general and local anesthetics (4)

Question 1

anesthetics are drugs that ______ the CNS or PNS for the purpose of pain relief, sedation, skeletal muscle relaxation, and decreasing reflexes

Answer 1

depresses

Question 2

_____ anesthesia: complete loss of consciousness and loss of body reflexes including respirations

Answer 2

general

Question 3

______ anesthesia: elimination of pain in the anesthetized nerves without impacting respirations

Answer 3

local

Question 4

name three contraindication for anesthetics

Answer 4

• pregnancy
• narrow-angle glaucoma
• known/family history of malignant hyperthermia

Question 5

name two major adverse effects of general anesthetics

Answer 5

malignant hyperthermia and toxicity/overdose

Question 6

what are some symptoms of malignant hyperthermia (4)

Answer 6

• sudden elevation in body temperature (>104)
• tachypnea
• tachycardia
• muscle rigidity

Question 7

name four anesthetics/sedatives

Answer 7

• ketamine (rapid onset of action; moderate sedation; no depression of cardiovascular, respiratory, bowel functions)
• nitrous oxide (weakest general anesthetic; inhaled gas ONLY)
• propofol
• sevoflurane (rapid onset/elimination; useful for outpatient surgery; greatly facilitates unconscious state, especially in peds patients)

Question 8

what anesthetic is given parenteral (IV) to induce and maintain anesthesia and sedation for ICU ventilation

Answer 8

propofol

Question 9

what are two other names for moderate sedation

Answer 9

conscious sedation or procedural sedation

Question 10

what happens to a patient under moderate sedation

Answer 10

-remain awake and responsive to commands; respiratory function remains intact
- anxiety and sensitivity to pain are reduced, patient cannot recall procedure

Question 11

name the combination of drugs used for moderate sedation

Answer 11

benzodiazepine (e.g. midazolam) or propofol + opiate analgesic (e.g. fentanyl, morphine)

Question 12

mechanism of action of local anesthetics

Answer 12

pain relief without loss of consciousness

(autonomic activity is lost, sensory/pain functions are lost, motor activity is lost)

Question 13

what is the drug classification (suffix) of local anesthetics

Answer 13

-caine

(lidocaine, bupivacaine, procaine, tetracaine)

Question 14

what is the most common local anesthetic

Answer 14

lidocaine

Question 15

what are lidocaine topical patches used for

Answer 15

pain of a specific body region (e.g. back pain)

Question 16

what type of lidocaine is used for minor, local surgical procedures

Answer 16

lidocaine infiltration injected into skin/tissue

Question 17

what type of lidocaine is used for headaches or temporary, acute, severe pain to a specific body region

Answer 17

nerve block

Question 18

what is an important indication of lidocaine

Answer 18

renders a specific portion of the body insensitive to pain

Question 19

what type of drug are succinylcholine and rocuronium

Answer 19

neuromuscular blocking drugs (NMBDs)

Question 20

NMBDs prevent nerve transmission in skeletal and smooth muscle causing what

Answer 20

muscle paralysis

(Order of paralysis: first fingers & eyes, then limbs, neck and trunk, then respiratory muscles)

Question 21

NMBDs paralyze the SKELETAL MUSCLES which are required for ______, making what required

Answer 21

breathing; mechanical ventilation

Question 22

what is an important indication for NMBDs

Answer 22

used with anesthetics during surgery to paralyze patient to control breathing during surgery

(do NOT cause sedation or pain relief; patient is paralyzed but conscious and can feel pain)

Question 23

what is a nursing implication for anesthetics/sedatives that a nurse should be aware of before therapy

Answer 23

older adults are more likely to experience adverse effects and toxicities from anesthesia because of altered metabolism and excretion of drugs

Question 24

what should be watched/monitored for during therapy

Answer 24

watch for sudden elevations in body temperature, which may indicate malignant hyperthermia