N106 Anesthesia & Pharmacology Flashcards
What are the three main types of anesthesia?
General Anesthesia: Administration of drugs by inhalation and/or IV route. Used for major surgeries or extensive tissue manipulation.
Regional Anesthesia: Renders only a specific region of the body insensitive to pain.
Local Anesthesia: Topical application, infiltration into tissues or conscious sedation.
What are common examples of topical anesthetics?
Emla (lidocaine/prilocaine); Cetacaine (spray - benzocaine/tetracaine/butamben/cetyl dimethyl ethyl ammonium bromide); Lidoderm (lidocaine); Anbesol (benzocaine)
Which type of anesthesia may be injected or applied topically and is commonly used in outpatient procedures such as eye surgery, removal of skin growths, dental procedures or carpal tunnel surgery?
Local Anesthesia
What type of local anesthesia is often used during diagnostic procedures (ie. endoscopy’s, bronchoscopy’s), burn dressing changes or chest tube insertions? It provides a depressed level of consciousness rather than complete anesthesia?
Conscious sedation
What must a patient be able to do to receive conscious sedation?
Maintain their own airway and respond to commands.
What type of regional anesthesia involves injection of a local anesthetic via IV line into an extremity below the level of a tourniquet after blood has been withdrawn?
IV Regional anesthesia (AKA Bier Block)
Which type of regional anesthesia requires a lumbar puncture and introduces local anesthetic into the subarachnoid space?
Spinal Anesthesia
What types of surgeries is spinal anesthesia often used for?
lower abdominal, pelvic, lower extremities, urologic, or surgical obstetrics
What is the difference between a spinal and an epidural anesthesia procedure?
The spinal introduces the anesthetic into the subacrachnoid space and the epidural injects anesthetic into the epidural space outside the dura mater.
What are three common pre-anesthetic opioids and what is most important to monitor regarding these drugs?
Fentanyl, Morphine, Hydromorphone (Dilaudid)
Monitor for respiratory depression
What are three common pre-anesthetic antianxiety medications?
Lorazepam (Ativan) (used more often than Valium)
Diazepam (Valium)
Midazolam (Versed)
What Anticholinergics may be administered prior to anesthesia and what do they do?
Atropine - Dries fluids (oral and respiratory secretions)
Scopolamine - anti-nausea, antiemetic
What are the nurses responsibilities when caring for a patient receiving preanesthetic drugs?
- Describe/explain surgery prep (fasting per orders, enema, shaving of operative site, etc)
- Describe/explain post-op care (ie. vital signs will be monitored frequently, equipment such as IV lines and cardiac monitors may be used)
- Demonstrate, describe and explain post-op activities (ie. deep breathing, coughing and leg exercises)
- Emphasizes the importance of pain control (educate about analgesics and relieving pain early and how to use the PCA pump)
How is Methohexital (Brevital) used for anesthesia?
It is a barbiturate
Used for induction of anesthesia
Can be used in conjunction w/ or as a supplement to other anesthetics.
Used in short surgical procedures with minimal painful stimuli.
Depresses CNS to produce hypnosis and anesthesia but does not produce analgesia.
How is Etomidate used for anesthesia?
Nonbarbiturate. Used for induction of anesthesia. May be used to supplement other anesthetics. For short surgical procedures. It is a hypnotic w/o analgesic activity.
How is Propofol (Diprivan) used for anesthesia?
Used for induction and maintenance of anesthesia.
May be used for sedation during diagnostic procedures and procedures that use a local anesthetic.
Also used for continuous sedation of intubated or respiratory-controlled patients in intensive care units.
What type of regional anesthesia is produced by injection of a local anesthetic drug into or near a nerve trunk. (ie. epidural block, transsacral (caudal) block, and brachial plexus block)
Conduction block
What is the purpose of administering an opioid or antianxiety drug as a preanesthetic?
To decrease anxiety and apprehension immediately before surgery.
Patients who are calm and relaxed:
Can be anesthetized more quickly
Usually require a smaller dose of an induction drug
May require less anesthesia during surgery
May have a smoother recovery from the anesthesia period
What is the purpose of administering cholinergic blocking (anticholinergic) drugs as a preanesthetic?
Cholinergic blocking drugs dry up secretions in the upper respiratory tract and decreases the possibility of excessive mucus production which can lead to pneumonia or atelectasis.
What is the purpose of administering an antiemetic drug as a preanesthetic?
To decrease the incidence of nausea and vomiting during the immediate postoperative recovery period.
How is Midazolam (Versed) used in anesthesia?
Short-acting benzodiazepine
CNS depressant
Relieves anxiety
Used for induction of anesthesia
Used for conscious sedation before minor procedures
Used as supplement to nitrous oxide and oxygen for short surgical procedures.
How is Ketamine (Ketalar) used in anesthesia?
Rapid acting general anesthetic.
Produces an anesthetic state characterized by profound analgesia, cardiovascular and respiratory stimulation, normal or enhanced skeletal muscle tone, and occasionally mild respiratory depression.
Used for diagnostic and surgical procedures that do not require relaxation of skeletal muscles.
Used for induction of anesthesia before administration of other anesthetic drugs.
Used as a supplement to other anesthetic drugs.
Which stage of general anesthesia is the stage of delirium and excitement, during which patients may move about, mumble incoherently and muscles are somewhat rigid?
Stage II
Which stage of general anesthesia is the stage of respiratory paralysis and is a rare and dangerous stage of anesthesia?
Stage IV
