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NRSG258 > NRSG258 - part 3 > Flashcards

NRSG258 - part 3 Flashcards

1
Q

Types of anaesthetics

A
  • General
  • Central Nerve blocks - Spinal / Epidural
  • Regional anaesthesia
  • Local infiltration
  • Sedation/analgesia
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2
Q

General anaesthesia

A

Reversable , unconscious state characterise by amnesia, analgesia and suppression of reflexes.

Physiological effect on CNS
* Sensory pathways

Depress

  • Conscious thought
  • Motor control
  • Perceptions
  • Memory
  • Sensations
  • Cardiovascular
  • Respiratory
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3
Q

Stages of anaesthesia

A

Stage I - analgesia

Stage II - delirium stage

Stage III - surgical anaesthesia

Stage IV - medullary depression

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4
Q

Pharmacological agents used in anaesthesia

A

IV Induction agents

Inhalation agents

Adjuncts

  • Opioids
  • Benzodiazepines
  • Neuromuscular blocking agents (muscle relaxants)
  • Antiemetics

Oxygen

Nitrous oxide

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5
Q

Neuromuscular agents

A

Endotracheal intubation

Skeletal muscle relaxation

Non depolarising
* Suxamethonium

Depolarising

  • Atracurium
  • Vecuronium
  • Pancuronium
  • Rocuronium

Reversable by anticholinesterase agents
* Neostigmine

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6
Q

Opioids - examples

A 
Fentanyl
Morphine
Pethidine
Alfentanil
Remifentanil
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7
Q

Opioids

A

Induce and maintain anaesthesia

Reduce stimuli

Analgesia

  • During surgery
  • Anaesthetic recovery
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8
Q

opiods - adverse effects

A
  • Respiratory depression
  • Vomiting
  • Bradycardia
  • Peripheral vasodilation when combined with anaesthesia
  • Pruritis
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9
Q

Antiemetics

A

Prevention of vomiting with aspiration

Counteract emetic effects

  • Inhalation agents
  • Opioids
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10
Q

Antiemetics - adverse effects

A 
Headache
Dizziness
Sedation
Malaise
Acute dystonic reactions
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11
Q

Anaesthetic emergencies

A 
Anaphylaxis
Laryngospasm
Bronchospasm
Aspiration
Malignant hyperthermia
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12
Q

Anaphylaxis - Treatment

A
  • Remove the causative agent
  • Administer O2 at 100%
  • Fluid replacement
  • Adrenaline
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13
Q

Laryngospasm - Treatment

A
  • Deepen anaesthesia

* Suction to remove stimulus

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14
Q

Bronchospasm - Treatment

A
  • Bronchodilators

* Increase inhalation agent

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15
Q

Aspiration - Treatment

A

Ventilatory support in ICU

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16
Q

Malignant hyperthermia - Treatment

A

Sodium dantrolene

17
Q

pain is….

A

an unpleasant sensory and emotional experience associated with actual or potential tissue damage

what ever the person says it is existing where ever they say it is

Protective mechanism - Warns of potential injury from within the body or outside envoronment

18
Q

Pain - types

A

Physical
Emotional
Physical
Spiritual

19
Q

Pain threshold

A

Level at which pain is felt

20
Q

Pain tolerance

A
  • Level of pain becomes unbearable

* Individual

21
Q

Pain assessment

A
  • Empower your patient - patient controlled analgesia (PCA) is a good option
  • Accept patient’s assessment of their pain.
  • Pain is subjective.
  • Pain is what the patient says it
  • Knowledge – you must understand the drugs you are administering.
  • Consult pain management teams/anaesthetists
  • For patients who are non-verbal - consider which pain assessment tool is appropriate
22
Q

Pain

A

Acute

Chronic

23
Q

Acute pain

A

Sudden onset

Related to an injury

24
Q

Chronic pain

A
  • Persistent or recurring
  • Continues more than 3 months
  • Continues after healing
  • Difficult to relieve
  • Goal of treatment – minimise pain related disabilities
25
Q

Acute Vs Chronic Pain - onset

A

A - Sudden onset

C - Long duration > 3 months

26
Q

Acute Vs Chronic Pain - Characteristics

A

A - Sharp, localised, radiates

C - Dull, aching, persistent, diffuse

27
Q

Acute Vs Chronic Pain - Responses

A

A
Anxiety, restless, cries, protects or rubs affected part, grimaces

C
Angry, depressed, withdrawn, affects sleep and physical activity

28
Q

Acute Vs Chronic Pain - Goals

A

A
Cure the cause, relief of pain, prevent transition to chronic pain

C
Restore functions, tolerance of some pain,Improve quality of life

29
Q

Acute Vs Chronic Pain - Medications

A

A - Opioids

C - Paracetamol, NSAISs, opioids, adjuvants

NRSG258 (9 decks)

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