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ANES 500 > exam 1 and only > Flashcards

exam 1 and only Flashcards

1
Q

MS. MAID

A

machine check, suction, monitors, airway, IV, drugs

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2
Q

O2 tank holds___ PSI, and how much should be in there prior to case

A

2000, at least 500

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3
Q

anesthesia machine flow

A

fresh gas from common gas outlet–>1 way inspiratory valve–>inspiratory breathing tube–>Y piece to pt–> 1 way expiratory valve–>in and out reservoir bag–>APL to scavenging–>CO2 absorber–>back to fresh gas

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4
Q

Pin index safety system

A

prevents accidental swapping of oxygen and nitrous. O2 is green and 2,5. Nitrous is blue and 3,5

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5
Q

Diameter safety system

A

verify piped gas, pressures are >50 psi

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6
Q

negative pressure test on anes machine

A

verifies no leaks between flow meters and common gas outlet

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7
Q

oxygen analyzer on anes machine

A

evaluates integrity of low pressure circuit

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8
Q

Volume vs pressure control

A

volume- machine delivers set volume, set Vt, RR, i:e, variable is PIP.
pressure- machine delivers set pressure. set PIP, RR, i:e. variable is Vt.

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9
Q

Who accredits nurse anesthesia programs

A

COA council of accreditation of nurse anesthesia educational programs

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10
Q

crna boards is called what and administered by

A

NCE national certification exam

national board of certification and recertification for nurse anesthetists

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11
Q

purpose of standards for nurse anesthesia practice

A

evaluate quality of care, provide common base for quality care, help public understand what to expect, support and preserve basic rights of patient

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12
Q

general anesthesia

A

a reversible state of unconsciousness produced by anesthetic agents.

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13
Q

induction sequence: conventional vs rapid sequence

A

benzo, o2 5 min, opioid, induction agent, ventilate, no ventilation for RSI, cricoid pressure and paralytic and tube, paralytic, tube, inhalation agent.

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14
Q

advantages/disadvantages of regional anesthesia

A

advantages: conscious, able to protect airway, pulm/cardiac/renal disease patients
disadvantages: unpredictable, needs a skilled practitioner, pt cooperation

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15
Q

advantage to inhalation induction

A

no IV access, children

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16
Q

nitrous oxide

A

increases muscle tone, provides analgesia, increases SVR and pulmonary vascular resistance, decreases breath holding, coughing, secretions and laryngospasm, ok in malignant hyperthermia.

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17
Q

sevoflurane

A

causes AV disturbances, decreases breath holding, coughing, laryngospasm. compound A. 7 flourine makes it less soluble in blood therefore acts and metabolized quickly.

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18
Q

sevoflurane

A

causes AV disturbances, decreases breath holding, coughing, laryngospasm. compound A. 7 flourine makes it less soluble in blood therefore acts and metabolized quickly.

19
Q

Desflurane

A

least soluble in blood therefore metabolized quickly. respiratory irritant.

20
Q

What effects potency of inhalation agents

A

heavier atomic mass, more potent. (ceiling effect)
lipid solubility increases potency
oil/gas partition directly proportional to agents potency
reflected by MAC. lower MAC, more potent.

21
Q

iso, sevo, des structures

A

iso- 5 F with a Cl
sevo- 7 F
des- 6 F no Cl

22
Q

fastest to slowest metabolized volatiles

A

sevo, des, iso

23
Q

volatile flammability

A

adding halogen (flourine, bromine, chlorine, or iodine) DECREASES flammability. sevo is the least flammable.

24
Q

Barbiturates

A

GABAa conducts Cl through its pore resulting in hyperpolarization
alkalinity makes them incompatible with opioids and muscle relaxants
do not use in porphyrias
neuroprotection
decrease CO, MV, TV, and RR

25
Q

Etomidate

A

minimal hemodynamic changes, minute ventilation decreases, RR increases, adrenocortical hypoperfusion, myoclonia.

26
Q

ketamine

A 
dissociative, NMDA antagonist
analgesia
minimal resp depression
stimulation of sympathetic nervous system
bronchodilation 
give benzo for psychomimetic effects
premedicate with anticholinergic
27
Q

Propofol

A

antiemetic effects if continuous infusion
anticonvulsant, neuroprotective
no analgesic properties
redistribution
can be eliminated by lungs (30%)
reduces MV, RR, response to CO2 and upper airway reflexes
Propofol infusion syndrome- children>adults, acidosis, brady, fever, rhabdo

28
Q

Benzos

A 
anticonvulsant but not neuroprotective
anteretrograde amnesia
anxiolytic
rapid onset
antagonized by flumazenil
decreases BP, little change in Resp function
29
Q

Opioids

A

supraspinal- postsynaptic (mu1)
spinal-presynaptic
g protein receptors, inhibit adenylate cyclase
Morphine and demerol have active metabolites
slow pain/C fibers
EEG and evoked potential monitoring stays intact
truncal rigidity
morphine-histamine release
bradycardia except meperidine

30
Q

Dexmedatomidine

A

alpha2 adrenergic agonist, hypnosis from locus coeruleus stimulation
decrease CBF
decrease HR and SVR
decrease TV no change in RR. vent response to CO2 unchanged
upper airway obstruction possible

31
Q

Redistribution and patient awakening

A

redistribution from central blood volume to muscles fat and tissues is responsible for patient awakening

32
Q

depolarizing vs nondepolarizing

A

nondepolarizing: NMBA competitively bind to Ach receptor, closing the receptor and preventing depolarization, aminosteroids and benzylisoquinalones
depolarizing: NMBA mimics action of Ach, inactivating Na channels. succs.

33
Q

preferred method of peripheral nerve stimulation

A

ulnar nerve

34
Q

TOF

A 
4 responses equal - less than 70% blockade
1 response abolished- 75%
2 responses abolished- 80%
3 response abolished- 90%
4/4 response abolished- 100%
35
Q

Order of paralysis of muscles

A
  1. extraocular
  2. face, neck, hands, feet
  3. abdomen, arms, legs
  4. eyeblink
  5. respiratory/diaphragm
    RECOVER IN REVERSE
36
Q

atracurium vs cisatracurium

A

atracurium- histamine release, hoffman elimination, ester hydrolysis
cis- no ester hydrolysis

37
Q

most common neuropathy associated with supine positioning

A

ulnar neuropathy

38
Q

larynx location in adult and infant

A

adult- C5-C6

infant- C4

39
Q

larynx composed of

A

thyroid, cricoid, arytenoid, corniculates, and epiglottis. also muscles and ligaments.

40
Q

mallampati

A

1- uvula, pillars, soft and hard palate
2- NO PILLARS, uvula, soft and hard palate
3- NO PILLARS ONLY BASE of uvula
4. only tongue

41
Q

cormack and lehane

A

Grade 1- see cords/glottis
Grade 2- see 1/2 of glottis
Grade 3- see epiglottis
Grade 4- no glottis or larynx

42
Q

atlanto occipital extension

A

flexion of neck aligns larynx and pharynx

extension of head aligns oral and pharyngeal axis.

43
Q

thyromental distance

A

less than 3 fingerbreadths is a poor laryngoscopic view.

ANES 500 (1 decks)

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