General and Local Anesthetic Agents

Question 1

What organs do you have to be cautious with when administering anesthetics in children and elderly patients?

Answer 1

Live and Kidney function

Question 2

What do general anesthetics cause to happen in the brain?

Answer 2

It depresses the CNS producing loss of pain sensation and consciousness.

Question 3

What is the use for local anesthetics?

Answer 3

To cause loss of pain sensation and feeling in a designated area of the body.

Question 4

What do local anesthetics not do?

Answer 4

They do not produce the systemic effects associated with severe CNS depression.

Question 5

What do all local anesthetics have for a prefix?

Answer 5

“caine”

Question 6

True or False:

You use one drug to get the effects of anesthesia?

Answer 6

False: You have to use multiple drugs.

Question 7

True or False:

The more medications given to the patient to reach the effects of anesthesia the better?

Answer 7

False: the least amount of medications used the better to reduce adverse effects.

Question 8

What is analgesia for?

Answer 8

Loss of pain perception

Question 9

What does the term unconsciousness mean in terms of anesthesia?

Answer 9

The loss of awareness of one’s surroundings.

Question 10

What is amnesia?

Answer 10

The inability to recall what took place.

Question 11

True of False:

Asthma does not effect the administration of anesthesia drugs?

Answer 11

False: Some of the anesthesia drugs are given in aerosol form that needs to be inhaled. So, if the patient has asthma it can effect the absorption of the medication.

Question 12

If a patient has a history of these two things an adverse reaction my occur.

Answer 12

Seizures or stroke.

Question 13

Why is renal function a risk factor for anesthesia?

Answer 13

If a person has reduced renal function they may not be able to excrete the drug properly leading to toxicity.

Question 14

Why is hepatic function a risk factor for anesthesia?

Answer 14

If a person has reduced hepatic function they may not be able to metabolize the drug properly leading to toxicity.

Question 15

What does it mean by balanced anesthesia?

Answer 15

A use of a combination of drugs, each with a different effect, causing the outcome wanted while in surgery.

Question 16

What is the preoperative medication administered that decreases secretions?

Answer 16

Cimetadine

Question 17

Why are sedative-hypnotics administered to patients while give anesthesia?

Answer 17

To relax the body during the excitement stage, and to paralyze the body during surgery.

Question 18

What are antiemetics?

Answer 18

Stoping nausea and vomiting

Question 19

Why would you administer an antiemetic during anesthesia?

Answer 19

To make sure they do not vomit causing aspiration.

Question 20

Why would you give an antihistamine during anesthesia?

Answer 20

To reduce allergic reactions.

Question 21

Why would you administer a narcotic during anesthesia?

Answer 21

To reduce pain and sedate the patient.

Question 22

What is the first stage of anesthesia?

Answer 22

The analgesia stage

Question 23

Why happens during the first phase of anesthesia?

Answer 23

Loss of pain

Question 24

What is the second stage of anesthesia?

Answer 24

The excitement stage

Question 25

What happens during the second phase of anesthesia?

Answer 25

Patient becomes combative, muscle spasms occur, elevate heart rate and blood pressure.

Question 26

What is the third stage of anesthesia?

Answer 26

Surgical anesthesia

Question 27

What happens during the third phase of anesthesia?

Answer 27

A paralytic relaxation of the muscle and loss of reflexes

Question 28

What is the fourth stage of anesthesia?

Answer 28

Medullary paralysis

Question 29

What happens during the fourth stage of anesthesia?

Answer 29

Deep CNS suppression; no respiratory rate. May become fatal

Question 30

True or False: | It is important to reach stage four of anesthesia?

Answer 30

False: you never want to reach stage four of anesthesia. This could become fatal.

Question 31

What is the induction period of anesthesia?

Answer 31

The period from the beginning of anesthesia until Stage 3 is reached.

Question 32

What is the maintenance period of anesthesia?

Answer 32

The period from stage 3 until the surgical procedure is complete.

Question 33

What is the recovery period of anesthesia?

Answer 33

The period of discontinuation of the anesthetic until the patient has regained consciousness.

Question 34

During the recovery period of anesthesia where does the patient get their care?

Answer 34

In the PACU.

Question 35

Are barbiturate and nonbarbiturate anesthetics rapid acting?

Answer 35

Yes

Question 36

What are volatile liquids used for in anesthesia?

Answer 36

To maintain

Question 37

What do gas anesthetics do?

Answer 37

Keeps the patient unconscious.

Question 38

True or False: | There are three phases of a general anesthetic?

Answer 38

False: there are 4.

Question 39

What is the difference between an analgesic and an anesthetic?

Answer 39

An analgesic reduces pain. | An anesthetic reduces the sensation of pain.

Question 40

What is the prototype for barbiturate anesthetics?

Answer 40

thiopental

Question 41

How is thiopental administered?

Answer 41

intravenously

Question 42

What does thiopental do?

Answer 42

It induces rapid anesthesia with an ultra short recovery period. Gets you to sleep.

Question 43

When is thiopental administered?

Answer 43

After the time out when every one is in the OR

Question 44

True or false: | Thiopental is lipophilic?

Answer 44

True

Question 45

True or false: | Thiopental does not diffuse rapidly into the brain.

Answer 45

False

Question 46

What are the adverse effects of thiopental?

Answer 46

Decreased BP, HR and RR.

Question 47

What do type of medications do you need to use caution with when using thiopental?

Answer 47

Other CNS suppressants.

Question 48

What kinds of drugs would thiopental reduce their effectiveness?

Answer 48

Birth control, epilepsy drugs, and anticoagulants.

Question 49

What is the major adverse effect of thiopental?

Answer 49

Walking up with delirium.

Question 50

What is the onset time of thiopental?

Answer 50

1 minute

Question 51

What is the duration of thiopental

Answer 51

20-30 minutes.

Question 52

What is the non-barbiturate prototype drug?

Answer 52

Midazolam

Question 53

What class does Midazolam belong to?

Answer 53

benzodiazepines

Question 54

What is does Midazolam do?

Answer 54

It potentiates GABA; produces amnesia and sedation

Question 55

True or False: | Midazolam has a slow onset?

Answer 55

False: it has a rapid onset.

Question 56

What conditions do you need to use caution with when using Midazolam? *hint- there are 4

Answer 56

COPD, kidney or heart disease, pregnancy, lactation.

Question 57

What are the adverse effects of Midazolam? | *hint there are 4

Answer 57

Respiratory and CNS depression; decreased BP, N & V

Question 58

What does Midazolam interact with?

Answer 58

Other CNS depressants

Question 59

What is Propofol used for?

Answer 59

Short procedures due to it being a short acting drug.

Question 60

When giving Midazolam by IV what is the onset time?

Answer 60

3-5 minutes

Question 61

When giving Midazolam by IV what is the peak?

Answer 61

< 30 mins

Question 62

When giving Midazolam by IV what is the duration?

Answer 62

2-6 h

Question 63

What is Nitrous Oxide?

Answer 63

An anesthetic gas

Question 64

How is an anesthetic gas administered?

Answer 64

It is inhaled though a nonrebreather mask

Question 65

True or false: | Nitrous Oxide is a potent analgesic?

Answer 65

True

Question 66

True or false: | Nitrous Oxide is lipophobic and produces severe CNS excitement.

Answer 66

False: | It is lipophilic and causes severe CNS depression.

Question 67

What is a contraindication of nitrous oxide?

Answer 67

pregnancy

Question 68

What are the adverse effects of nitrous oxide? | *hint there are 5

Answer 68

Hypoxia, bowel obstruction, sinus pain, pneumothorax, inactivates Vitamin B12.

Question 69

What does nitrous oxide interact with? | *hint there are 2

Answer 69

Other CNS depressants & Halothane

Question 70

What is the prototype drug for volatile liquids?

Answer 70

Halothane

Question 71

How is Halothane administered?

Answer 71

It is inhaled

Question 72

What is the use for Halothane?

Answer 72

To induce or maintain anesthesia

Question 73

What are the contraindications for Halothane? | *hint there are 4

Answer 73

Hepatic or cardiovascular disease, pregnancy or lactation.

Question 74

What is the main danger of Halothane?

Answer 74

It can trigger malignant hyperthermia

Question 75

What do you need to make sure to have in the room just in case when administering Halothane?

Answer 75

Life support just incase malignant hyperthermia sets in.

Question 76

What is the onset and peak of Halothane?

Answer 76

Rapid

Question 77

What is the duration of Halothane?

Answer 77

To the end of inhalation.

Question 78

``` Identify a contraindication to general anesthetics. A. No suitable veins B. Sickle cell disease C. Status epilepticus D. Anemia ```

Answer 78

A. No suitable veins | General anesthetics and their antidotes are normally administered by IV.

Question 79

Why is Halothane normally kept cold?

Answer 79

Because it is unstable at room temperatures

Question 80

What is the antidote for malignant hyperthermia?

Answer 80

Dantrolene

Question 81

How often can you administer Halothane?

Answer 81

Once every three weeks.

Question 82

If a patient has history of this you should not administer Halothane?

Answer 82

Jaundice.

Question 83

True or false: | Both anesthetic gases and volatile liquids are flammable?

Answer 83

False: | Only anesthetic gases are flammable.

Question 84

What is the topical administration drug of local analgesics?

Answer 84

EMLA cream

Question 85

What do you do after applying a topical analgesic?

Answer 85

You cover it with plastic wrap for 45 minutes. | After removal of plastic wrap the skin will appear completely white and it will numb

Question 86

What local analgesic is given through infiltration?

Answer 86

All the caine drugs. Novacaine, lidocaine etc.

Question 87

When is a local analgesic through infiltration administered?

Answer 87

For giving stitches

Question 88

What is a field block?

Answer 88

A specific area block

Question 89

When is a field block commonly used?

Answer 89

In L&D for a pundendal block of the whole pelvic girdle.

Question 90

When is a nerve block commonly used?

Answer 90

In ortho surgeries.

Question 91

When a nerve block is used in orthopedic surgeries what is used after to decrease blood flow so the surgery can begin?

Answer 91

A tourniquet

Question 92

What is the action of the local anesthetic lidocaine?

Answer 92

A temporary interruption in the production and condition of nerve impulses.

Question 93

The permeability of these ions get affected by lidocaine.

Answer 93

Sodium

Question 94

What would indicate the use of lidocaine?

Answer 94

For infiltration anesthesia, peripheral nerve block, spinal anesthesia and the relief of pain

Question 95

When giving an epidural what part of the spine does it effect?

Answer 95

The medication bathes outside of the spinal sac and the nerves.

Question 96

When giving a spinal what part of the spine does it effect?

Answer 96

It goes closer to the spinal cord than an epidural and gives total pain relief

Question 97

When administering an epidural and spinal injection what does the patient have to do so the needle is placed in the spine correctly\?

Answer 97

The patient needs to leave forward with their back fully rounded to separate their vertebrae.

Question 98

What are the contraindications for lidocaine? | *hint there are 5

Answer 98

Known allergy, heart block, shock, pregnancy and lactation

Question 99

What are the adverse reactions to lidocaine? | *hint there are 7

Answer 99

headache, restlessness, anxiety, blurred vision, cause, vomiting, myocardial depression.

Question 100

What are the drug-to-drug interactions with lidocaine?

Answer 100

Succinycholine & epinephrine

Question 101

What are the two route you can give lidocaine?

Answer 101

IM and topical

Question 102

What is the onset time of lidocaine when given IM.

Answer 102

5-10 minutes

Question 103

What is the peak time of lidocaine when give IM?

Answer 103

5-15 minutes

Question 104

What is the duration time of lidocaine when give IM?

Answer 104

2 h

Question 105

What important assessment should the nurse make before a patient receives a general anesthesia? A. Assess skin lesions B. Assess family support C. Assess preoperative teaching

Answer 105

A. Assess skin lesions | Make sure to monitor for skin breakdown