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Pharmacology 451 > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

Local anesthetics MOA

A
  • Sodium channel blocker
  • blocks nerve communication and Na from entering channels
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2
Q

Local anesthetics blocks perception of?

A
  1. pain
  2. temperature
  3. touch
  4. deep pressure
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3
Q

Why is epinephrine added to local anesthetics?

A
  1. constricts blood vessels and decreases blood flow to keep medication in area longer
  2. extend duration of action
  3. decreases the risk of toxicity and the risk of spreading
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4
Q

epinephrine cannot go in IV because?

A

it increases HR, BP, and increases heart dysrhythmias

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5
Q

Routes of local anesthesia

A
  1. topical
  2. infiltration
  3. nerve block
  4. spinal
  5. epidural
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6
Q

Spinal anesthesia can cause

A
  • headache
  • urinary retention
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7
Q

spinal anesthesia is inserted in

A

L1 and below
(avoid spinal cord)

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8
Q

to prevent headaches and urinary retention from spinal anesthesia they must

A
  • drink fluids
  • lay flat for 8 hrs
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9
Q

Nursing care for anesthesia

A
  • use smallest amount
  • apply to small area
  • avoid open skin
  • wear gloves
  • tell pt to avoid exercise
  • dont wrap area
  • if injecting, aspirate
  • rescue equipment nearby
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10
Q

nursing interventions for general anesthesia

A
  • check gag reflex
  • teach pt area will be numb (4-6hrs)
  • if block given, increase risk of falls
  • assess vitals
  • assess injection site
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11
Q

General anesthetics MOA

A
  • alter the neurons in the CNS
  • rapid and complete loss of sensation and consciousness
  • balanced w/ IV and inhaled
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12
Q

Stages of general anesthetics

A
  1. loss of pain
  2. excitement and hyperactivity
  3. surgical
  4. paralysis of medulla region
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13
Q

general anesthesia interventions

A
  • screen for hx of reactions (malignant hyperthermia)
  • pt iv access
  • assess LOC/airway/circulation
  • shivering
  • BP, HR, temp
  • turn, cough, deep breathe, ROM, ambulation
  • pain
  • ask AO questions
  • educate when alert and w/ caregiver
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14
Q

Balanced anesthesia types

A
  1. propofol and short acting barbs
    (induction: getting them to anesthetic balance)
  2. neuromuscular blocking agents
    (muscle relaxant)
  3. opioids/nitrous oxide
    (analgesia)
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15
Q

benefits of balanced anesthesia

A
  • get pt out of stage 2 fast
  • pt safety
  • lower doses when combining drugs decreases the risk of toxicity
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16
Q

Inhaled anesthetic MOA

A
  • increases signals to chloride and potassium channels
  • weakened excitatory neurons
17
Q

types of inhaled anesthetics

A
  1. therapeutic gases
  2. volatile liquids (room temp liquid that turns to vapor when inhaled)
18
Q

Adjuncts to anesthesia

A
  1. anticholinergics (dry secretions and suppress bradycardia)
  2. benzodiazepines (decrease anxiety, fear or pain, promote amnesia)
  3. opioids (morphine to counteract pain)
  4. antiemetics
  5. neuromuscular blocking agents
19
Q

Malignant hyperthermia

A
  • rare reaction from anesthesia
  • life threatening
  • rapid hypermetabolic reaction
20
Q

s/s of malignant hyperthermia

A
  • sustained muscle contraction
  • increase HR and temp
  • muscle breakdown
  • acidosis
21
Q

treatment for malignant hyperthermia

A
  • DC medication
  • dantrolene
  • supportive care
  • decrease temp
  • cooling blanket
  • decrease HR and BP
  • STOP MED IN SURGERY
22
Q

Neuromuscular blocking agents

A
  1. causes paralysis ONLY
  2. no loss of consciousness
  3. no sedation
  4. no analgesia
  5. no amnesia
23
Q

Neuromuscular blocking agents interventions

A
  • baseline neuro assessment
  • dosage should be maintained by using peripheral nerve stimulation during procedure
  • monitor sedation
  • discontinue as soon as possible
  • monitor for malignant hyperthermia
  • post neuro assessment
24
Q

Bispectral index (BIS)

A
  • how we assess how well our pt is sedated and how well we are controlling pain for a pt who’s receiving a neuromuscular blocker
25
Q

Bispectral index (BIS) values

A

100: completely awake
40-60: general anesthesia
0: coma/ fully unconscious

26
Q

Muscle spasms

A

involuntary contraction
- overuse
- injury
- med
- epilepsy
- dehydrated
- electrolyte imbalance

27
Q

muscle spasticity

A

continuous state of contraction
- damage to CNS
- head injury
- lesions stroke

28
Q

non-pharmacological treatments

A
  • immobilization
  • hot/cold therapy
  • physical therapy
  • surgery
  • acupuncture
  • herbal therapy

Pharmacology 451 (10 decks)

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