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AFN Chem & Physics > Module 9 Part 4 > Flashcards

Module 9 Part 4 Flashcards

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1
Q

Monitor core temperature with general anesthesia >___ minutes

A

> 30 minutes

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2
Q

Maintain core temp of >___C

A

> 36C

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3
Q

Hypothermia

A

<36C

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4
Q

Hyperthermia

A

> 38C

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5
Q

Normothermia

A

37C

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6
Q

What drug can inhibit the sweating response?

A

Atropine

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7
Q

The majority of heat loss in the preoperative setting occurs within the first ____ hour(s)

A

1 hour

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8
Q

Hypothermia reduces the MAC of volatile anesthetic agents by __% per degrees C

A

5%

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9
Q

Name 3 risks of hypothermia

A
  • Increased O2 consumption through shivering
  • Increased risk CV events & MI
  • Increased risk sickling with sickle cell dz
  • Impaired coagulation
  • Increases surgical blood loss
  • Decreased drug metabolism
  • Reduced MAC of volatile anesthetic agents by 5% per C
  • Increased wound infection and delayed healing
  • Impaired immune function
  • Prolonged PACU stay
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10
Q

What method of heat transfer accounts for the majority of heat transfer in the OR?

A

Radiation

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11
Q

2nd leading cause of heat loss?

A

Convection

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12
Q

Keep OR at least >___C

A

> 23C

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13
Q

1 unit of PRBCs or 1L of crystalloids can decrease temp by _____ degrees C

A

0.25C

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14
Q

Benchmark for adequate neuromuscular recovery is an adductor pollicis (_____ nerve) Train of Four (TOF) ratio of >_____

A

Ulnar nerve

>0.9

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15
Q

Device that uses electrical impulses transmitted from stimulator to superficial peripheral nerve by surface electrodes

A

peripheral nerve stimulator (PNS)

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16
Q

The ________ is most resistant to NMB and it recovers more _______ than peripheral muscles

A

Diaphragm

Quickly

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17
Q

Which nerve is the gold standard for PNS monitoring?

A

Ulnar nerve

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18
Q

Contraction of the _______ muscle of the ______ via stimulation of the ulnar nerve is the preferred site for determining the level of neuromuscular blockade

A

adductor

thumb

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19
Q

Out of the five clinical test types of neuromuscular function, the TOF and _______ stimulation are the most commonly used.

A

tetanic

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20
Q

When is the most useful time to use single twitch PNS monitoring?

A

Induction

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21
Q

Without a baseline for single twitch PNS measuring, if muscle movement is detected at all during stimulation, what does this simply mean?

A

NMB <100%

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22
Q

Single twitch PNS monitoring involves a single twitch at ___ to ___ hertz (Hz) for ___ to ___ milliseconds (ms)

A
  1. 1 - 1 Hz

0. 1 - 0.2 ms

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23
Q

The TOF test delivers four separate stimuli every ___ seconds at a frequency of __ (Hz) for __ seconds.

A

every 0.5 seconds
2 Hz
2 seconds

24
Q

The most widely used means of stimulation is the ______

A

TOF

25
Q

With TOF stimulation what is the term for the decrement in twitch height

A

Fade

26
Q

Twitch suppression of 90% = TOF count of __ or less

A

1

27
Q

TOF stimulation is most sensitive between ___% and ___% paralysis

A

70-100%

28
Q

T1-T3 twitches are present. What is the percent NMB?

A

75-80% block

29
Q

T1 & T2 twitches are present. What is the percent NMB?

A

80-85% block

30
Q

Only T1 twitch is present. What is the percent NMB?

A

90-95% block

31
Q

No twitches are present with TOF. What is the percent NMB?

A

100% block

32
Q

What agent does not have a TOF fade?

A

Succinylcholine

33
Q

Intraoperatively, the ideal degree of paralysis necessary for any procedure with sufficient anesthetic depth is ___% to ___%.

A

85-95% (1-2 twitches)

34
Q

How many TOF twitches visible for ideal degree of paralysis intraop?

A

1-2 twitches visible

35
Q

___-__________ agents have a TOF fade.

A

Non-depolarizing

36
Q

What TOFR should be obtained before extubation?

A

0.9

37
Q

During onset of _______ block, each of the four twitches is decreased equally in size; there is no fade

A

depolarizing

38
Q

___-________ block → more fade = deeper block

A

Non-depolarizing

39
Q

Depolarizing block → no fade; if fade present = _______ block

A

Phase 2 block

40
Q

If larger doses of depolarizing agent are given, for example in techniques that require repeated bolus doses or infusions of succinylcholine, then a ________ block may develop

A

Phase 2

41
Q

_______ blocks with depolarizing agents mimic non-depolarizing blocks

A

phase 2

42
Q

Tetanus consists of continuous electrical stimulation for __ seconds at ___ or ___ Hz

A

5 seconds

50 or 100 Hz

43
Q

With tetanus stimulation, if the muscle contraction produced is sustained for the entire 5 seconds of stimulation without fade, significant paralysis is ______.

A

unlikely

44
Q

This type of stimulation test is painful and should not be repeated too often in order to avoid muscle fatigue

A

Tetanus stimulation

45
Q

The adult brain comprises approximately __% to __% of body weight

A

2-3%

46
Q

The adult brain requires approximately __% to __% of cardiac output

A

15-20%

47
Q

The ______ monitoring system can monitor patient’s level of consciousness (LOC)

A

BIS (bispectral index)

48
Q

A BIS monitor uses the analysis and processing of ____ electrical signals

A

EEG

49
Q

What does BIS value of 0 mean?

A

No brain activity

50
Q

What does BIS value of 100 mean?

A

Pt awake and alert

51
Q

BIS values between ___ and ___ suggest adequate general anesthesia for surgery

A

40-60

52
Q

______ is a controversial marker of renal function

A

UO

53
Q

Try to keep UO >______

A

> 0.5mL/kg/hr

54
Q

Increased response time and/or decrease in response rate to a clinical alarm as a result of too many alarms

A

Alarm fatigue

55
Q

“_________” phenomenon is a natural behavior to disregard signals that have been false in the past

A

“Cry wolf”

AFN Chem & Physics (21 decks)

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