Local And Systemic Anesthetics

Question 1

Two major anesthetics

Answer 1

General anesthesia: induces a state of unconsciousness

Regional or local anesthesia: blocks pain sensations to specific areas of the body without loss of consciousness

Question 2

Implied consent

Answer 2

When a pt is unconscious and cant give consent you give implied consent

Question 3

What is the nurse responsible for checking with the pt

Answer 3

Exact meds pt on including:
Herbal meds
OTC
Home remedies

Question 4

Drugs that can be suspended temporarily without harm should be done how much?

Answer 4

Extent of at least 5 times their half-life

Question 5

Nursing responsibilities within pre-op phase

Answer 5

Complete a focused assessment

Cover experiences with anesthesia

Med history

All paperwork must be obtained before the pre-op meds are administered

Question 6

Nursing responsibility during intra-op phase

Answer 6

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

Question 7

Nursing responsibilities post-op phase

Answer 7

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

Question 8

Two types of general anesthetics

Answer 8

Inhallation and intavenous

Question 9

Inhalation

Answer 9

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

Question 10

Inhaled anesthetics

Answer 10

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

Question 11

-ane

Answer 11

Anesthetic

Question 12

Intravenous anesthetics

Answer 12

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

Question 13

IV anesthetic

Ultra-short acting barbiturates

Answer 13

Sodium pentothal

Rapid onset
Recovery may result with shivering and trembling (common with most anesthetics)

Question 14

IV anesthetics

Non-barbiturates (benzodiazepines)

Answer 14

Midazolam (versed)-conscious sedation

Diazepam (valium)-anxiety
Lorazepan (ativan)-anxiety

Question 15

Other IV anesthetics

Answer 15

Propofol (diprivan)-for fractures, amnesia affect, only advanced practice can give

Etomidate (Amidate)-rapid unconsciousness

Ketamine (Ketalar)-peds works good, PTSD pts

Question 16

What comes first paralysis or sedation

Answer 16

Sedation

Question 17

Meds used as pre-anesthetic adjunctive agents

Answer 17

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

Question 18

Local anesthesia

Answer 18

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)

Question 19

how does local anesthetics work

Answer 19

Stop axonal conduction by blocking sodium channels which stops the conduction of sensation

Question 20

Why is local anesthetics given with a vasoconstrictor such as epinephrine

Answer 20

To help decrease the local blood flow and delay systemic absorption of the local anesthetic

(Prevent it from going systemic)

Question 21

What happens if local anesthetic goes systemic

Answer 21

Cause CNS delays/problems (respiratory depression)

Question 22

Local anesthetic meds

Answer 22

Procaine (novocaine)
Lidocaine (Xylocaine)
Benzocaine (Butesin)
Tetracaine (pontocaine, ciractin)
Dibucaine (nupercainal)
Cocaine

Can be injected, applied topically, or inhaled

Question 23

Local anesthetic nursing responsibilites

Answer 23

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

Question 24

Local anesthetic SE/AR/Precautions

Answer 24

Local irritation (remove patch and clean site)

Systemic toxicity

Cardiovascular effects (esp with cocaine or if absorbed systemically)

CNS problems if absorbed systemically

Question 25

Spinal block

Answer 25

Injected into the sub-arachnoid space

Causes pain and motor function to cease

Headache may occur due to CSF leakage (hole didnt heal) put blood in hole to clot

Spinal patch

Wherever spinal block is placed lose function there down

Question 26

Injectable anesthesia

Answer 26

Conduction (block)

Epidural block

Question 27

Conduction (block)

Answer 27

Injected into the vicinity of nerve trunk to inhibit the conduction of impulses to and from the area supplied by the nerve

Question 28

Epidural block

Answer 28

Injected into the epidural space (lies just outside the subarachnoid space)

Loss of sensation, keeps motor skills intact