Anesthesia Flashcards
(47 cards)
Preoperatively anxiety is most effectively relieved by which of the following?
Good anesthesiologist
H2 antagonists help prevent aspiration pneumonitis by doing which of the following?
Increasing pH of gastric contents
What is the most common complication immediately following extubation of the trachea?
Laryngospasm
What is the proper drug injection site for a spinal anesthesia?
B/w the arachnoid and the pia mater of the spinal cord
What is true of a headache that is likely to be diagnosed as a spinal headache?
Goes away when lying down
What is the most common cause of hypotension in the postanesteshia care unit?
Hypovolemia
What is the most effective way to preserve myocardial perfusion in an ischemic heart?
Heart rate as low as possible
A patient who has a mitral valve prolapsed is at increased risk because what is likely to occur?
Fatal arrhythmia
If a patient quits smoking 3 days prior to surgery, what is likely to occur with regards to anesthesia effect?
Improved O2 delivery to the tissues
Tight control of blood glucose (90-120mg/dl) throughout the surgical period benefits the patient with type I diabetes by decreasing the likelihood of what?
Wound infection
Which of the following is of great concern to the anesthesiologist when dealing with a patient who has untreated hyperthyroidism?
Response to stress may be severe arrhythmia and hypertension
Which of the following anesthetic conditions increases Sickling and vascular occlusion?
Hypovolemia
What usually causes central nervous system excitement after the injection of Local anesthetic?
IV injection
What is the most potent opioid currently available?
Sufentanil
Which narcotic causes the least respiratory depression in equianalgesic doses?
All are alike
What anesthetic would most likely cause anterograde amnesia?
Midazolam
Which induction agent permits the earliest return of normal functioning?
Propofol
What is the most reliable monitor of adequacy of ventilation?
Capnograph
Which of the following, when monitored continuously, can show ischemic episodes during anesthesia?
Leads II and V5
Why is patient controlled analgesia superior to intermittent opioid administration?
Patient does not experience wide swings in level of pain
A 70 year old man with a history of tobacco abuse, hypertension, prior stroke, and laryngeal Cancer is brought to the emergency department after found unresponsive at his home. It is estimated by family members that he lost consciousness approximately one hour earlier. He underwent a total laryngectomy 10 years prior with no subsequent evidence of recurrent Cancer. His current medications include ramipril and a daily aspirin. On physical examination, the patient is nonresponsive to voice or painful stimuli and his respirations are shallow. Vital signs are: Temperature 37.9 C (98.9 F), blood pressure 200/100 mmHg, pulse is 93/min, respirations are 13/min, and an O2 saturation level of 87%. There are no apparent signs of trauma secondary to a fall. The pupils are small, but equal and reactive. The patient’s tracheostomy is widely patent; breath sounds are distant but present bilaterally without crackles. An arterial blood gas reveals pH 7.25, PaO2 45. What is the most appropriate next step in management?
Place endotracheal tube in patient’s tracheostomy and begin mechanical ventilation
A 69 year old man had a gastric tube placed a day ago. The patient has a long history of dementia secondary to Alzheimer’s disease and was admitted to the hospital for failure to thrive (FTT). A full evaluation revealed only severe dementia but no obvious cause for FTT. A swallowing study was performed that indicated likely aspiration of all foods. After discussion with the family, a decision was made to place a gastric tube for the purposes of feeding. The surgery was uneventful and the patient appears to be doing well during a routine postoperative check. Later that evening, the patient is found severely obtunded. He is now 34 hours postoperative. He has been getting tube feedings for the past five hours and had minimal gastric residuals at the 2 hour check time. On arrival, he is cyanotic with labored breathing. His pulse oximeter reads 85% on 100% non-rebreather mask. On inspection of the patients mouth and oropharynx, there are tube feedings visible. What is the most likely cause of the patients respiratory distress?
Regurgitation and aspiration of gastric tube feedings
A patient had an anterior neck injury, hoarseness, aborted respirations, subcutaneous emphysema, and laryngeal crepitus following a motor vehicle accident. What is the best method of securing the airway in this situation?
Tracheostomy
A 2.525 lb (1150g) 10 day old boy is undergoing a bowel resection for necrotizing enterocolitis. Heart rate is 200/min and blood pressure measured through a femoral artery catheter is 45/24 mmHg. The next most appropriate step is the administration of what?
Normal saline infusion
