Anesthesia Flashcards
Local anesthetics MOA
- Sodium channel blocker
- blocks nerve communication and Na from entering channels
Local anesthetics blocks perception of?
- pain
- temperature
- touch
- deep pressure
Why is epinephrine added to local anesthetics?
- constricts blood vessels and decreases blood flow to keep medication in area longer
- extend duration of action
- decreases the risk of toxicity and the risk of spreading
epinephrine cannot go in IV because?
it increases HR, BP, and increases heart dysrhythmias
Routes of local anesthesia
- topical
- infiltration
- nerve block
- spinal
- epidural
Spinal anesthesia can cause
- headache
- urinary retention
spinal anesthesia is inserted in
L1 and below
(avoid spinal cord)
to prevent headaches and urinary retention from spinal anesthesia they must
- drink fluids
- lay flat for 8 hrs
Nursing care for anesthesia
- use smallest amount
- apply to small area
- avoid open skin
- wear gloves
- tell pt to avoid exercise
- dont wrap area
- if injecting, aspirate
- rescue equipment nearby
nursing interventions for general anesthesia
- check gag reflex
- teach pt area will be numb (4-6hrs)
- if block given, increase risk of falls
- assess vitals
- assess injection site
General anesthetics MOA
- alter the neurons in the CNS
- rapid and complete loss of sensation and consciousness
- balanced w/ IV and inhaled
Stages of general anesthetics
- loss of pain
- excitement and hyperactivity
- surgical
- paralysis of medulla region
general anesthesia interventions
- screen for hx of reactions (malignant hyperthermia)
- pt iv access
- assess LOC/airway/circulation
- shivering
- BP, HR, temp
- turn, cough, deep breathe, ROM, ambulation
- pain
- ask AO questions
- educate when alert and w/ caregiver
Balanced anesthesia types
- propofol and short acting barbs
(induction: getting them to anesthetic balance) - neuromuscular blocking agents
(muscle relaxant) - opioids/nitrous oxide
(analgesia)
benefits of balanced anesthesia
- get pt out of stage 2 fast
- pt safety
- lower doses when combining drugs decreases the risk of toxicity
Inhaled anesthetic MOA
- increases signals to chloride and potassium channels
- weakened excitatory neurons
types of inhaled anesthetics
- therapeutic gases
- volatile liquids (room temp liquid that turns to vapor when inhaled)
Adjuncts to anesthesia
- anticholinergics (dry secretions and suppress bradycardia)
- benzodiazepines (decrease anxiety, fear or pain, promote amnesia)
- opioids (morphine to counteract pain)
- antiemetics
- neuromuscular blocking agents
Malignant hyperthermia
- rare reaction from anesthesia
- life threatening
- rapid hypermetabolic reaction
s/s of malignant hyperthermia
- sustained muscle contraction
- increase HR and temp
- muscle breakdown
- acidosis
treatment for malignant hyperthermia
- DC medication
- dantrolene
- supportive care
- decrease temp
- cooling blanket
- decrease HR and BP
- STOP MED IN SURGERY
Neuromuscular blocking agents
- causes paralysis ONLY
- no loss of consciousness
- no sedation
- no analgesia
- no amnesia
Neuromuscular blocking agents interventions
- baseline neuro assessment
- dosage should be maintained by using peripheral nerve stimulation during procedure
- monitor sedation
- discontinue as soon as possible
- monitor for malignant hyperthermia
- post neuro assessment
Bispectral index (BIS)
- how we assess how well our pt is sedated and how well we are controlling pain for a pt who’s receiving a neuromuscular blocker
