Anesthesia Part IV Flashcards
What is the reversal agent for Opioids?
What is the reversal agent for Benzodiazepenes?
naloxone (Narcan)
flumazenil (Romazicon)
Is laughing a symptom of Ideal sedation with Nitrous?
No
Is there Nitrous Dependence?
Controlled substance?
Yes
No
Initial Signs of Early/Ideal sedation: Breathing:
Peripheral Vasodilation:
Decreased muscle tone:
Drop in BP:
normal
yes
yes
NO (not initially)
When we give Nitrous to pts they should be…
Conscious and Responsive
Oxygen is what color?
Nitrous is what color?
Oxygen is on the?
Nitrous is on the?
Green
Blue
Right
Left
If pt is nauseous, uncomfortable, on Nitrous, you should…
You should not…
Lower nitrous
increase Oxygen
2 demographics that aren’t a good candidate for sedation:
ASA IV
Really young
*other than that wide open
If a pt is undergoing conscious sedation, do we see a change in vitals?
Mood altered?
Cooperative:
Breathing faster, more shallow:
Minor
yes, whole point
yes
No (breathing pattern wouldn’t change much, if anything would go the other way)
Why is Shivering a complication of Nitrous administration?
Vasodilation
*lose heat, get cold, start shivering
Other than fear, what is a protective response to pain?
Withdrawal reflex
Do physical attributes like height and weight influence pain experience?
Negative
*expectations, attitudes, learned responses, age, personality, and genetics do
What type of Nociceptors do we have?
Polymodal
What would be a good example of Neuropathic Pain?
Trigeminal Neuralgia
What is something we can do to help pts handle anxiety and fear?
PREP
prepare, rehearse, empower, praise
What does PREP stand for?
prepare
rehearse
empower
praise
What are we facilitating/changing when we give a pt medications for post-op pain?
Pain Tolerance
Gate Theory - what fibers close the gate?
Large myelinated
c fibers small, dull
T/F
Nitrous is a selective CNS depressant
False
*non-selective
T/F
Nitrous is the wimp of all inhaled drugs
(weak one)
True
What sedative drug is only available for oral administration?
This is what class of drug?
triazolam Halcion
benzodiazepene
What are 4 different ways to administer sedation?
Oral
IV
Intramuscular
Inhalation
What is the capacity (in Liters) for the e-cylinder for Oxygen?
If the tank is 1/2 full, how much do we have?
*x number of liters/min, can figure out how long we can run oxygen if we know this number
625 L
312.5 L
What type of Flowmeters do we see on our Nitrous Units?
*most common
*Ball
Rod
Rotameter
Benzodiazepenes are _____ drugs only and don’t provide _______
sedative
analgesia
Small, incremental doses of a drug until desired clinical effect is observed
Titration
Titration is the ____ dose of a drug until _____ is observed
incremental
desired clinical effect
When we administer Nitrous, what do we begin and end the procedure with?
If you reach the max dose, what then?
100% Oxygen
Nothing - failure
With the units we use, what is the Maximum amount of Nitrous we can administer?
70%
If the Nitrous tank is 35% empty (65% full), what is the PSI?
750-800 psi
The Oxygen Unit is _____ PSI when full
The Nitrous Unit is _____ PSI when full
PSI remains constant until it is _____ full
2000
750-800
25%
T/F
You can administer Nitrous if you don’t have Oxygen available
False
*need oxygen - it is the fail safe built into the system
How much Oxygen is in the E-Cylinder when full?
- we’ll have to figure something out with this number
- most likely how long until empty with a Flow Rate
625 L
What is the Primary function of the Reservoir Bag?
Respiratory effort is also seen and from this we can determine the…
Additional volume for deep breathing
Flow Rate (e.g. 6 Liters)
If an Oxygen tank is half full and Flow Rate is 5 LPM, how much time do you have left for the procedure if you stop at 30% full on Oxygen tank?
50% is 312.5
so, if stop at 30%, only have 20% left
130 Liters @ 5 LPM = 26 minutes
