Surg 102 Chapter 12 (Fuller)

Question 1

What is a polarizing agent?

Answer 1

cause muscle paralysis by stimulating involuntary muscles, which is followed by muscle fatigue

Question 2

What drugs are commonly used as polarizing agents?

Answer 2

succinylcholine and decamethonium

Question 3

What is a nondepolarizing agent?

Answer 3

prevent muscle contraction by binding to the muscle’s cholinergic receptor

Question 4

What drugs are commonly used as nondepolarizing agents?

Answer 4

-mivacurium (short acting)

• atracurium (intermediate duration)
• cistatracurium (intermediate duration)
• vecuronium (intermediate duration)
• rocuronium/Zemuron (intermediate duration)
• tubocurarine (long duration)
• gallamine (long duration)
• metocurine (long duration)
• pancuronium (long duration)
• pipecuronium (long duration)

Question 5

Regional anesthesia provides reversible loss of sensation in a specific area of the body without _____.

Answer 5

affecting consciousness

Question 6

The most common uses of regional anesthesia are :

Answer 6

1. limb surgery in which complete nerve block is possible
2. procedures in which consciousness is desirable or required
3. minor superficial procedures
4. patients for whom general anesthesia poses a significant risk

Question 7

What are the different types of regional anesthesia?

Answer 7

1. topical anesthesia
2. local infiltration
3. nerve block
4. spinal, caudal, and epidural anesthesia

Question 8

What is topical anesthesia?

Answer 8

an anesthetic is applied directly to the eye, skin, or mucous membrane

Question 9

What is local infiltration?

Answer 9

a small amount of drug is introduced through multiple injections into the skin and subcutaneous tissue

Question 10

What is a nerve block?

Answer 10

a single nerve or nerve plexus (group) is anesthetized, blocking sensory stimuli to the tissue enervated by that nerve or group

Question 11

What are spinal, caudal, and epidural anesthesia?

Answer 11

specific techniques for blocking transmission to the middle and lower body

Question 12

Monitored anesthesia care (MAC) is _____ provided during regional anesthesia.

Answer 12

continuous patient monitoring

Question 13

Topical anesthesia is used on _____ and _____ during ophthalmic procedures.

Answer 13

mucous membranes and superficial eye tissue

Question 14

Topical anesthetics are used before insertion of _____ and _____devices and also before _____ and _____to prevent reflexive gagging.

Answer 14

endotracheal and LMA

laryngoscopy and bronchoscopy

Question 15

Local infiltration is injection of an anesthetic into _____ to produce a small area of anesthesia.

Answer 15

superficial tissues

Question 16

During a nerve block, the anesthetic agent is injected into the _____.

Answer 16

adjacent tissue, not into the nerve itself

Question 17

During an intravenous (Bier) block, blood is temporary displaced from a _____.

Answer 17

limb and replaced by a regional anesthetic agent

Question 18

Spinal anesthesia is injection of anesthetic into the _____.

Answer 18

subarachnoid space

Question 19

During spinal anesthesia, two positions are used–_____ or _____.

Answer 19

lateral (side-lying) or sitting

Question 20

A _____ position is used with patient lying on his side and the knees drawn up.

Answer 20

knee-chest

Question 21

Epidural anesthesia is produced when the anesthetic agent is injected into the epidural space that surrounds the _____.

Answer 21

dural sac

Question 22

What are the risks associated with spinal anesthesia?

Answer 22

hypotension, postspinal headache, total spinal anesthesia

Question 23

Caudal and epidural anesthesia target the _____.

Answer 23

epidural space

Question 24

In the epidural anesthesia the approach is through the _____.

Answer 24

lumbar interspace

Question 25

In caudal anesthesia the approach is through the _____.

Answer 25

caudal canal

Question 26

All health care worker must maintain current certification in _____ and be able to respond in case of a cardiac or respiratory arrest

Answer 26

CPR

Question 27

The signs and symptoms of cardiac arrest vary according to whether the patient is _____.

Answer 27

fully conscious at the time or sedated

Question 28

During cardiopulmonary arrest a conscious patient may feel _____.

Answer 28

nausea, shortness of breath, chest pain or pressure, or pain radiating from the jaw, neck, or shoulder

Question 29

It is important to remember that resuscitative efforts must begin _____ to prevent neurological damage from lack of oxygen to the brain.

Answer 29

quickly

Question 30

Brain damage may occur as quickly as _____ after circulatory collapse.

Answer 30

3 minutes

Question 31

A _____ is autonomic spasming of the laryngeal muscles.

Answer 31

laryngospasm

Question 32

A laryngospasm is usually associated with _____ or _____ of the laryngeal nerve during intubation or extubation.

Answer 32

airway secretions or stimulation

Question 33

Laryngospasms are treated with positive-pressure administration of oxygen or, in severe cases, administration of _____.

Answer 33

succinylcholine to paralyze the muscles

Question 34

Anaphylaxis is a _____ to a material or drug that can lead to shock.

Answer 34

true allergic reaction

Question 35

Sign and symptoms of anaphylaxis include _____.

Answer 35

rash, abnormal lung sounds detected during auscultation, wheezing, and difficulty breathing.

Question 36

During severe shock, the supply of _____ and _____ to all body tissues is inadequate.

Answer 36

oxygen and nutrients

Question 37

What are the different types of shock?

Answer 37

1. circulatory shock 2. cardiogenic shock 3. anaphylactic shock 4. neurogenic shock 5. septic shock

Question 38

Circulatory shock is a state of _____ for supplying the whole body.

Answer 38

inadequate blood volume | can be caused by hemorrhage, burns, severe diuresis

Question 39

Cardiogenic shock is caused by heart failure, which disables the _____ because blood cannot be pumped adequately throughout the body.

Answer 39

vascular system

Question 40

Anaphylactic shock is caused by true allergy, resulting in _____, which slows or halts normal circulation.

Answer 40

vasodilation and pooling of blood

Question 41

Neurogenic shock is caused by _____ to maintain vascular tone.

Answer 41

failure of the autonomic nervous system

Question 42

Septic shock is caused by _____, which results in hypovolemia.

Answer 42

severe infection

Question 43

Treatment of shock is targeted at restoring _____, _____, and _____.

Answer 43

circulatory function, electrolyte balance, and oxygenation of tissues

Question 44

Malignant hypothermia (MH) is a rare physiological response to all _____ and _____.

Answer 44

volatile anesthetic agents and succinylcholine

Question 45

Malignant hypothermia causes a severe immediate or delayed _____.

Answer 45

hypermetabolism

Question 46

During malignant hypothermia the patient exhibits an extremely _____, _____, _____, and _____.

Answer 46

high core temperature, tachychardia, tachypnea, and increased muscle rigidity

Question 47

Emergency drugs for MH treatment include _____ and agents to treat specific metabolic disorders.

Answer 47

Dantrium

Question 48

_____ is the rupture of red blood cells.

Answer 48

hemolysis

Question 49

Hemolysis is associated with _____ during blood transfusion.

Answer 49

ABO factor incompatibility

Question 50

Patients under _____ do not show signs and symptoms of hemolytic reaction.

Answer 50

anesthesia

Question 51

ABO mismatch symptoms outside of surgery include:

Answer 51

1. back pain 2. chills 3. hypotension 4. dyspnea

Question 52

What is analgesia?

Answer 52

the absence of pain, produced by specific drugs

Question 53

What is anesthesia?

Answer 53

the absence of sensory awareness or medically induced unconsciousness

Question 54

What is anesthetic?

Answer 54

a drug that reduces or blocks sensation or induces unconsciousness