Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Justin Lyle Cards > AP Exam 4 part IV > Flashcards

AP Exam 4 part IV Flashcards

1
Q

GI/GU consequences of pain

A
  1. decreased gastric emptying/intestinal motility 2. increased urinary sphincter tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

coagulation consequences of pain

A
  1. increased plt aggregation 2. venous stasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

immunologic consequences of pain

A

decreased immune fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

psychologic consequences of pain

A
  1. fear 2. anxiety 3. hopelessness 4. anger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

poorly controlled pain contributes to increased ______________ & ____________

A

morbidity and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hypothermia is defined as body temp < ____________C

A

36

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

causes of hypothermia

A
  1. ambient room temperature 2. methods of heat transfer (radiation, evaporation, convection, conduction) 3. redistribution of blood from periphery to core 4. general, regional(neuraxial), and MAC anesthesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

majority of heat loss occurs through

A

radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

___________ = transfer (loss) of body heat to a cooler environment

A

radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Evaporation causes:

A
  1. sweating (rare with anesthesia) 2. surgical wounds and cleansing 3. respiratory losses 4. transcutaneous evaporation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

___________________ is a mechanism of heat loss, esp in peds, where they may lose 1/5 of body heat

A

transcutaneous evaporation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the 2nd most common mechanism of heat loss in the OR = _________________

A

convection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

________________ = heat loss to cool air/”wind chill” factor

A

convection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

________________ is heat loss from direct contact with surfaces, but is negligible during surgery

A

conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how can you prevent redistrubition hypothermia

A

warming before induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is redistribution hypothermia

A

initial rapid decrease in core temp followed by slow reduction in core temp 2/2 anesthetic induced vasodilation (core heat to flow peripherally)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

physiologic consequences of hypothermia

A
  1. increased O2 consumption (400-500% via shivering) 2. increased CV events: MI, CVA 3. increased sickling with sickle cell pts 4. imparied coagulation and cold induced defect in plt function (increases surgical blood loss) 5. decrease in drug metabolism and elimination 6. CNS depression 7. decreased pt satisfaction 8. impaired wound healing/surgical site infection 9. prolonged PACU stay and increase in hospital costs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: prevention of hypothermia is far superior to active rewarming

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

hypothermia prevention

A
  1. preop cutaneous warmin: forced air warming blanket 2. airway heating and humidification (HME) 3. warm IV fluids 4. warm ambient OR temp (>23 C) 5. cutaneous heating: warm blankets, forced air warming systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

1 UPRBC or 1 L of crystalloid can decrease temp by ________C

A

0.25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pt related factors for increased risk of PONV

A
  1. female 2. non-smoker 3. hx of PONV/motion sickness 4. childhood/young adult
22
Q

surgery related risk factors for PONV

A
  1. increased duration (>3 hrs) 2. type of surgery: breast, abdominal, laproscopic, GYN, strabismus 3. NPO status
23
Q

anesthesia related risk factors for PONV

A
  1. volatile anesthetis 2. N2O 3. intra/postop opioids
24
Q

1 - 2 risk factors for PONV = ____________ risk

A

mod-severe

25
Q

how do you prevent mod-to-severe (1-2 RF) risk of PONV

A

2-3 drugs from different classes

26
Q

3-4 risk factors for PONV = ______________ risk

A

severe

27
Q

how do you manage someone at severe risk for PONV (3-4 RF)

A
  1. consider avoiding GA or use propofol based anesthetic 2. minimize opioids 3. prevention with 3 drugs from different classes
28
Q

medications for PONV prophylaxis

A
  1. Zofran 2. reglan 3. Droperidol 4. Decadron 5. Scopolamine transdermal 6. pregabalin
29
Q

_______________ is a 5-HT3 antagonists, that works to prevent PONV at peripheral and CNS sites.

A

zofran

30
Q

_________________ & ___________ are D2 antagonists that works to prevent PONV by working in the CTZ

A

reglan; droperidol

31
Q

goal of fluid management during perioperative period

A
  1. maintain intravascular fluid volume 2. maintain LV filling pressure 3. maintain CO, BP, and O2 delivery to tissues
32
Q

________________ may mask low intravascular volume

A

hypothermia

33
Q

T/F: using urine output in the postoperative period as an index of volume status is a reliable measure

A

false; can be misleading.

34
Q

olguria is defined as, UOP of < __________ mL/kg/hr

A

0.5

35
Q

what meds can cause an increased risk of urinary retention in the postoperative period

A
  1. opioids 2. ketamine 3. G.A 4. NSAIDs
36
Q

what surgeries is urinary retention in the postoperative period usually common with?

A
  1. urologic 2. inguinal 3. genital
37
Q

polyuria is defined as UOP > _________ ml/kg/hr

A

5-Apr

38
Q

what is the leading cause of AKI in hospitalized pts

A

surgery

39
Q

triggers of tubular dysfunction

A
  1. hypotension and hypovolemia 2. cardiac dysfunction 3. cardiac overload 4. abnormal HTN 5. tissue edema 6. microvascular dyfx 7. nephrotoxic
40
Q

systemic inflammation associated with surgery often leads to _________________

A

progressive tubular injury

41
Q

patient risk factors for AKI

A
  1. CKD 2. obesity/metabolic syndrome 3. DM 4. CV dz 5. hepatobiliary dz 6. anemia 7. foley catheter fx (position, kink, obstruction)
42
Q

what provides the greatest protective benefit to the kidney ?

A

maintain MAP within renal autoregulation and administration of appropriate fluid therapy

43
Q

anesthetic implications of oliguria

A
  1. maintain MAP within autoreg 2. purposeful intravascular fluid expansion 3. maintaining optimal blood volume, Hgb level and CO 4. optimize comorbidities
44
Q

_________________ solutions improve renal perfusion and dilutes nephrotoxins

A

isotonic crystalloid

45
Q

renal protective strategies (with evidence)

A
  1. correct anemia and min blood transfusion 2. maintain perfusion: MAP 80-160 (autoreg) 3. avoid nephrotoxins 4. use balanced crystalloid solutions 5. avoid diuretics 6. continue statins 7. maintain normoglycemia 8. consider low dose precedex and NaHCO3 9. dexmethasone 10. early initiation of renal replacement therapy
46
Q

what fluid should be avoided to protect the kidney

A

0.9% NS and HES solutions

47
Q

what medications should be held prior to surgery, to protect the kidneys

A
  1. ACE 2. ARB 3. Diuretics 4. NSAIDs
48
Q

PACU orders will typically consist of/include

A
  1. VS and parameters 2. respiratory support 3. fluids 4. analgesics, anxiolytics, antiemetics 5. other PRN meds: antihtn, respiratory, insulin 6. lab and dx tests 7. d/c criteria
49
Q

Discharge from PACU

A
  1. patient focuesed outcome indicators 2. discharge disposition 3. aldrete score 4. ideally evaluated for d/c by qualified anesthesia provider
50
Q

PPE protect who?

A

the patient and the healthcare provider

Justin Lyle Cards (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions