Intraoperative Carlos

Question 1

What is the most important effect during moderate and deep sedation?

Answer 1

Respond purposefully to verbal commands

Question 2

It is given by the nurse under the direct supervision of physician

Answer 2

Moderate and deep sedation

Question 3

This is the stage where anesthetic administration is done

Answer 3

Stage I: Beginning Anesthesia (ONSET)

Question 4

What happens during the “end” of the anesthetic administration in Stage I

Answer 4

During loss of consciousness

Question 5

What are the nursing interventions done during Stage I?

Answer 5

1 Close the OR door
2 Avoid unnecessary noises or motions
3 Stand by to assisst client

Question 6

This is the stage where the patient experiences loss of consciousness

Answer 6

Stage II: Excitement (Delirium)

Question 7

What are the nursing interventions done during Stage II?

Answer 7

1 Assisst anesthesiologist in restraining the client

2 Touch the client only for purpose of restraint

Question 8

This is the stage where there is loss of eyelid reflexes

Answer 8

Stage III: Surgical Anesthesia

Question 9

What happens during the “end” of Stage III

Answer 9

1 There is loss of most reflexes
2 Depression of vital functions
3 Client is unconscious, relaxed muslces, blink and gag reflexes are present

Question 10

What are the goals of anesthesia?

Answer 10

1 Control excessive biologic responses

2 Protection of patients from stress-induced complications

Question 11

Define general anesthesia

Answer 11

1 Reversible state consisting of complete loss of consciousness and sensation
2 Protective reflexes such as cough and gag are lost
3 Produces amnesia and hypnosis
4 Can be administered through IV or inhalation

Question 12

This is the stage where fuctions are expressively depressed

Answer 12

Stage IV: Medullary Depression (Stage of Danger)

Question 13

What happens during the end of Stage IV?

Answer 13

1 There is respiratory and circulatory failure
2 Client is not breathing
3 Heartbeat may not be present

Question 14

What are some nursing interventions done in Stage IV?

Answer 14

1 Respond immediately to assisst in establishing airway
2 Provide cardiac arrest tray, dru, syringes, etc.
3 Assisst with closed or open cardiac massage

Question 15

1st Induction

Answer 15

Pulse: Irregular

B.P.: Normal

Question 16

2nd Excitement

Answer 16

Pulse: Irregular and fast
BP: High

Question 17

3rd Operative

Answer 17

Pulse: Steady and slow
BP: Normal

Question 18

4th Danger

Answer 18

Pulse: Weak and thready
BP: Low

Question 19

Types of general anethsesia

Answer 19

1 Intravenous Anesthesia

2 Inhalation Anesthesia

Question 20

What happens during intravenous anesthesia?

Answer 20

`1 Px is unconscious over 30 seconds after the administration
2 Rapid transmission from consicous to surgical anesthesia stage

Question 21

Example of IV anasthesia

Answer 21

Thiopental Sodium and Ketamine

Question 22

What happens during inhalation anesthesia?

Answer 22

1 Ease administration and elimination through the respi system
2 Maintain client stage III anesthesia following induction

Question 23

Example of inhalation anesthesia

Answer 23

Halothane and Isoflurane

Question 24

What are adjuncts to GA?

Answer 24

Drugs are added to an inhalation anesthetic other than IV induction drug

Question 25

What is dissociative anesthesia?

Answer 25

1 Interrupts associative brain pathways | 2 Reduce painful sensation in one region

Question 26

What is local A?

Answer 26

1 Does not involve sedation or LOC | 2 Block only peripheral nerves

Question 27

What is filled block A?

Answer 27

Injected and infiltrated into area proximal to the planned incision

Question 28

What is peripheral nerve block A?

Answer 28

Anesthetizes nerve or nerve plexus

Question 29

What is spinal A?

Answer 29

Surgical procedure involving the lower half of the body

Question 30

What are the advantages of spinal anesthesia?

Answer 30

1 Reduces N and V 2 Lowers respi complication 3 Early post-op recovery 4 Better pain control

Question 31

What is epidural block?

Answer 31

Involves an injection of a local anesthetic into an epidural space

Question 32

What are the nursing managements of spinal and epidural anesthesia

Answer 32

1 Closely observe the manifestation of ANS blockage such as hypotension, bradychardia, N/V 2 Patient may have tingling in the arms and feet 3 Post dural puncture headache such as back pain, isolated nerve injury, and meningitis

Question 33

What are the classifications of complications of major surgery?

Answer 33

1 Due to Anesthesia 2 Due to Surgery 3

Question 34

What are some common complications of general anesthesia?

Answer 34

1 Direct trauma to the mouth 2 Hypothermia due to long operations 3 Allergic reaction to anesthetic agent

Question 35

What are some complications due to surgery?

Answer 35

1 Peri-op complications | 2 Post op complicatons

Question 36

What are some periop complications?

Answer 36

``` 1 Hypotension 2 Inc. BP 3 Cardiac Arrest 4 Hypoxia 5 Asphyxia 6 Chemical causes ```

Question 37

What are the signs of chemical causes?

Answer 37

1 Noisy breathing during partial obstruction | 2 Cyanosis

Question 38

How to maintai safety and prevent injury?

Answer 38

``` 1 Position the client 2 Provide quipment safety 3 Maintain surgical asepsis 4 Assist with wound closure 5 Monitoring ```

Question 39

What are the things that needs to be documented?

Answer 39

1 Drains, tubes and other devices 2 Types of closure and dressing used 3 Post op diagnosis

Question 40

What are some gerontologic considerations?

Answer 40

1 Carefully monitor the response to anesthetic agents 2 Consider using warming devices 3 Increase the need for clear and concise communuication 4 Anesthetic drugs nned to be carefully titrated

Question 41

What are some anaphylactic reactions?

Answer 41

1 Hypotension | 2 Tachycardia

Question 42

What happens during malignant hyperthermia?

Answer 42

1 Characterized by hyperthermia with skeletal muscle rigidity that can result to death

Question 43

What are other factors of malignant hyperthermia?

Answer 43

1 Stress 2 Trauma 3 Heat

Question 44

What is the treatment of malignant hyperthermia?

Answer 44

1 Dantrolene (Dantrium)

Question 45

What does Dantrolene do?

Answer 45

Reduces muscle contraction