Special Topics Flashcards

1
Q

What is anesthesia?

A

controlled, reversible state of unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the goal of anesthesia?

A

maintenance of physiologic homeostasis, function of all systems during operation to minimize adverse outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is amnesia?

A

result of GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a neuromusclar blockade?

A

allows muscle relaxation for prolonged periods of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some advantages of GA?

A

useful for surgery, controls airways, can be used for unpredicted durations or events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 3 phases of GA?

A
  1. induction- IV meds
  2. maintenance- volatile gases- NO or TIVA total IV anesthesia
  3. emergence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are characteristics of emergence stage?

A

autonomic hyper responsiveness- HTN, tachycardia, bronchospasm

can be blunted with short acting narcotics, BB or lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some complications from GA?

A

endotracheal intubation- leads to sore throat or damage to teeth

also: N/V, pain, cardiac arrhtymias, MI, CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is neuraxial anesthesia?

A

spinal, needle inserted into L3-L4 subarachnoid space

leads to temporary numbness and muscle relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is SA generally used for?

A

lower extremity procedures such as THA

decreased surgical time, blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is epidural anesthesia?

A

type of NA, small gauge catheter into epidural space

used in combo with GA to reduce peri op stress response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are complications from EA?

A

puncture headaches, spinal hematoma, epidural abcess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a nerve block?

A

commonly used when involving extremities

used in brachial plexus, sciatic, femoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is advantage of nerve block?

A

avoid hemodynamic instability associated with GA and neuromuscular blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are local nerve block complications?

A

pain, weakness, ecchymosis, hematoma, infection, numbness , nerve laceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are systemic effects of a nerve block?

A

systemic toxicity, allergic reactions, pneumo, phrenic nerve paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are other types of anesthesia?

A

monitored anesthesia care- no complete LOC

conscious sedation- should be able to maintain airway integrity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are pt implications for GA?

A

N/V, precautions of on going effects of anesthesia, complications, level of arousal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should you watch for in response to activity after GA?

A

pain, BP/OTN, HR response, more vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a thoracentesis?

A

therapeutic or diagnostic removal of pleural fluid

complication: pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a thoracotomy?

A

incision into chest, usually along intercostal, rib occasionally cut

22
Q

What are complications from thoracotomy?

A

atelectasis, PNA, excess bleeding, infection

23
Q

What are PT implications?

A

pulm hygeine, deep breathing, segmental, mobilization, ROM, positioning

24
Q

What are signs of lung transplant rejection?

A

decreased SaO2 at rest, CXR showing inflammation

25
Q

What is PT role in someone with transplant rejection?

A

continue pulm hygeine

re evaluate activity tolerance

26
Q

What is an anastomotic dehiscence?

A

sudden or increasing air leak in lungs/incision

stop mobility notify team

27
Q

What is most important for PT for lung transplant pts?

A

move early and often

28
Q

What is a laparotomy?

A

surgical procedure to open the peritoneal space

29
Q

What is NIH criteria for gastric bypass?

A

BMI of 40 or higher

or BMI of 35 plus with one or more co related co morbidities

30
Q

What are post op nutritional concerns?

A

weight loss of 65-80% excess weight typical

31
Q

What is a whipple procedure?

A

used for severe pancreatitis or pancreatic cancer

32
Q

What is malnutrition?

A

imbalance between the boys nutritional requirements and intake of these nutrients

33
Q

What is cause of undernutrition?

A

inadequate intake, malabsorption, hyper metabolism, poverty/SES, elderly GI cancers

34
Q

What is cause of over nutrition?

A

over eating, lack of activity, meds, endocrine dysfunction

35
Q

What are malabsorption syndromes?

A

inability of small or large intestines to absorb nutrients

causes: HIV (CD4 receptors), pancreatic disorders (can’t break down proteins and fats), crohns surgery

36
Q

What is normal calorie per kg intake?

37
Q

After elective surgery?

38
Q

After multiple traumas?

39
Q

After sepsis?

40
Q

after burns?

A

protein requirements are doubled

41
Q

What is pulmonary cachexia?

A

occurs in 1/3 of pts with COPD, severe weight loss and muscle wasting

resting energy is proportionally higher as severity of COPD increases

usually aligns with mortality rates

42
Q

What meds can cause overeating?

A

steroids, antidepressants, antipsychotics, cushing’s (increased cortisol secretion from increased ACTH)

43
Q

What is a clear liquid diet?

A

consists of foods that are clear and liquid, used to maintain hydration and keep colon contents to minimum

good for fluids but lack carbs, fat and proteins

44
Q

What is full liquid diet for?

A

used when person has difficulty chewing or swallowing

45
Q

What is a mechanical soft diet?

A

consists of food the require minimal chewing

46
Q

What is difference between TPN and PPN?

A

TPN= large diameter veins

PPN = small diameter veins

47
Q

What is house diet?

A

no restrictions

48
Q

What is ADA diet?

A

diabetes, restrict calories and carbs

49
Q

What is cardiac diet?

A

restricts fats and cholesterol, sodium

encourage potassium

may limit fluids

50
Q

What is renal diet?

A

restricts proteins, sodium, potassium calcium

possible fluid restriction

51
Q

What is neutropenic diet?

A

no unpasteurized milk

all meats cooked, packaged and no deli

no unwashed fruit, veggies

bottled water