Chapter 11: General and Local Anesthetics Flashcards
The physician has requested “lidocaine with epinephrine.” The nurse recognizes that the most important reason for adding epinephrine is which of these factors?
a. It helps to calm the patient before the procedure.
b. It minimizes the risk for an allergic reaction.
c. It enhances the effect of the local lidocaine.
d. It reduces bleeding in the local surgical area.
d. It reduces bleeding in the local surgical area.
The surgical nurse is reviewing operative cases scheduled for the day. Which of these patients is more prone to complications from general anesthesia? (Select all that apply.)
a. A 79-year-old who is about to have hip replacement surgery
b. A 49-year-old athlete who quit heavy smoking 12 years ago
c. A 19-year-old who has a history of substance and alcohol abuse
d. A 30-year-old who is in perfect health but has never had anesthesia
e. A 50-year-old scheduled for outpatient laser surgery for vision correction
a. A 79-year-old who is about to have hip replacement surgery
c. A 19-year-old who has a history of substance and alcohol abuse
Which human need statement is appropriate for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery?
a. Altered urinary elimination, decreased, related to the use of vasopressors as anesthetics
b. Decreased self control related to the effects of general anesthesia
c. Altered safety with risk for falls related to decreased sensorium for 2 to 4 days postoperatively
d. Altered oxygenation, decreased, due to the CNS depressant effect of general anesthesia
d. Altered oxygenation, decreased, due to the CNS depressant effect of general anesthesia
A patient is recovering from general anesthesia. What is the nurse’s main concern during the immediate postoperative period?
a. Airway
b. Pupillary reflexes
c. Return of sensations
d. Level of consciousness
a. Airway
A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moderate sedation with propofol. The patient asks, “I am afraid of feeling it when they shock me.” What is the nurse’s best response?
a. “You won’t receive enough of a shock to feel anything.”
b. “You will feel the shock but you won’t remember any of the pain.”
c. “These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure.”
d. “They will give you enough pain medication to prevent you from feeling it.”
c. “These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure.”
During a patient’s recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply.)
a. Respiratory depression
b. Tachypnea
c. Tachycardia
d. Seizure activity
e. Muscle rigidity
b. Tachypnea
c. Tachycardia
e. Muscle rigidity
Which drug classes are used as adjunctive drugs with anesthesia? (Select all that apply.)
a. Sedative-hypnotics
b. Anticonvulsants
c. Anticholinergics
d. Inhaled gases
e. Opioid analgesics
a. Sedative-hypnotics
c. Anticholinergics
e. Opioid analgesics
While assisting with a procedure in the emergency department, the nurse prepares lidocaine for use with which type of anesthesia?
a. Moderate sedation
b. Infiltration
c. Intravenous
d. General
b. Infiltration
The nurse monitoring a patient after surgery keeps in mind that the primary concern with the use of a neuromuscular blocking drug is which adverse effect?
a. Respiratory arrest
b. Headache
c. Bradycardia
d. Hypertension
a. Respiratory arrest
To decrease the possibility of a headache after spinal anesthesia, the nurse will provide which instruction to the patient?
a. Sit in high Fowler’s position.
b. Maintain strict bedrest.
c. Limit fluids.
d. Ambulate in the hall several times a day.
b. Maintain strict bedrest.
The nurse is reviewing a policy for local anesthesia. Local anesthesia is indicated for which procedures? (Select all that apply.)
a. Cardioversions
b. Suturing a skin laceration
c. Diagnostic procedures
d. Long-duration surgery
e. Dental procedures
b. Suturing a skin laceration
c. Diagnostic procedures
e. Dental procedures
A patient who has just returned from surgery has suddenly developed a severe elevation in body temperature. The nurse recognizes that this change may indicate which condition?
a. A normal temperature change after surgery
b. Malignant hypertension
c. Malignant hyperthermia
d. Fever
c. Malignant hyperthermia
During a procedure, the nurse is monitoring a patient who has received dexmedetomidine for moderate sedation. The nurse will observe for which potential adverse effect?
a. Respiratory depression
b. Tachycardia
c. Dizziness
d. Hypotension
d. Hypotension
Which of the following is an identified advantage for the use of nitrous oxide?
a. It demonstrates effectiveness as a single agent.
b. It has good analgesic properties.
c. It does not promote postoperative nausea and vomiting.
d. It offers a parenteral and inhaled route option.
b. It has good analgesic properties.
When the effects of local anesthetics begin to wear off, which physiologic response is the first to occur?
a. Memory returns.
b. Motor activity returns.
c. Sensory activity returns.
d. Autonomic activity returns.
b. Motor activity returns.
