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Health Alterations > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What is a serious condition to find out related to family history prior to anesthesia?

A

Malignant hyperthermia, which is an inherited condition

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2
Q

What 3 level enzymes do we check for liver function tests?

A

ALP, ALT, AST

ALP: 20-140

ALT: 7-56

AST: 10-40

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3
Q

You have a young, healthy patient who experiences cardiac arrest during surgery. What should you presume? What is the treatment?

A

Presume hyperkalemia and initiate treatment:

  • Hyperventilation
  • Bicarbonate (1-2 mEq/kg IV)
  • Glucose/insulin
  • Calcium chloride 10 mg/kg or calcium gluconate 10-50 mg/kg for life-threatening hyperkalemia
  • Check glucose hourly
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4
Q

What is a normal BNP level?

A

Men: <35

Women: <64

In pt 60+

Men: 35-91

Women: 96-163

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5
Q

What is a common ending for B1 agonists?

A

-erol

Remember: B1 is -olol

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6
Q

What is the diet to control HTN?

A

Dietary Approaches to Stop Hypertension (DASH)

4 servings fruits/vegetables per day

Low saturated fat and cholesterol

Low sodium (2 g/day)

Alcohol 2 drinks/day

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7
Q

What is an early sign of LHF?

A

Cough described as irritating, nocturnal, and nonproductive

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8
Q
A
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9
Q

What is the top priority during the perioperative period?

A

Patient safety

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10
Q

What are normal sodium levels?

A

Na+ = 135-145

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11
Q

What are normal levels for potassium?

A

K+ = 3.5-5.0

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12
Q

When does the preoperative period begin and end?

A

Begins when the patient is scheduled for surgery and ends when the patient is transferred to the surgical suite.

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13
Q

What are some causes of right-sided HF

A

LHF, right ventricle MI, pulmonary HTN (r/t LHF)

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14
Q

What is HTN?

A

BP greater than 140/90

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15
Q

What are the two conditions that are part of COPD?

A

Emphysema and chronic bronchitis

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16
Q

When are vital signs taken post-operatively?

A

q15 x4

q30 x4

q1

q4

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17
Q

What urine output are we looking to achieve?

A

30 cc/hour

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18
Q

What are normal cholesterol levels?

A

Total: <200 mg/dL

LDL: <100 mg/dL

HDL: >60 mg/dL

Triglycerides: <150 mg/dL

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19
Q

What are normal carbon dioxide levels?

A

CO2 = 23-30

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20
Q

Furosimide (lasix)

A

Class: Loop diuretic

Action: Block Cl and Na reabsorption

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21
Q

What is carboxyhemoglobin?

A

CO2 bound to O2 binding sites of hemoglobin

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22
Q

What is a normal prothrombin time?

A

11-12.5 sec, 85-100%

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23
Q

What activates the renin-angiotensin system (RAS)? Which drugs act on this system?

A

Decreased renal blood flow

ACE inhibitors and ARBs

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24
Q

What does a preoperative urinalysis look for?

A

Protein, glucose, blood, bacteria in the urine (to check for potential kidney disease)

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25
Q

What should the nurse monitor for in a patient just starting and ACEI or ARB?

A

ACE-inhibitors and ARBs should be given slowly because the first dose may cause rapid drop in BP. Monitor BP every hour for several hours.

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26
Q

What is the most reliable indicator of fluid gain/loss?

A

Weight (not edema)

27
Q

What would cause RHF without the presence of LHF?

A

COPD, pulmonary HTN, or acute respiratory distress syndrome

28
Q

A patient under general anesthesia is experiencing limb muscle rigidity, what should the nurse suspect and what course of action should be taken?

A

Possible malignant hyperthermia (MH)

  • Notify the surgeon
  • Discontinue succinylcholine
  • Hyperventilate with 100% O2
  • Stop procedure as soon as possible
  • Dantrolene 2.5 mg/kg rapid IV with large-bore IV
  • Bicarbonate 1-2 mEq/kg if ABG not available
  • Cool
29
Q

What is the primary risk of kidney impairment in regards to anesthetic agents?

A

Kidney impairment decreases the extretion of drugs

30
Q

When must temperature be taken post-surgery?

A

Within 15 minutes

31
Q

Spironolactone (Aldactone)

A

Class: Potassium-sparing diuretic

Action: Interfere with Na-K exchange

32
Q

What are normal blood urea nitrogen levels?

A

BUN = 10-20

33
Q

When should prophylactic antibiotics begin and end?

A

Begin one hour before surgery to ensure bactericidal blood and tissue levels by the time the incision is made. Antibiotics should be discontinued within 24 hours of completion of surgery.

34
Q

What heart sound is a common early sign of HF?

A

S3

35
Q

HCTZ (Hydrochlorothiazide)

A

Class: Diuretic

Action: Inhibits Na, K, Cl reabsorption

Nursing: Monitor I/O, weight, electrolytes (especially K and glucose)

36
Q

What is a normal INR?

A

0.7-1.8

37
Q

What are normal albumin results

A

3.5 to 5.5 g/dL

38
Q

When are activities for post-operative care taught?

A

In the pre-operative phase

39
Q

What food allergies are related to latex allergies?

A

Avocados, bananas, strawberies, and other fruits

40
Q

Mannitol

A

Class: Osmotic diuretic

Action: Produces osmotic pressure pulling fluid into tubule

41
Q

What are normal PTT results

A

25-35

42
Q

What is a common ending for cholinergic antagonists?

A

-tropium

43
Q

Patients with which type of condition have the most frequent complications with anesthesia?

A

Cardiac conditions

44
Q

When should a urinary catheter be removed following surgery?

A

POD 1 or POD 2

45
Q

What are s/s of malignant hyperthermia?

A
  • Increased ETCO2
  • Trunk or total body rigidity
  • Masseter spasm or trismus
  • Tachycardia/tachypnea
  • Acidosis
  • Increased temperature (may be late sign)
46
Q

What is the most common cause of heart failure?

A

Systemic hypertension

47
Q

What are normal and elevated troponin ranges? What level indicates probable MI?

A

Normal: < 0.04

Elevated: 0.04 - 0.39

Probable MI: 0.40+

48
Q

What heart failure starts with which side of the heart?

A

Left ventricular HF

49
Q

How should hair removal, if required, be performed?

A

With electric clippers or chemical depilatories only

50
Q

What are s/s of RHF

A

Peripheral edema, increased venous pressure

51
Q

How often should pain be assessed after surgery?

A

q 2 hours

52
Q

Are beta-blockers to be continued during surgery?

A

Yes - significant reduction in coronary events has been noted for those already on beta-blockers prior to surgery

53
Q

What are common signs of RHF?

A

Edema in lower legs, progressing to thighs and abdominal wall

** Ask about weight gain, as one might retain 10-15 pounds of fluid before pitting edema occurs

54
Q

What are normal calcium levels?

A

Ca+ = 8.5-10.2

55
Q

What should venous thromboembolism prophylaxis be applied?

A

24 hours prior to and 24 hours after surgery

56
Q

What is ETCO2 and what does it measure

A

End-title carbon dioxide - it measures effectiveness of ventilation

57
Q

What does SCIP stand for and what does it focus on?

A

Surgical Care Improvement Project

Focuses on infection prevention, prevention of serious cardiac events, and prevention of VTE/DVT

58
Q

What is post-acute care of MH?

A
  • ICU at least 24 hours
  • Dantrolene 1 mg/kg q 4-6 hours
  • CK (creatine kinase) lab q 6
  • Frequent ABG
59
Q

What is a normal hematocrit?

A

Females: 35-45%

Males: 42-52%

60
Q

What is a normal WBC

A

5,000-10,000

61
Q

What are normal chloride levels?

A

Cl- = 98-106

62
Q

What are normal protein levels

A

6-8.3 g/dL

63
Q

What food allergies are related to an allergy to propofol?

A

Egg, peanut, or soy allergies

Health Alterations (2 decks)

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