chapter 18: intraoperative care

Question 1

____ _____ _____ project focuses on improving surgical care by significantly reducing the number of complications from surgery

Answer 1

surgical care improvement

Question 2

_____ _____ started 30-60 mins before surgical incisions

Answer 2

prophylactic antibiotic

Question 3

in the or the _____ nurse serves as the pts advocate

Answer 3

circulating

Question 4

_____ ______ ____ ______ has improved compliance with standards and reduced complications from surgery

Answer 4

WHO surgical safety checklist

Question 5

_____ position used for some types of pelvic organ surgery

Answer 5

lithotomy

Question 6

______ of ____ under pressure in immobile pts plays major role in the development of pressure ulcers in the OR

Answer 6

hypo perfusion of tissue

Question 7

general anesthesia causes peripheral blood vessels to _____

Answer 7

dilate

Question 8

general anesthesia causes what to dilate?

Answer 8

peripheral blood vessels

Question 9

___-_____ ________ based technology allows ACP’s to track the level of pt awareness during surgery and adjust the anesthesia as needed

Answer 9

non-invasive electroencephalogram

Question 10

______ ____ is most common approach for general anesthesia

Answer 10

balanced technique

Question 11

inhalation agents can cause:

_____
__________
increased ______

Answer 11

cough
laryngospasms
increased secretions

Question 12

the choice for delivering inhaled agents is through an _____ tube or ______

Answer 12

ET tube
LMA

Question 13

___ ___ permits control of inhalation and protects airway from aspiration

Answer 13

ETA tube

Question 14

_____ is an important option for pts with difficult airways

Answer 14

LMA

Question 15

____ is a commonly used dissociative anesthetic

Answer 15

ketamine

Question 16

______ anesthesia interrupts associative brain pathways while blocking sensory pathways

Answer 16

dissociative

Question 17

ketamine used in asthmatic pts undergoing surgery bc it promotes _______

Answer 17

bronchodilation

Question 18

regional blocks used as _____ preop, to manage ____ ____ intraop, and postop to ___ _____

Answer 18

-analgesic
-surgical pain
-control pain

Question 19

_____ anesthesia interrupts generation of nerve impulses by altering the flow of sodium into nerve cells

Answer 19

local

Question 20

some local anesthetics are mixed with ______ to provide vasoconstriction

Answer 20

epinephrine

Question 21

some local anesthetics are mixed with epinephrine to provide _______

Answer 21

vasoconstriction

Question 22

topical local anesthetic applied how long before procedure?

Answer 22

30-60 mins

Question 23

with ____ ____ anesthesia the pt has a double cuff tourniquet applied as a safety measure

Answer 23

IV regional

Question 24

2 types of regional anesthesia

Answer 24

spinal
epidural

Question 25

pts given ____ anesthesia experience vasodilation and may become hypotensive

Answer 25

spinal

Question 26

pts given spinal anesthesia experience ______ and may become _______

Answer 26

vasodilation hypotensive

Question 27

______ anesthesia is an injection of local anesthesia into cerebrospinal fluid in subarachnoid space

Answer 27

spinal

Question 28

an _______ is an injection of local anesthetic into the epidural space via thoracic or lumbar approach

Answer 28

epidural

Question 29

observe for signs of autonomic nervous system blockade in pts given an ______

Answer 29

epidural

Question 30

when a pt is given an epidural observe for signs of _____ _____ ___ blockade

Answer 30

autonomic nervous system

Question 31

signs of autonomic nervous system blockade (4)

Answer 31

bradycardia hypotension nausea vomiting

Question 32

onset of _____ anesthesia more rapid than _______

Answer 32

spinal epidural

Question 33

older adults at greater risk for postop ______

Answer 33

hypothermia

Question 34

in an epidural ______ pathways are blocked but _____ fiber still intact

Answer 34

sensory motor

Question 35

initial clinical manifestations of an ________ ________may be masked by anesthesia

Answer 35

anaphylactic reaction

Question 36

anaphylactic reactions cause (4)

Answer 36

bronchospasms tachycardia hypotension pulmonary edema

Question 37

the altered control of intracellular calcium is seen with

Answer 37

malignant hyperthermia

Question 38

_____ appears to be the primary trigger for malignant hyperthermia

Answer 38

succinylcholine

Question 39

which stage of general anesthesia is this? beginning analgesia and relaxation. the client feels dizzy and detached with reduced sensation to pain. clients are sometimes sensitive to noise and stimuli

Answer 39

stage 1

Question 40

which stage of general anesthesia is this? the client might feel delirious, act excited, or could be loud or crying. this stage can be bypassed if meds are given quickly enough. pupils dilate but still respond to light

Answer 40

stage 2

Question 41

which stage of anesthesia can be bypassed if meds are given quickly enough?

Answer 41

stage 2

Question 42

which stage of general anesthesia is this? operative or surgical anesthesia. the client has relaxed muscles and eventually loses reflexes. vital functions begin to reduce, sensation is lost, and the client cannot hear. pupils are small but reactive

Answer 42

stage 3

Question 43

which stage of general anesthesia is this? dangerous levels of anesthesia. vital organ function is depressed to the point of respiratory failure and cardiac arrest. pupils are fixed and death can occur. anesthesia must be stopped immediately. the client might receive stimulant meds and narcotic agonists

Answer 43

stage 4

Question 44

anticholinergics decrease the risk of bradycardia during surgery due to the _______ response to surgical manipulation

Answer 44

parasympathetic

Question 45

avoid giving sedatives within 14 days of starting or stopping an _____

Answer 45

MAOI

Question 46

____ _____ can cause restlessness, altered speech, blurred vision, metallic taste, tremors, and tachycardia

Answer 46

systemic toxicity

Question 47

treatment for systemic toxicity

Answer 47

administration of rapid acting barbiturate