Local And Systemic Anesthetics Flashcards
Two major anesthetics
General anesthesia: induces a state of unconsciousness
Regional or local anesthesia: blocks pain sensations to specific areas of the body without loss of consciousness
Implied consent
When a pt is unconscious and cant give consent you give implied consent
What is the nurse responsible for checking with the pt
Exact meds pt on including:
Herbal meds
OTC
Home remedies
Drugs that can be suspended temporarily without harm should be done how much?
Extent of at least 5 times their half-life
Nursing responsibilities within pre-op phase
Complete a focused assessment
Cover experiences with anesthesia
Med history
All paperwork must be obtained before the pre-op meds are administered
Nursing responsibility during intra-op phase
Maintenance of safety, physiological monitoring and psychological support
Ensure the client is positioned properly to avoid nerve damage
Continuously monitor for s/s of malignant hyperthermia
Nursing responsibilities post-op phase
Immediate objective is to assist the pt with recovery from anesthesia
Continuously assess ABCs, metabolic state (glucose), skin integrity, I&Os, IVs and general state
Education: avoid using alcohol 24 hours after anesthesia
Prepare pt for some degree of psychomotor and sensory impairment after surgery
Two types of general anesthetics
Inhallation and intavenous
Inhalation
Hases or liquids that can be given as gases
Volatile
Complete anesthetics
Provide a controllable anesthetic state
AR are rare
Can be revered quickly bc concentration is lessened by expelled air
Inhaled anesthetics
Nitrous oxide (laughing gas)
-dental, minor surgeries, put pt in semi conscious state
Halothane (fluothane)
-monitor cardiac for dysrhythmias during intra/post op bc it may sensitize the myocardium
Desflurane
Enflurane
Isoflurane
Sevoflurane
-ane
Anesthetic
Intravenous anesthetics
May be used as an adjunct with inhalation anesthetic
Decrease the amount of inhaled anesthetic required to alleviate some emotional distress due to pt not having the tight mask on while still conscious
IV anesthetic
Ultra-short acting barbiturates
Sodium pentothal
Rapid onset
Recovery may result with shivering and trembling (common with most anesthetics)
IV anesthetics
Non-barbiturates (benzodiazepines)
Midazolam (versed)-conscious sedation
Diazepam (valium)-anxiety
Lorazepan (ativan)-anxiety
Other IV anesthetics
Propofol (diprivan)-for fractures, amnesia affect, only advanced practice can give
Etomidate (Amidate)-rapid unconsciousness
Ketamine (Ketalar)-peds works good, PTSD pts
What comes first paralysis or sedation
Sedation
Meds used as pre-anesthetic adjunctive agents
Narcotic analgesics
Reduce pain, thus reducing anxiety
Morphine (fractures), meperidine (demerol)
Anti-nausea meds
Promethazine (phenergan) for nausea r/t pain
Skeletal muscle relaxants
Succinylcholine
Local anesthesia
May be injected into tissues
May be infected in or around a nerve or nerve trunk to affect a larger region (spinal or epidural)
Can also be achieved by freezing (can damage tissue)
how does local anesthetics work
Stop axonal conduction by blocking sodium channels which stops the conduction of sensation
Why is local anesthetics given with a vasoconstrictor such as epinephrine
To help decrease the local blood flow and delay systemic absorption of the local anesthetic
(Prevent it from going systemic)
What happens if local anesthetic goes systemic
Cause CNS delays/problems (respiratory depression)
Local anesthetic meds
Procaine (novocaine)
Lidocaine (Xylocaine)
Benzocaine (Butesin)
Tetracaine (pontocaine, ciractin)
Dibucaine (nupercainal)
Cocaine
Can be injected, applied topically, or inhaled
Local anesthetic nursing responsibilites
Assess pt for past responses to anesthetic
Continuously assess level of pain, consciousness, and ABCs
Use minimal amounts to achieve anesthesia
Have resuscitative equipment nearby
Local anesthetic SE/AR/Precautions
Local irritation (remove patch and clean site)
Systemic toxicity
Cardiovascular effects (esp with cocaine or if absorbed systemically)
CNS problems if absorbed systemically
