Exam 1 Part 2 Flashcards
Contact precautions
- MRSA
- VRE
- C. Diff
- gown and glove PPE
Droplet precautions
- Measles
- Mumps
- Meningitis
- Streptococcus
- Wear a mask
Airbourne precautions
- TB
- Wear N-95
- Do not have contact with pts with varicella, varicella zoster, and measles (rubella)
Thoracic cases
- tumor resection
- lung reduction
- transplant
- esophageal/tracheal resection
- thoracoscopy/bronchoscopy
Thoracic anesthetic concerns
- general anesthesia
- one lung ventilation
- sternotomy
- positioning
- invasive monitoring
- icu transport
- chest tube placement
Neurosurgery
- Intracranial
- Spinal
- Functional–for people with tremors
Neurosurgery anesthesia concerns
- general, local, or MAC
- cerebral blood flow
- hyperventilate to decrease blood flow
- stay vigilent on twitches! Keep paralyzed!
- use propofol to slow brain down** called burst suppression**
Intracranial pressure > than _____ mmHg
15
Increase in tissue or fluid within the rigid cranial vault
Signs/symptoms: headache, n/v, altered consciousness
Treatments: decadron (steroid), diuretics (mannitol)
Orthopedic anesthesia concerns
- GA, Regional, Nerve Block
- Tourniquets increase BP
- polymethylmethacrylate
*
Opthalmology anesthesia concerns
- GA, MAC, Retrobulbar block
- Intraocular pressure:want it low
-
Oculocardiac reflex (accidentally pull lateral rectus) let the muscle go!
- Opthalmic tract of trigeminal nerve
- Vagus nerve
- Gas expansion–have to wear bracelet and no flying
Prone positioning
- padding under knees
- padding under ankles
- padding under elbows
Vascular anesthetic concerns
- GA, regional
- invasive monitors–location
- anticoag
- neuro monitoring
- length of case
- patient population–patients can be too sick to be put under GA
Laparascopic cases
- Splenectomy
- Herniorrhaphy
- Appendectomy
- Cholecystectomy
- Kidney donor
- Bowel resection
- Adrenalectomy
- Gastric bypass
- GERD Cessation
Laparascopic anesthesia concerns
- GA
- insufflation causes decrease in BP
- increased PIP (peak inspiratory press.)
- EtCO2 Issues
- Pneumo everything and pneumothorax
Transplant anesthesia concerns
- GA
- electrolyte imbalance
- organ preservation
- coagulation anomaly
- pathophysiology of patient
- volume status
- IV access
Pediatric cases
Older kids are physiollogically similar to adults. Just consider weight-based doses.
Obstretic anesthetic concerns
- GA, spinal (can’t push), epidural (can push)
- drug effects on mother/fetus
- fetal distress monitoring
- aortocaval compression (positioning)
- teratogenic drugs–VERSED causes birth defects
Gyno cases:
Hysteroscopy
Hysterectomy
Myomectomy
D&C
- hysteroscopy: not that quick
- hysterectomy–can be bloody
- myomectomy–fibroid
- D&C very quick
Gynecologic Anesthesia
- Patient can choose GA vs. Regional!
- Blood loss
- Monitoring
- age of patient
- apprehension
genitourinary cases
- cystoscopy is short
- TURP (trans urethral resection of prostate
- stone extraction
- nephrectomy
- prostatectomy
Cystectomy with neobladder
long bloody case
Genitourinary anesthesia concerns
- GA, regional, MAC
- Location from OR
- Obturator reflex
- Bx or resection of lateral wall of bladder
*
TURBT
Trans-urethral resection of bladder tumor
TURP syndrome
- Water
- Electrolytes
- Sorbitol
- Mannitol
- Low Na+ can cause coo coo patients
Otorhinolaryngology cases
- Endoscopy always GA because so stimulating.
*
ENT anesthesia concerns
- GA
- fire protection
- tracheostomy
- nasal intubation
- muscle relaxants
- field avoidance
- no airway
