Overview Of Anesthesia Flashcards

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1
Q

Who was the pioneer of chemistry?

A

Joseph priestly (1773)

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2
Q

Who coined the term “laughing gas” and what was it

A

Humphrey Davy & nitrous oxide

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3
Q

Who associated ether with the potential for anesthesia?

A

Crawford Long (1842)

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4
Q

In 1844 Horace Wells used what for a tooth extraction?

A

N2O

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5
Q

Who received credit for the first ether anesthetic

A

Morton in 1846 at mass general

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6
Q

First anesthetist

A

John snow

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7
Q

Who had first OB anesthetic performed on them

A

Queen Victoria in 1850

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8
Q

When was Na Lyme developed

A

1927

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9
Q

First nurse known to have specialized in anesthesia:

A

Sister Mary Bernard at St Vincent’s hospital in Erie PA in 1887

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10
Q

“Mother of anesthesia” for mastery of open drop ether

A

Alice Magow

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11
Q

First court ruling that threatened nurses providing anesthesia

A

Frank vs South of 1917
Nurses won

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12
Q

When was NANA founded and by who

A

Agatha Hodgins in 1934

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13
Q

AANA

A

founded by Agatha hodgins
Located in Illinois
4 month program

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14
Q

First certification exam developed

A

1945

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15
Q

CRNA credential adopted

A

1956

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16
Q

When was the first certification exam done via computers

A

1996

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17
Q

Three categories of anesthesia

A

MAC
Regional
General

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18
Q

MAC

A

monitored anesthesia care
Local sedation
Anesthesia on standby

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19
Q

Regional

A

Bier block
Epidural
Spinal
Axillary block
Scalene block

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20
Q

General

A

MAsk
LMA
ETT

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21
Q

Inhalation agents

A

Isoflurane
Sevoflurane
Desflurane

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22
Q

Isoflurane

A

Forane

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23
Q

Sevoflurane

A

Ultane

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24
Q

Desflurane

A

Suprane

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25
Q

What determines the selection of the type of anesthesia?

A

Patient condition
Surgical procedure
Patient preference
Surgeon preference

26
Q

What is the ideal agent?

A

Stable in: temperature, humidity, light
Nonflammable in air, O2, N2O
Easily handled in liquid and gas forms
Potent

27
Q

Ideal agents:

A

Poorly soluble in blood- rapid induction
Nontoxic
Not metabolized
Minimal side effects
No adverse interactions

28
Q

Occurs when anesthetizing partial pressure achieved in the brain

A

Induction

29
Q

3 characteristics of anesthesia

A

Amnesia
Analgesia
Akinesia

30
Q

What are grundel’s signs

A

Stage 1 amnesia
Stage 2 delirium
Stage 3 surgical plane
Stage 4 overdose

31
Q

Explain MAC

A

Minimum alveolar concentration of inhalation agent at 1 atmosphere which prevents movement in 50% of the subjects in response to a noxious stimuli

32
Q

How much MAC do you need to prevent movement in 95% of patients

A

1.2-1.3

33
Q

Strengths of N2O

A

Analgesia, rapid uptake/elimination, little cardiac/respiratory depression

34
Q

Weaknesses of N2O

A

Expansion closed air space
Effect on B12 metabolism limits fio2
N/v
Toxic
Carcinogenic to provider and pregnant patients

35
Q

Strengths of Isoflurane

A

Good muscle relaxation
Stable cardiac rate/rhythm

36
Q

Weaknesses of Isoflurane

A

Pungent odor that cannot be used for mask induction or maintenance

37
Q

Strengths of Desflurane

A

Rapid induction/ emergence

38
Q

Weaknesses of Desflurane

A

Difficult to handle
New vaporizer
Costly

39
Q

Strengths of Sevoflurane

A

Similar to Isoflurane
Can use for mask induction of adults or peds

40
Q

Weaknesses of Sevoflurane

A

Unstable in CO2 absorbers
Metabolized to fluoride
New vaporizer
Costly
Causes fires

41
Q

Thiopental

A

Barbiturate
3-5mg/kg/IV

42
Q

Methohexital (brevital)

A

Barbiturate
1-1.5mg/kg/IV
kids rectally 25mg/kg
Can be used in propofol shortage

43
Q

Midazolam (versed)

A

Benzodiazepine
1-3 mg IV

44
Q

Etomidate (amidate)

A

Nonbarbiturate
0.2-0.3mg/kg/IV induction
No analgesic effects
Good for unstable cardiac patient or hypovolemic patient

45
Q

Ketamine

A

Dissociative
1-2mg/kg/IV
Interferes with communication between limbic and thalamus
No resp depression
Bronchodilator

46
Q

Propofol (diprivan)

A

Hypnotic
2-2.5mg/kg/IV induction
20-200mcg/kg/min infusion

47
Q

Describes drugs which bind to morphine receptor
Useful for induction
Used for maintenance with inhalation

A

Opioids

48
Q

Effect of mu2. Receptor

A

Depress ventilation
Decrease HR
physical dependence
Euphoria
Muscle rigidity

49
Q

Narcan (naloxone)

A

Pure competitive antagonist for mu
Dose 20-40 mcq IV
peak 1-2 min
Duration 30-45 min

50
Q

Flumazenil (Mazicon)

A

Pure benzodiazepine antagonist
Dose 0.2-1mg Q1 min

51
Q

Inhalation agent
Faster and better and less side effects than other agents

A

Halothane (1956)

52
Q

Caused renal issues

A

Methoxyflurane (1959)

53
Q

Caused seizures in EEGs

A

Enflurane (1972)

54
Q

Faster for onset and emergency and had less side effects than the previous

A

Isoflurane (1980)

55
Q

______ and other nurses provided anesthesia during the Civil War

A

Catherine S Lawrence
(1861-1865)

56
Q

____ organized lakeside general hospital school of anesthesia in Ohio

A

Agatha Hodgins

57
Q

Dexmedetomidine (precedex)

A

Loading- 0.5-1mcg/kg IV over 10 min
Onset 10-20 min
Infusion: 0.4-0.7 mcg/kg/hr

58
Q

Intraoperative anesthetic dose of fentanyl

A

2-50mcg/kg IV

59
Q

Intraoperative anesthetic dose of sufentanil

A

0.25 mcg/kg IV

60
Q

Intraoperative anesthetic dose of morphine

A

0.03-0.15 mg/kg IV