PACU

Question 1

PONV Risk Factors (5)

Answer 1

female
young
large body habitus
hx PONV/motion sickness
non-smoker

Question 2

medications that increase PONV

Answer 2

VA
Nitrious oxide
opioids
anticholinesterase (neo triggers mu receptors)

Question 3

surgical procedures increase PONV

Answer 3

lap
gyno
eye/ent
breast
neuro

Question 4

postop factors leading to pONV

Answer 4

hypovolemia
POP
hypotension

Question 5

where is area postrema

Answer 5

dorsomedial medulla oblongata

Question 6

receptors contributing to ponv

Answer 6

serotonin
histamine
cholinergic
dopaminergic

Question 7

chemoreceptor trigger zone (area postrema) location and receptors

Answer 7

located in 4th ventricle

d2 receptors
nk receptors?
5ht3 receptors

Question 8

vomitting center (nucleus of tractus solitarius)

Answer 8

histamine
nk1?
5ht3
m1

Question 9

gi tract

Answer 9

5ht3

Question 10

emergence delirium

Answer 10

usually d/t pain

r/o: hypoxemia, acidosis, hypotension, bladder distention, occult bleeding

Question 11

rf emergence delirium

Answer 11

young, preop anxiety, psych d/o, active duty or veteran

Question 12

rf delirium

Answer 12

depression, advanced age, dementia, reduced physical reserve, sensory impairment

Question 13

shivering in absence of hypothermia r/t

Answer 13

pain

tx w/demeral 25 mg IV

Question 14

hypoxemia s/s

Answer 14

restless, tachycardia, cardiac irritability

late: bradycardia, hypotension, cardiac arrest