Test 5 Thermoregulation

Question 1

Thermoregulation

Answer 1

Mammals ability to self-regulate their body temperature irrespective of the environmental factors

Question 2

Hyperthermia

Answer 2

Above normal temperature

Question 3

Normothermia

Answer 3

Normal temperature

Question 4

Hypothermia

Answer 4

Lower than normal temperature

Question 5

Thermoregulation goal during surgery is?

Answer 5

Maintain normal body temperature

Question 6

What are the risks for deviation from normothermia in surgery?

Answer 6

Anesthesia
OR environment
Open body cavities

Question 7

Ways to measure surgery pt temperature..

Answer 7

Foley catheter
Rectal probe

Question 8

Describe hypothermia in more detail

Answer 8

Body temp below 35 degrees C
Potentially dangerous/ costly
60% experience some hypothermia
Goal is to be proactive
Hard to reverse once cold

Question 9

Maintaining normothermia..

Answer 9

Core temp 35C/ 98.6F
Hypothalamus controls
Shouldn’t vary more then 0.5C
Varies with environment

Question 10

Maintaining normothermia naturally

Answer 10

Cold responses
Thermogenesis- shivering

Question 11

Vasoconstriction

Answer 11

Cold response
Constricts peripheral vessels to conserve heat in the core

Question 12

Thermogenesis- shivering

Answer 12

Most common
-Increase in o2
-Stress on respiratory and cardiovascular system
-uncomfortable for most

Post op shivering is common

Question 13

Thermogenesis- non shivering

Answer 13

Unique to infants
Burning of “brown fat”
- more heat then adipose tissue
- lost as people age

Question 14

Heat loss- radiation

Answer 14

Loss to OR environment
Ex cold room

Question 15

Heat loss- convection

Answer 15

Lost to air currents
Ex fans

Question 16

Heat loss- conduction

Answer 16

Heat loss to cooler surface
Ex OR table

Question 17

Heat loss- evaporation

Answer 17

Loss due to perspiration or respiration

Question 18

Heat loss- perioperative

Answer 18

Anesthesia- decrease metabolism and inhibits cold responses

Question 19

Hypothermia complication-
wound infection

Answer 19

Impairs ability to resist infection
Vasoconstriction > decreased blood pressure> tissue hypoxia> increased wound infection

Question 20

Hypothermia complication-
Cardiac dysfunction

Answer 20

Cardiac arrest
Unstable angina or ischemia (first 24 hours)

Question 21

Hypothermia complications-
Coagulopathy

Answer 21

Impairs platelet aggregation= increase bleeding time

Question 22

Hypothermia complications-
Altered drug effect

Answer 22

Affects neuromuscular blocking agents, local anesthesia, and CV drugs

Question 23

Hypothermia complications-
Increased mortality

Answer 23

Increase fluids, transfusion, and vasopressors= increase organ dysfunction and death

Question 24

Hypothermia complications-
Prolonged recovery time

Answer 24

Longer PACU stays to meet temperature discharge requirements

Question 25

Inducing hypothermia

Answer 25

Intentional Rewarmed at conclusion Manipulated by cardiopulmonary bypass machine

Question 26

What are ways to prevent Hypothermia

Answer 26

Easier to prevent then to treat Raise OR temp Limit skin exposure Cover the head

Question 27

Warm cotton blankets

Answer 27

-Passive method- don’t provide heat to core body - insulators which reduce heat loss by 30%

Question 28

Thermal drapes

Answer 28

Aluminum Reflects heat back Reduces intraop loss Not actively providing heat

Question 29

Fluid warmers

Answer 29

Blood products stored at 34-43F By immersion in H2O By IV warming unit

Question 30

Fluid warmers

Answer 30

Irrigation warmer From warmed bottles Maintained at 89-105F Hemolysis occurs if above 110F

Question 31

Infrared lights

Answer 31

L&D department Aka radiant heat Direct exposure to skin

Question 32

Conductive warming

Answer 32

Water mattress Circulates water through the blanket infection risks

Question 33

Bair hugger

Answer 33

Convection warmer Effective prevention/ treatment Self supporting cocoon Contraindicated in aortic cross-clamping

Question 34

Malignant hyperthermia

Answer 34

Rare- reaction to anesthetic agents Inherited genetic predisposition to MH Symptoms - rapid temp increase - tachycardia - muscle rigidity - acidosis

Question 35

Malignant hyperthermia- tx

Answer 35

MH cart Drugs dantrolene and ryanodex Pack groin, axilla, and head with ice Cold irrigation in body cavities

Question 36

St role in Malignant hyperthermia

Answer 36

Follow anesthesia directions Protect sterile field Acquire cold irrigation Retrieve MH cart