I have 10 preop assessments due this week. Would love it if you guys could help me out and write this one for me. I have included the case study below. I just need a detailed preop assessment, no more than one page. Please include references at the end.

Michael Thomas is a 30 year old patient coming in for a knee arthroscopy. He has a history of atrial fibrillation x 9 months and is on 5 mg of Coumadin qod. He has no allergies and is otherwise healthy. He is physically active and takes excellent care of himself. When questioning him about his home medications he states Coumadin is the only thing he takes. When you specifically mention possibly taking herbal medications he says these are not ‘medicines’.

How would you reply to his statement?

After your reply he tells you he is on Saw Palmetto, St. John’s Wort, and Valerian to help him sleep. What, if any, are your anesthetic concerns?

Mr. Thomas preoperative assessment labs and VS are:

CXR – normal

EKG – normal sinus rhythm with a rate of 74

Labs:

K+ 4.1

Na+ 138

Glucose 88

PT 14

PTT 38

INR 2.2

BP 124/70

HR 78

SaO2 100%

Resp 16

Are there any concerns from any of his preoperative assessment numbers?

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