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Intro to Anesthesia > Intro to Anesthesia Final > Flashcards

Intro to Anesthesia Final Flashcards

1
Q

AANA Code of Ethics

A

Principles of conduct & professional integrity (decision making and behavior of nurse anesthetists)

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2
Q

Practice standards

A

Authoritative statements describing minimum rules and responsibilities for which anesthetists are held accountable

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3
Q

Practice guidelines

A

Systematically developed statements to assist providers in clinical decision making (commonly accepted in crna community)

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4
Q

Position statements

A

Express AANA’s official positions or beliefs on practice-related topics

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5
Q

Position statements define:

A

Knowledge
Skills
Abilities specific to CRNAs

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6
Q

Use of unnecessary invasive preoperative testing is most likely to put the provider in violation of the principle of:

A

Nonmaleficence (Obligation to do no harm; primum non nocere)

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7
Q

Automy

A

Pt’s ability to choose w/o controlling interference by others, and without limitations that prevent meaningful choices

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8
Q

Nonmaleficence

A

Asserts a provider has an obligation not to inflict hurt or harm

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9
Q

No distinction between ___ or ___ harm

A

Unintentional or intentional

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10
Q

Beneficence

A

Principle that providers should act for benefit of others (prevent harm and actively help patients)

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11
Q

Justice

A

Principle that people under similar circumstances and conditions should be treated alike (distributive justice)

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12
Q

Informed consent for anesthesia should include a discussion of which topics

A

Risks & benefits of each type of appropriate anesthetic
Patient preferences, questions, and fears

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13
Q

6 elements of informed consent

A

Competence
Decision making capacity
Disclosure of information
Understanding of disclosed information
Voluntary consent
Documentation

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14
Q

Assent is a term used when….

A

Minor children are included in the informed consent discussion
Agreement should be sought

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15
Q

Implied consent is used in __

A

Emergencies, when immediate treatment is required and the patient is unconscious or unable to consent

Permits healthcare providers to provide lifesaving care

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16
Q

What must an anesthesia provider do to obtain informed consent for epidural placement in a paturient who recently received 50mg of Meperidine

A

Determine that the patient has sufficient capacity

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17
Q

Capacity is one of the elements of ____

A

Consent (should be ascertained as part of the informed consent process)

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18
Q

Pre-anesthetic evaluation also includes:

A

Current H&P, labor progress, and effectiveness of current analgesia

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18
Q

True or false: OB patients need to receive general and regional anesthetic consent

A

True

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18
Q

What should occur if there is a maternal-fetal conflict?

A

Anesthesia providers should communicate with the mother open and non-coercive while procuring ethics consultation, referencing hospital policy, and reviewing state law

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19
Q

Terminal cancer patient with DNR presents for port-a-cath placement. Which standard of nurse anesthesia practice has the most immediate relevance to the anesthetist’s preoperative activities?

A

Standard 4 on informed consent and related anesthesia services

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20
Q

You should do what to a pre-existing advanced directive before a procedure?

A

RECONSIDER– some events that may occur are responses to the anesthetic and not part of the terminal disease process

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21
Q

Who does the AANA recommend be present when discussing changes in advances directives during the informed consesnt process?

A

Patient, family and healthcare team

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22
Q

Are DNR orders automatically suspended during procedures in the OR

A

No, policy language that dictates automatic suspension of advanced directives during anesthesia should be rewritten in favor of patient-centered approach

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23
Q

Withdrawal

A

Physical and emotional response to very low drug levels

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24
Q

Impairment

A

Inability to engage in activities of daily living

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25
Q

Tolerance

A

Markedly diminished effects of the same drug amount

26
Q

Addiction

A

Need (physiological or compulsive) for a substance
** often associated with a loss of self control

27
Q

Substance use disorder

A

Recurrent use of a substance that leads to clinical and functional impairment

28
Q

First nurse to specialize anesthesia, setting foundation in 1877

A

Sister Mary Bernard

29
Q

Mother of Anesthesia, open drop ether and first to publish her work

A

Alice Magaw (1893)

30
Q

Private CRNA and pioneered nitrous oxide anesthesia, later establishing Lakeside Hospital in 1915

A

Agatha Hodgins

31
Q

Who started AANA in 1931

A

Agatha Hodgins

32
Q

Nurses first provided anesthesia to soldiers wounded during the ___

A

Civil War

33
Q

Post WW2, discredited ___

A

Anti-nurse anesthetist sentiments aimed to discredit the profession

34
Q

Nitrous oxide 1772 used for ___ by ___

A

Dental anesthesia by Sir Humphrey Davy

35
Q

Ether was popularized by ___

A

William Morton Ether Dome at Mass General Hospital 1844

36
Q

James Simpson developed

A

Chloroform in 1847

37
Q

AANA established in 1931 by

A

Agatha Hodgins

38
Q

First annual meeting in 1933

A

Beginning of organized support for CRNAs

39
Q

Certification Initiatives 1945 instituted mandatory certification for CRNAs to ___

A

Enhance professional standards (first certification exam administered)

40
Q

Accreditation Recognition (1955)

A

US Dept of Health recognized AANA as accrediting agency for nurse anesthesia schools

41
Q

State Practice Act 1972-1976

A

AANA and ASA issued Joint Statement on Anesthesia Practice

42
Q

Direct Reimbursement 1986

A

Congress passed legislation allowing CRNAs to receive direct reimbursement under Medicare Pt B, a significant recognition of role

43
Q

Professional Recognition 2000

A

First observation of National Nurse Anesthesia week

44
Q

Standard 14 Culture of Safety

A

Collaborative and cooperative patient care environment through interdisciplinary engagement, open engagement, a culture of safety and supportive leadership

45
Q

Standard 13 Wellness

A

Physically and mentally able to perform duties of the role

46
Q

Standard 12 Quality Improvement Process

A

Constant Assessment of anesthesia care for best patient outcomes

47
Q

Standard 11 Transfer of Care

A

Evaluation of patient’s status and determine when it’s appropriate to transfer the responsibility of care to another qualified healthcare provider

48
Q

Standard 10 Infection Control and Prevention

A

–

49
Q

Standard 9 Monitoring, Alarms

A

Document BP, HR, resps every 5 min for all anesthetics, continuous monitoring of oxygenation, ventilation, hemodynamics
Thermoregulation (MH monitoring), neuromuscular monitoring when NMBs are used

50
Q

Standard 8 Patient Positioning

A

Proper body alignment to maintain perfusion, protecting pressure points, and nerve plexus

51
Q

Standard 7 Anesthesia Plan Implementation and Management

A

Continuous assessment of the patient’s response to the anesthetic and surgical or procedural intervention

52
Q

Standard 6 Equipment

A

Prechecks, operating equipment safely

53
Q

Standard 5 Documentation

A

Communicate anesthesia care data and activities through legible, timely, accurate, and complete documentation in the patient’s healthcare record

54
Q

Standard 4 Informed Consent for Anesthesia Care

A

Obtain and document or verify documentation that the patients or legal representative has given informed consent for planned anesthesia care or related services in accordance with law, accreditation standards, and institutional policy

55
Q

Standard 3 Plan for Anesthesia Care

A

Patient specific plan of care

56
Q

Standard 2 Pre-anesthesia patient evaluation and assessment

A

Anesthesia focused physical assessment, general health, home meds, relevant diagnostics, preexisting conditions

57
Q

Standard 1 Patient Rights

A

Autonomy, dignity, safety

58
Q

Medical direction involves an ____

A

Anesthesiologist overseeing the delivery of anesthesia care, allowing up to 4 CRNAs to work concurrently

59
Q

Medical supervision occurs when a physician oversees ___

A

More than 4 CRNAs, without the need for hands-on involvement, ensuring availability for assistance

60
Q

To legally achieve medical direction ___

A

Anesthesiologists must meet 7 specific billing requirements outlined in TEFRA of 1982

61
Q

How many states do not require physician supervision for CRNAs

A

43

62
Q

How many states have no supervision or direct requirements?

A

37

63
Q
A

Intro to Anesthesia (2 decks)

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