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Regional Blocks > Brianna’s CAPA Misc Notes > Flashcards

Brianna’s CAPA Misc Notes Flashcards

1
Q

Herbals that impair coagulation due to platelet inhibition

A

-chamomile
-Vit E
-Feverfew (clotting time)
-garlic

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2
Q

Herbals that prolong bleeding time

A

-Ginger
-Garlic

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3
Q

Herbals that inc risk of bleeding

A

-Gingko Biloba
-Black Cohosh

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4
Q

Herbal that reduces blood concentration of certain anesthesia agents

A

St Johns Wart

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5
Q

Desflurane

A

Highest incidence of laryngospasm

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6
Q

Sevoflurane

A

-lowest incidence of laryngospam
-choice for pediatrics
-sweet smelling
-fast emergence… may in risk for emergence delirium

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7
Q

Neostigmine

A

-last approx 75 minutes

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8
Q

Pediatric Pain Scales

A

-Wong Baker FACES 3+
-FLACC 2 mo-7 yrs (face, legs, activity, cry, consolability)

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9
Q

Hypocalcemia

A

<8.5-10.5 watch for laryngeal spasms or skeletal muscle spasms

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10
Q

Flumanezil

A

-benzo reversal
-0.2mg over 15 seconds, repeat Q 1 min, max 1 mg
-peds 0.01mg/kg
-duration 1-2 hrs

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11
Q

Narcan

A

-adults 0.2-0.4mg
-(duration 1-4 hrs)
-peds 0.1mg/kg

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12
Q

Medications okay to take day of surgery

A

Beta Blockers, clonidine, nitrates, digoxin, Ca Channel blockers (-ipine, cardizem), antidysrhythmics, statins, ACE (-pril), ARBs (-artan), seizure meds, antiparkinson, antidepressants, pain meds except NSAIDS

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13
Q

Medications to hold prior to surgery

A

Diuretics, MAO inhibitors , diabetic meds, MVIs, herbals 2 weeks. Anticoagulants:
-aspirin- 1 week
-NSAIDS 3-5 days
-Coumadin 4-5 days
-plavix/clopidrogrel 1 week
-ticlopidine (ticlid) 10-14 days

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14
Q

Hyper vs Hypokalemia

A

Hyperkalemia: peaked T waves, depressed ST seg

Hypokalemia: U waves, wide QRS, slow reflexes (ileus)

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15
Q

Fasting

A

-clears 2 hrs
-breast milk 4 hrs
-formula/light meal 6 hrs
-high fat/protein meal 8 hrs

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16
Q

Esophageal surgery

A

Airway concern
-HOB elevated
-low cont suction

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17
Q

Gastric surgery considerations

A

-pulm toilet, assess for hypovolemia, risk for aspiration
-do not manipulate ngt.

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18
Q

Small bowel surgery considerations

A

Assess for Na and Bicarbonate loss, electrolyte imbalances, stoma care

19
Q

Rectum/Anus surgery considerations

A

Assess for retention

20
Q

Thyroidectomy or parathyroidectomy considerations

A

Assess for hypocalcemia (muscle twitches, tingling, weakness)
-pharyngeal nerve damage- say “e”

21
Q

ENT & Dental procedure considerations

A

Ice for swelling
-irritation can inc secretions 4x

22
Q

Vocal cord surgery considerations

A

Provide materials for pt to write with

23
Q

Fluid requirements

A

-Adult KG + 40 = ml/hr
-Pediatric 0-10kg. 4ml/kg/hr
-ped 10-20kg. 40+ 2ml/kg/hr for each kg over 10
-ped >20kg 60+ 1ml/kg/hr per kg over 20

24
Q

Pediatric hypotension

A

SBP 70 + (age x 2)

25
Q

Adequate UOP

A

Adults 1ml/kg/hr
Pediatrics 2-3ml/kg/hr

26
Q

Pediatric ACLS medications

A

-epi 0.01mg/kg
-amio 5mg/kg
-adenosine 0.1mg/kg first, second 0.2mg/kg
-atropine 0.02mg/kg

27
Q

More herbal supplement info

A
28
Q

Epi anaphylaxis

A

1: 1,000

Tx for CPR 1:10,000

29
Q

Halothane

A

Bronchodilating effects

30
Q

Diuretics

A

Potassium Wasting: bumex, lasix, -thiazides

Potassium sparing: aldactone, spirinolactone

31
Q

ICD implantable debfibrillator

A

-driving restricted 6 mo
-limited movement on affected side
-bed rest 6-18 hrs
-no MRIs

32
Q

ESWL shock wave lithotripsy

A

-monitor for dec UOP from large calculi blocking ureter
-pain, bruising, hematuria common (2-3days)
-encourage fluids!

33
Q

Von Willebrand disease

A

-common hematologic disorder- easily bruises, epistaxis
DDAVP desmopressin is synthetic vasopressin to help minimialize bleeding

34
Q

Skin graft

A

Elevation promotes venous return

35
Q

Posterior hip arthroplasty

A

-lower extremities in neurotransmitter alignment
-avoid hip flexi on >90
Avoid internal rotation
-if anterolateral approach- avoid external rotation

36
Q

HELLP

A

LDH is first enzyme to inc

37
Q

Pituitary procedure considerations

A

-monitor temp: hyper then hypothalamic issues. Hypo then Dec thyroid stem hormone levels

38
Q

MH susceptible pts

A

1+ hrs phase 1
1.5+ hrs phase 2

39
Q

Myasthenia gravis

A

-associated with prolonged blockade
-rapid fatigue of voluntary muscles

40
Q

Ethmoidectomy (sinus surgery) considerations

A

-cocaine for vasoconstriction- CV effects
-change mustache dressing 2-3x in first 4 hrs is normal. Do not swallow secretions… leads to n/v. ice preferred. Assess vision

41
Q

Ketamine

A

-bronchodilator effects
-inc HR, BP
-inc secretions
-inc ICP, inc cerebral flow

42
Q

Blephartoplasty (eyelid surgery)

A

Avoid heavy lifting and bending
-ice ok, no hot liquids for 24 hrs

43
Q

Sickle cell pt goal

A

Avoid acidosis, hypothermia, dehydration,

Regional Blocks (2 decks)

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