Surgical Procedures & Perioperative Care Flashcards

What is the standard patient positioning for transurethral resection of the prostate (TURP)?

Answer: Lithotomy

Lithotomy position provides optimal perineal and urethral access required for all transurethral endoscopic procedures.

Which irrigation fluid is used during monopolar TURP to avoid conducting electrical current?

Answer: Glycine 1.5%

Glycine 1.5% is a non-electrolyte, non-hemolytic solution used in monopolar TURP because normal saline conducts electricity and would disperse monopolar current.

What is the hallmark presentation of transurethral resection (TUR) syndrome?

Answer: Hyponatremia with neurological symptoms

TUR syndrome results from systemic absorption of hypotonic irrigant, causing dilutional hyponatremia that manifests as neurological symptoms including confusion, seizures, and cardiovascular instability.

Before ureteroscopy, which pre-operative assessment finding most warrants procedure postponement?

Answer: Positive urine culture

A positive urine culture must be treated before ureteroscopy to prevent urosepsis from instrumenting an infected, closed urinary system under pressure.

Per current ASA guidelines, what is the recommended NPO duration for solid foods before elective urologic surgery?

Answer: 6 hours

Current ASA guidelines require 6 hours NPO for light meals and 8 hours for fatty meals, with the standard recommendation for solid foods being 6 hours before elective surgery.

According to AUA guidelines, which antibiotic class is recommended for prophylaxis before cystoscopy in high-risk patients?

Answer: Fluoroquinolones or trimethoprim-sulfamethoxazole

AUA Best Practice Statement recommends fluoroquinolones or trimethoprim-sulfamethoxazole for antimicrobial prophylaxis before lower urinary tract endoscopic procedures in at-risk patients.

Which post-operative complication occurs most frequently after percutaneous nephrolithotomy (PCNL)?

Answer: Fever and urinary tract infection

Fever and urinary tract infection are the most common complications after PCNL, occurring in up to 35% of patients due to bacteremia from stone manipulation in the renal collecting system.