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AP Exam 2 > Anesthesia and Surgical Complications P2 > Flashcards

Anesthesia and Surgical Complications P2 Flashcards

1
Q

What rhythm is the worse thing for heart patients with CAD and why?

A

Sinus tachycardia because of increased myocardial demand for O2 so treat immediately!

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2
Q

ST segment depression is examined _____ to baseline.

A

relative

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3
Q

What rhythm

  • has a QRS > 0.12
  • strangely shaped
  • MAY have inverted t-wave
A

PVC

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4
Q

What do PVCs generally indicate?

A

electrolyte imbalance

  • hypokalemia
  • hypomagnesemia
  • myocardial ischemia
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5
Q

What rhythm is indicated by >3 consecutive PVCs > 100 bpm <200 bpm

A

Ventricular tachycardia

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6
Q

Is QRS preceded by a P wave in ventricular tachycardia?

A

NO

sustained VT often degenerates to v. fib

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7
Q

Ventricular tachycardia medical emergency associated with _______ and low cardiac output.

A

hypotension

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8
Q

What is first treatment for ventricular tachycardia?

A

defibrillation at 200, 300, 360 J

antidysrhythmics: amiodarone, 100mg lidocaine

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9
Q

What rhythm is characterized by quivering, pulseless ventricular movements > _____ bpm

A

300 bpm

ventricular fibrillation

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10
Q

What is the most common dysthythmia associated with cardiac arrest?

A

ventricular fibrillation

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11
Q

What has occasional P wave, no QRS?

How do you treat this rhythm?

A

ventricular asystole

GIVE EPI

CANNOT SHOCK THIS RHYTHM!

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12
Q

What is normally the iatragenic (of or relating to illness caused by medical examination or treatment) cause of ventricular asystole?

A

HYPERkalemia

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13
Q
  • K-penicillin
  • potassium sparing diuretics (too good at sparing K)
  • ACE inhibitors
  • NSAIDS
  • renal failure
  • OLIGURIA
A
  • Causes for hyperkalemia (6)
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14
Q

What is expressed in a hyperkalemia ECG?

A

Peaked t-waves

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15
Q

Arrhythmias
heart block
DELAYED CONDUCTION
ventricular standstill
peaked T waves
decreased P waves
prolonged PR interval
sine wave

A

hyperkalemia

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16
Q

What are neuromusclular effects from hyperkalemia? (4)

A
  • Paresthesia
  • weakness, respiratory insufficiency
  • flaccid paralysis
  • mental confusion
17
Q

How do you treat hyperkalemia? (5)

A
  • Give Ca to drive K into the cells
  • Give insulin with D5W to treat high insulin
  • Hyperventilate
  • Sodium bicarb
  • Lasix
18
Q

What rare inherited myopathy is characterized by:

  • ineffective uptake of calcium by sarcoplasmic reticulum
  • inappropriate release of intracellular Ca
A

malignant hyperthermia

19
Q

Malignant hyperthermia is unapparent until these agents are administered: (2)

A

inhalational anesthetic

Succx

20
Q

1st signs of malignant hyperthermia: (3)

A
  • increased CO or HR
  • HYPERCARBIA
  • TACHYCARDIA
  • Hyperthermia
  • MASSETER MUSCLE SPASM
  • Metabolic acidosis
  • Hyperkalemia from muscle breakdown

by the time you see temp increase, already going down bad pathway

21
Q

Treatment for malignant hyperthermia?

A
  • stop triggering agent
  • cancel procedure
  • 100% OXYGEN
  • DANTROLENE 2 MG/KG Q 5 MIN
22
Q

Dantrolene mixed with _____ saline and given every ____ minutes.

A

cold

5

23
Q

How do you prepare a machine for malignant hyperthermia patient?

A
  • Take agents out of line
  • 10L flows–leave on for hours
  • change absorbent
  • first case of day
24
Q

What are other surgical complications?

A
  • AIRWAY INJURY #1
  • dental damage
  • alopecia
  • corneal abrasion
  • AIR EMBOLISM (sitting position)
  • ulnar nerve injury
  • 0.2-0.4 % awareness
25
Q

What injury can result from being in prone position?

A

ischemic optic neuropathy

blindness

26
Q

Most common allergic reaction:

A

muscle relaxant allergy

27
Q

What are most common human errors?

A
  • unrecognized breathing circuit disconnect
  • mistaken drugs
  • airway mismanagement
  • anesthesia machine misuse
  • fluid mismanagement
  • IV line disconnect
28
Q

A human error or equipment failure that could have led or did lead to an undesirable outcome ranging from _____ to ______.

A

Definition of critical incident

  • increased length of hospital stay
  • death
29
Q

What accounts for majority of errors besides human error?

A
  • equipment failure
  • disconnection

AP Exam 2 (5 decks)

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