions �... � The decision to perform preoperative testing should be based on the history and physical examination findings, perioperative risk assessment, and clinical judgment.  A preoperative complete blood count is indicated for patients at risk of anemia based on their history and physical examination findings, and those in whom significant perioperative blood loss is anticipated.  Preoperative random glucose or A1C measurement should be considered if an abnormal result would change the perioperative management.  Preoperative coagulation testing should be reserved for patients who are taking anticoagulants, who have a history of bleeding, or who have medical conditions that predispose them to coagulopathy (e.g., liver disease).  Patients in their usual state of health who are undergoing cataract surgery do not require preoperative testing 2. Describe the management of common medications in the preoperative period. (antihypertensives, anti-coagulants, and diabetic management agents) Anti-hypertensives  alpha blockade, followed by the addition of CCB or beta-blockers as needed to control BP.  should be less than 160 mm Hg before surgery  Patients should increase fluid and salt intake orally with time. Anticoagulants  Discontinue warfarin 5 days before surgery  Three days before surgery, start subcutaneous LMWH or unfractionated heparin (UFH), depending on the renal function of the patient at therapeutic doses.  Two days before surgery assess INR, if greater than 1.5 vitamin K can be administered at a dose of 1 to 2 mg Diabetic Management Agents  Diabetic patients should preferably be scheduled for surgery early in the day  Hypoglycemia (BG less than 70 mg/dl) treatment is with glucose tablets/gels or intravenous dextrose solutions  For OHA, Stop at least 1-2 days before procedure (longer if Chronic Kidney Disease or very high risk of bleeding)  Restart 24 hours after surgery (72 hours after surgery if high bleeding risk) 3. Discuss the components of informed consent  the nature of the procedure,  the risks and benefits and the procedure,  reasonable alternatives  risks and benefits of alternatives  assessment of the patient's understanding of elements 1 through 4. 4. Describe the components of risk stratification that are able to determine a patient’s risk based on testing and co-morbid decisions.  History  ECG  Age  Risk factors  Troponin level [Show More]

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