Surgical Patient Care Exam Review: Preoperative to Postoperative Management for Physician Assistants

Prepare for your physician assistant certification exam with this detailed review of surgical patient care from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This summary includes preoperative risk assessment, trauma and burn management, surgical nutrition, and postoperative complication handling.

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Preoperative Evaluation

• Patient History & Examination: Use AMPLE mnemonic (Allergies, Medications, Past medical history, Last meal, Events) and DRUGS mnemonic for drug history.
• Risk Assessment: Identify cardiac risks, anesthesia complications, and DVT risk; initiate prophylaxis with heparin, enoxaparin, warfarin, or fondaparinux.
• Surgical Nutrition: Critical for critically ill to maintain energy and nitrogen balance.

Intraoperative Care

• Surgical Techniques: Laparoscopic approaches preferred for minimal invasiveness and faster recovery.
• Complication Prevention: DVT prophylaxis focuses on risk factors like stasis, intimal damage, and hypercoagulability.

Trauma Management

• Initial Assessment: Follow ABCs—Airway, Breathing, Circulation—and perform primary/secondary injury surveys.

Burn Management

• Classification & Treatment: Assess burn depth; prioritize ABCs and fluid resuscitation.
• Surgical Procedures: Escharotomy for circumferential burns; fasciotomy to relieve compartment syndrome.

Postoperative Complications

• Fever Evaluation: Use Five Ws—Wind, Water, Wound, Walking, Wonder drugs—to identify causes.
• Common Complications: Wound infections, thromboembolism, and wound evisceration (emergency).

Glossary of Key Terms

• Anastomotic Leakage: Leakage from surgical bowel connection.
• Crystalloid: Fluid with electrolytes used for resuscitation.
• Debridement: Removal of necrotic tissue from wounds.
• Incentive Spirometer: Device to promote lung expansion via deep breathing.
• Necrotizing Fasciitis: Severe bacterial soft tissue infection.
• Pneumoperitoneum: Air in abdominal cavity, often post-surgery or trauma.
• Sepsis: Life-threatening systemic inflammatory response to infection.
• Thromboembolism: Blood clot blocking vessels, a serious postop risk.

Conclusion: Key Takeaways for Surgical Patient Care Exam Prep

Master the essential components of surgical patient care, from preoperative evaluation through postoperative complication management. Understanding risk assessment, trauma protocols, burn treatment, and DVT prevention is critical for physician assistant certification success and clinical proficiency.

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