Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Periop > Exam 2 Week 6 > Flashcards

Exam 2 Week 6 Flashcards

1
Q

Anesthesia may be administered by (2)

A

Anesthesiologist or CRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Main ND for Anesthesia =

A

High risk for injury r/t

  • Drug reaction
  • ineffective airway
  • decreased CO, F + E imbalance
  • ineffective breathing pattern
  • Alteration in thought process, - Ineffective thermoregulation and hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Desired pt outcome =

A

successful recovery + return to pre-anesthesia physiological state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Preanesthesia assessment

A
  • Obtain info as a safety check. Make sure important data is known by surgical team
  • Ask if patient or family has past hx of malignant hyperthermia
  • Ask about PMH, meds, allergies, pregnancy test, etc.

Support the patient - emotional and physiological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pre-anesthesia instructions - varies w/ procedure and pt condition (4)

A
  • Shower, enema
  • NPO - avoid passive regurgitation
  • Pre-op meds
  • Explain post-op routines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Analgesia =

A

= Pain relief without anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anesthesia =

A

= Absence of normal sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of Anesthesia

A

1) General
2) Regional
3) Local

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General Anesthesia

  • ____ depression
  • physical status controlled by?
A
  • CNS

- anesthesia care provider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

General Anesthesia characterized by (3)

A

Amnesia
Analgesia
Skeletal muscle relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

General Anesthesia uses =

A

= combo of IV + Inhalation agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Inhalation agents via =

Most ____ method for anesthesia

A

Mask, ETT, or Laryngeal managed airway (LMA)

  • controllable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inhalation agents (4)

  • give with ____
  • ____ is common
A

Nitrous oxide, Isoflurane, Desflurane, Sevoflurane

  • O2
  • shivering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
IV agents (2) 
- are \_\_\_\_ to inhalation agents
A

Barbiturates, Non Barbiturates

- Supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Barbiturate (1)

A

Thiopental Sodium (Pentothal) - no pain control, respiratory and CV depressant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Non-Barbiturate (1)

A

Diprovan (Propofol) - milk of amnesia. Rapid acting, respiratory depression → monitor V/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Adjuncts to Gen. Anesthesia (3)

A
  • Hypnotics/Tranquilizers
  • Narcotics
  • Neuromuscular Blocking Agent (Muscle relaxant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypnotics/Tranquilizers (2)

  • used for ____ and as adjunct
  • produces _____
  • Antidote = _______
A

Versed, Valium

  • induction
  • amnesia
  • Flumazenil (reverses sedation and resp depression)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Narcotics (3)

  • used preop or intraop
  • produces profound ____ relief and ____ depression
A

Morphine, Demerol, Fentanyl

  • pain relief, respiratory
20
Q

Neuromuscular Blocking Agent (Muscle relaxant)

  • causes muscle ____ and relaxes __ and ___ during intubation
A

Succinylcholine

  • paralysis, jaw, larynx
21
Q

4 Stages of General Anesthesia

A

Stage 1: Induction
Stage 2: Maintenance
Stage 3: Surgical Anesthesia
Stage 4: Overdose

22
Q

Stage 1 Induction =

1

A

= Begins w/ induction and ends w/ loss of consciousness

- Pt can still feel pain

23
Q

Stage 2 Maintenance =

1

A

= From loss of consciousness to loss of eyelid reflex

  • some involuntary movements
24
Q

Stage 3: Surgical Anesthesia =

A

= Target depth of anesthesia → relaxed muscles, regular breathing, eye movements stop, and loss of pain and hearing sensation

25
Q

What happens at the end of stage 3?

A

= emergence starts when pt starts to wake up and ends when pt exits OR

26
Q

Stage 4: Overdose =

A

= Marked by hypotension or circulatory failure → can lead to death

27
Q

Sequence for administration of anesthesia

1) __ site access
2) ______ pt and place mask over nose
3) Inject ___ -> ____ -> ____

A

1) IV
2) Hyperventilate
3) Narcotic -> Barbiturate -> Muscle relaxant

28
Q

Nursing action during intubation =

  • how?
  • (2) uses
A

= Cricoid pressure (Sellik Maneuver)
- downward pressure w/ thumb and index finger

  • Compresses esophagus to aid in visualization of trachea for intubation, prevent regurgitation
29
Q

Aldrete Postanesthesia Scoring System used to =

4

A

= evaluate recovery for gen Anesthesia

(ARCO) Activity, Respiration, Circulation, O2 sat

30
Q

Patients are discharged from PACU if they have a score of?

A

> /- 9

31
Q

Malignant Hyperthermia =

A

= Emergency complication that can ONLY happen with general anesthesia

32
Q

Earliest sign of malignant hyperthermia?

A

Unanticipated increase in end-tidal CO2

33
Q

Other characteristics of malignant hyperthermia?

A

Tachycardia, jaw muscle rigidity, hyperkalemia, lactic acidosis
Increase body temp → later sign

34
Q

Drugs that trigger malignant hyperthermia? (2)

Give what inhalation med if pt has hx?

A

Halothane (inhalation) or Succinylcholine (IV)

  • nitrous oxide
35
Q

How fast can malignant hyperthermia happen?

A

immediately - up to 24 hrs

36
Q

Tx of malignant hyperthermia

  • What medication?
A
  • Immediately D/C all triggering agents
  • Hyperventilate pt - 100% O2
  • Administer Dantrolene Sodium (Dantrium) - give until patient responds or up to max 20 doses. And then continued for 48 hrs or more
  • Immediately stop surgery
  • Cool the patient
  • Wound irrigation w/ cold saline
  • Cold IV solution
  • Surface cooling + cold gastric/rectal lavage
37
Q

Moderate/Conscious Sedation =

What 2 meds?

A

= Drug-induced depression of consciousness but still able to respond to verbal commands and can maintain patent airway

  • narcotic analgesic + sedative hypnotic
38
Q

Moderate Sedation can be given by?

A

RN*

39
Q

Regional =

3 types

A

= made insensible to pain → patient is awake (no loss of consciousness) but can’t feel pain

1) Local
2) Nerve blocks
3) Spinal and epidural blocks

40
Q

Spinal =

Epidural/Caudal =

A

= Injected into CSF in subarachnoid space and affects from tip of xiphoid down to toes

= Injected into epidural space (safer) or injected into caudal canal of sacrum, Used for OR/OB

41
Q

IV Block (Bier block) =

  • used for what type of surgery?
A

= involves IV injection of local anesthetic into vein w/ tourniquet occluded extremity on 2 portions of the arm

  • Used for shorter surgeries on UE
42
Q

Nerve Block =

used for what surgeries?

A
  • Injection of local anesthetic into and around nerve/nerve group
  • Used for surgeries for orbital socket, cervical, elbow and wrist
43
Q

Local =

  • most common med? topical meds? (2)
  • topical applied to?
  • used for what type of procedures?
A

= Injection of anesthetic into SubQ tissue at or close to incision site

  • Lidocaine, Lidocaine, Cocaine
  • applied to mucous membrane or open wound
  • minor/superficial
44
Q

Risks for regional anesthesia?

A
  • Anaphylaxis, incorrect administration technique, systemic absorption of med, infection
45
Q

Medication Safety on Sterile Field

  • All medications and solutions ___ and ___ sterile field must be labeled
  • NO ___-_____
  • Label all (4)
A
  • On and Off
  • x pre-labeling
  • syringes, basins, med cups, bowls
46
Q

Med safety done by (2)

  • Confirm (5)
A

Circulator + Scrub

  • Med name
  • Strength
  • Dose
  • Concentration
  • Expiration date

Periop (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions