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Flashcards in Exam 1 Chapter 5 Deck (141)
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61

Patients under general anesthesia

not arousable
not even to painful stimuli
they lose the ability to maintain ventilatory function.
require assistance in maintaining a patent airway.
impaired cardiovascular function.

62

patients at greatest risk of anesthesia awareness

cardiac
obstetric
major trauma

63

Anesthetic agents used in general anesthesia

inhaled or administered by IV

64

what are the most reliable guides to patient's condition when general anesthesia is administered?

responses of the pupils
BP
respiration
cardiac rates

65

Type of anesthesia used to block nerves in the peripheral and CNS?

local anesthesia
blocks transmission of pain sensation along nerve fibers.
topical application
local infiltration.

66

A form off local anesthesia in which an anesthetic agent is injected around nerves, so that the area supplied by these nerves is anesthetized?

regional anesthesia
spinal, epidural
peripheral nerve blocks

patient is awake and aware

67

Spinal Anesthesia

nerve block
anesthetic into subarachnoid space lumbar level (L4 and L5)
anesthesia of the lower extremities, perineum, and lower abdomen.
side in knee to chest position for the lumbar puncture.
Position on back when injection has been made.

68

EBP shows that healthy patients are allowed clear fluids up to 2 to 3 hours prior to surgery. True or False

True

69

Benzodiazepines (versed, valium, Ativan) properties.

relieve anxiety
induce sleep
produces amnesia
no analgesic properties
metabolized by the liver
rapidly absorbed

when combined with opiates, increased the effect of the drug.
increase risk of respiratory depression.

70

Side effect of benzodiazepines (versed, valium, ativan)

CNS depression
respiratory depression
hypotension
bradycardia
drowsiness and ataxia
fatigue and confusion
weakness and dizziness

71

what is the reversal agent for benzodiazepines (versed, valium, Ativan)

Flumazenil (Romazicon)

72

Properties of Opioids (morphine, Demerol, Fentanyl)

analgesic and sedation

73

side effects of opioids (morphine, Demerol, Fentanyl)

respiratory depression
N/V
drowsiness
hypotension, orthostatic hypotension
bronchospasm in asthmatics
metabolized in the liver
excreted in the kidneys

74

what is the reversal agent for Opioids (morphine, Demerol, Fentanyl)

Naloxone (Narcan)

75

What are some properties of Histamine (H2) receptor antagonists (Tagamet, Pepcid, Zantac, Prilosec, Prevacid)

inhibit gastric acid secretion

Side effects: skin rash (hypersensitivity)
decreased RBC's, WBC's platelet synthesis

Nursing care: do not administer at same time as antacids
give oral preparation with meals.

76

Antiemetics (Reglan, Droperidol, Zofran, Phenergan)

Properties: Alleviate nausea and vomiting
Side Effects: drowsiness (CNS depression)
hypotension
dry mouth (anticholinergic effect)
blurred vision (dilation from anticholinergic)
in coordination

77

Anticholinergics (Atropine, Glycopyrolate, scopolamine)

Properties: decrease salivation, prevents bradycardia, inhibit smooth muscle contraction in GI tract.

Side Effects: decreased parasympathetic stimulation
decreased peristalsis, decreased salvation, urinary retention, CNS disturbances.

78

What will happen if a patient aspirates vomitus?

asthma-like attach
severe bronchial spasms
wheezing
pneumonitis
pulmonary edema
extreme hypoxia

79

what should the RN do if gagging occurs during surgery/

turn pt to the side
lower head of table or bed
provide a basin
might have to suction

80

what is given to increase gastric fluid PH?

Bicitra

81

what medications can be given to decrease gastric acid production?

histamine (h2) receptor antagonist- cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid).

82

what is the most common cause of anaphylaxis?

medications

RN must be aware of the type and method of anesthesia used as well as the specific agents.

83

Intervention for hypoxia and other respiratory complications

vigilant monitoring of O2 status.
peripheral perfusion
pulse oximetry values

84

Hypothermia

Indicated by a core body temperature that is lower than normal (36.6C (98.0F) or less).

85

what is the goal of intervention if hypothermia occurs?

minimize or reverse the physiologic process.

86

what are some possible cause of temperature changes 12 hr after surgery?

effects of anesthesia medication
low temp in OR
body heat loss during surgical exposure (open body wounds or cavities)
infusion of cold fluids
inhalation of cold gases
decrease muscle activity
age

87

what are some possible causes of temperature first 24-48 hr after surgery?

inflammatory responses to surgical stress
lung congestion
atelectasis

88

what are some possible cause of temperature elevation above 100 F (37.7) third/later after surgery?

wound infection
urinary infection
respiratory infection
phlebitis

89

On what post-op day would an RN expect to see an elevated temp related to a wound infection?

3 days

90

wound infection is often accompanied by?

fever spiking in afternoon and near-normal in the morning .