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NUR 317 Exam 2 Questions And 100% Correct Answers
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NUR 317 Exam 2 Questions And 100% Correct AnswersAnesthesia- differ: advantages, disadvantages, and rationale for choice
General
MAC
Regional
Local
General anesthesia: state of depressed CNS activity w/ loss of conciousness, no
response to stimulation, muscle relaxation, no reflexes
-used for major surgery, longer in length, requiring complete muscle relaxation or need
to control ventilation
-require advanced airway management-intubation and ventilator support
-start with IV induction then, inhalation agents adjuncts
-must be NPO prior
-Complications: damage teeth, sore throat, hoarse voice from intubation
Monitored anesthesia care (MAC): minor procedures, aka concious sedation; done in or
outside the OR
-administration of sedatives/hypnotics and opioids to point where client relaxes enough
,to perform minor procedures w/o discomfort, controls pain and anxiety
-client can respond to verbal stimuli, remains protective reflexes, easily arousable
-independently maintains a patent airway
-Used for minor surgical procedures (dental, cosmetic, ophthalmic), endoscopy, bone
marrow aspiration, lumbar puncture, cardioversion, wound care,
reduction/immobilization of fractures, placement/removal of implanted devices,
catheters, tubes
-Twilight experience: dont remember what is going on
-Anxiolytic + anaglesia
Regional anesthesia :local conduction or field block: reduction of sensation in selected
parts of body; client will be awake
-Spinal: anesthetic agent is injected into CSF; sensory and motor blockade below level
of innervation
-Epidural: injected into epidural space in thoracic/lumber area, blocks sensory but
motor function is intact
-Nerve blocks: injection into area of nerves to block sensation
Local anesthesia: injection or topical application of anesthetic agent to targeted area
(procaine, lidocaine), loss of sensation w/o loss of conciouseness
Anesthesia reactions and catastrophic events in the OR
Respiratory depression
,Reverseal drugs:
-flumazenil (Romazicon): reverses benzodiazepines, angeoslitic
-nalaxome (Narcan): reverse opioid anagelsics
Anaphylactic reactions: life-threatening reaction, closing off of the airways
tachycardia, hypotension, bronchospasms, pulmonary edema
most commonly caused by LATEX allergy (must identify in pre-op*)
Define what causes malignant hyperthermia
How to determine if the patient is at risk
Explain clinical manifestations and treatment.
Acute life-threatening medical emergency; RARE inherited muscle disorder induced by
anesthesia characterized by hyperthermia with skeletal muscle rigidity
Hypermetabolic condition causing an alteration in calcium activity> Muscle rigidity,
hyperthermia, CNS damage
during intubation or in recovery
-important to identify during pre-op assessment**
-Succinycholine (Anectine) is the main trigger (administered right before intubation)
Manifestations:
-Initial: Tachycardia*, Increased carbon dioxide level, decreased oxygen sat
, -Followed by: dysrhythmias, muscle rigidity, hypotension, tachypnea, skin mottling,
cyanosis, myoglobinuria
-Late: Very high temperature (as high as 41.7 C or 107 F)
-can lead to death
Nursing interventions:
-STOP surgery
-administer IV dantrolene (Dantrium)
-100% oxygen
-ABGs, monitor cardiac rhythm
Administer cool IV fluids 0.9% sodium chloride, cool mist cooling blanket, ice packs to
axilla, groin neck and head, iced lavage
Urinary catheter/watch for myoglobinuria
Admit to ICU
Postoperative phase
Nursing care priorities
Begins immediately after surgery
PACU: usually located near the OR, reduces transportation time and allows for easy
accessibility with anaesthesia and operating room staff
Nursing care priorities: provide for patient safety; identify actual and potential patient
problems
Client needs frequent assessment and intervention
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