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Preoperative Nursing Management > General and Local Anesthetic Agents > Flashcards

General and Local Anesthetic Agents Flashcards

1
Q

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

A

Live and Kidney function

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2
Q

What do general anesthetics cause to happen in the brain?

A

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

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3
Q

What is the use for local anesthetics?

A

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

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4
Q

What do local anesthetics not do?

A

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

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5
Q

What do all local anesthetics have for a prefix?

A

“caine”

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6
Q

True or False:

You use one drug to get the effects of anesthesia?

A

False: You have to use multiple drugs.

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7
Q

True or False:

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

A

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

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8
Q

What is analgesia for?

A

Loss of pain perception

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9
Q

What does the term unconsciousness mean in terms of anesthesia?

A

The loss of awareness of one’s surroundings.

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10
Q

What is amnesia?

A

The inability to recall what took place.

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11
Q

True of False:

Asthma does not effect the administration of anesthesia drugs?

A

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.

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12
Q

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

A

Seizures or stroke.

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13
Q

Why is renal function a risk factor for anesthesia?

A

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

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14
Q

Why is hepatic function a risk factor for anesthesia?

A

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

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15
Q

What does it mean by balanced anesthesia?

A

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

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16
Q

What is the preoperative medication administered that decreases secretions?

A

Cimetadine

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17
Q

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

A

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

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18
Q

What are antiemetics?

A

Stoping nausea and vomiting

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19
Q

Why would you administer an antiemetic during anesthesia?

A

To make sure they do not vomit causing aspiration.

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20
Q

Why would you give an antihistamine during anesthesia?

A

To reduce allergic reactions.

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21
Q

Why would you administer a narcotic during anesthesia?

A

To reduce pain and sedate the patient.

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22
Q

What is the first stage of anesthesia?

A

The analgesia stage

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23
Q

Why happens during the first phase of anesthesia?

A

Loss of pain

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24
Q

What is the second stage of anesthesia?

A

The excitement stage

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25
Q

What happens during the second phase of anesthesia?

A

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

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26
Q

What is the third stage of anesthesia?

A

Surgical anesthesia

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27
Q

What happens during the third phase of anesthesia?

A

A paralytic relaxation of the muscle and loss of reflexes

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28
Q

What is the fourth stage of anesthesia?

A

Medullary paralysis

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29
Q

What happens during the fourth stage of anesthesia?

A

Deep CNS suppression; no respiratory rate. May become fatal

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30
Q

True or False:

It is important to reach stage four of anesthesia?

A

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

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31
Q

What is the induction period of anesthesia?

A

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

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32
Q

What is the maintenance period of anesthesia?

A

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

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33
Q

What is the recovery period of anesthesia?

A

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

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34
Q

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

A

In the PACU.

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35
Q

Are barbiturate and nonbarbiturate anesthetics rapid acting?

A

Yes

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36
Q

What are volatile liquids used for in anesthesia?

A

To maintain

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37
Q

What do gas anesthetics do?

A

Keeps the patient unconscious.

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38
Q

True or False:

There are three phases of a general anesthetic?

A

False: there are 4.

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39
Q

What is the difference between an analgesic and an anesthetic?

A

An analgesic reduces pain.

An anesthetic reduces the sensation of pain.

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40
Q

What is the prototype for barbiturate anesthetics?

A

thiopental

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41
Q

How is thiopental administered?

A

intravenously

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42
Q

What does thiopental do?

A

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

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43
Q

When is thiopental administered?

A

After the time out when every one is in the OR

44
Q

True or false:

Thiopental is lipophilic?

A

True

45
Q

True or false:

Thiopental does not diffuse rapidly into the brain.

A

False

46
Q

What are the adverse effects of thiopental?

A

Decreased BP, HR and RR.

47
Q

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

A

Other CNS suppressants.

48
Q

What kinds of drugs would thiopental reduce their effectiveness?

A

Birth control, epilepsy drugs, and anticoagulants.

49
Q

What is the major adverse effect of thiopental?

A

Walking up with delirium.

50
Q

What is the onset time of thiopental?

A

1 minute

51
Q

What is the duration of thiopental

A

20-30 minutes.

52
Q

What is the non-barbiturate prototype drug?

A

Midazolam

53
Q

What class does Midazolam belong to?

A

benzodiazepines

54
Q

What is does Midazolam do?

A

It potentiates GABA; produces amnesia and sedation

55
Q

True or False:

Midazolam has a slow onset?

A

False: it has a rapid onset.

56
Q

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

A

COPD, kidney or heart disease, pregnancy, lactation.

57
Q

What are the adverse effects of Midazolam?

*hint there are 4

A

Respiratory and CNS depression; decreased BP, N & V

58
Q

What does Midazolam interact with?

A

Other CNS depressants

59
Q

What is Propofol used for?

A

Short procedures due to it being a short acting drug.

60
Q

When giving Midazolam by IV what is the onset time?

A

3-5 minutes

61
Q

When giving Midazolam by IV what is the peak?

A

< 30 mins

62
Q

When giving Midazolam by IV what is the duration?

A

2-6 h

63
Q

What is Nitrous Oxide?

A

An anesthetic gas

64
Q

How is an anesthetic gas administered?

A

It is inhaled though a nonrebreather mask

65
Q

True or false:

Nitrous Oxide is a potent analgesic?

A

True

66
Q

True or false:

Nitrous Oxide is lipophobic and produces severe CNS excitement.

A

False:

It is lipophilic and causes severe CNS depression.

67
Q

What is a contraindication of nitrous oxide?

A

pregnancy

68
Q

What are the adverse effects of nitrous oxide?

*hint there are 5

A

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

69
Q

What does nitrous oxide interact with?

*hint there are 2

A

Other CNS depressants & Halothane

70
Q

What is the prototype drug for volatile liquids?

A

Halothane

71
Q

How is Halothane administered?

A

It is inhaled

72
Q

What is the use for Halothane?

A

To induce or maintain anesthesia

73
Q

What are the contraindications for Halothane?

*hint there are 4

A

Hepatic or cardiovascular disease, pregnancy or lactation.

74
Q

What is the main danger of Halothane?

A

It can trigger malignant hyperthermia

75
Q

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

A

Life support just incase malignant hyperthermia sets in.

76
Q

What is the onset and peak of Halothane?

A

Rapid

77
Q

What is the duration of Halothane?

A

To the end of inhalation.

78
Q 
Identify a contraindication to general anesthetics.
A. No suitable veins
B. Sickle cell disease
C. Status epilepticus
D. Anemia
A

A. No suitable veins

General anesthetics and their antidotes are normally administered by IV.

79
Q

Why is Halothane normally kept cold?

A

Because it is unstable at room temperatures

80
Q

What is the antidote for malignant hyperthermia?

A

Dantrolene

81
Q

How often can you administer Halothane?

A

Once every three weeks.

82
Q

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

A

Jaundice.

83
Q

True or false:

Both anesthetic gases and volatile liquids are flammable?

A

False:

Only anesthetic gases are flammable.

84
Q

What is the topical administration drug of local analgesics?

A

EMLA cream

85
Q

What do you do after applying a topical analgesic?

A

You cover it with plastic wrap for 45 minutes.

After removal of plastic wrap the skin will appear completely white and it will numb

86
Q

What local analgesic is given through infiltration?

A

All the caine drugs. Novacaine, lidocaine etc.

87
Q

When is a local analgesic through infiltration administered?

A

For giving stitches

88
Q

What is a field block?

A

A specific area block

89
Q

When is a field block commonly used?

A

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

90
Q

When is a nerve block commonly used?

A

In ortho surgeries.

91
Q

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

A

A tourniquet

92
Q

What is the action of the local anesthetic lidocaine?

A

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

93
Q

The permeability of these ions get affected by lidocaine.

A

Sodium

94
Q

What would indicate the use of lidocaine?

A

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

95
Q

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

A

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

96
Q

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

A

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

97
Q

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

A

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

98
Q

What are the contraindications for lidocaine?

*hint there are 5

A

Known allergy, heart block, shock, pregnancy and lactation

99
Q

What are the adverse reactions to lidocaine?

*hint there are 7

A

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

100
Q

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

A

Succinycholine & epinephrine

101
Q

What are the two route you can give lidocaine?

A

IM and topical

102
Q

What is the onset time of lidocaine when given IM.

A

5-10 minutes

103
Q

What is the peak time of lidocaine when give IM?

A

5-15 minutes

104
Q

What is the duration time of lidocaine when give IM?

A

2 h

105
Q

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

A

A. Assess skin lesions

Make sure to monitor for skin breakdown

Preoperative Nursing Management (15 decks)

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