NUR 512 Anesthesia Overview

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Questions and Answers

What is a primary action to ensure patient safety during sedation?

Encourage the patient to eat

Monitor airway and oxygen status (correct)

Increase the ambient room temperature

Keep the patient in a sitting position

Which condition is characterized as an inherited muscle disorder triggered by certain anesthetics?

Hypotension

CNS depression

Malignant hyperthermia (correct)

Muscle fatigue

What is an early symptom of malignant hyperthermia?

Hypotension

Skin mottling

Increased CO2 level (correct)

Extremely elevated temperature

What action should be taken if a patient exhibits hypotension during sedation?

Lower the head of the bed Signup and view all the answers

What can be a late manifestation of malignant hyperthermia?

Extremely elevated temperature Signup and view all the answers

What is a key characteristic of general anesthesia?

It induces reversible loss of consciousness. Signup and view all the answers

Which of the following is NOT a risk factor for general anesthesia?

Allergy to ester-type anesthetics Signup and view all the answers

What is the primary mechanism of action for general anesthesia?

Inhibiting neuronal impulses in the central nervous system. Signup and view all the answers

In which type of anesthesia are inhalants such as halothane and isoflurane commonly used?

General anesthesia Signup and view all the answers

What is a potential complication specifically associated with moderate sedation?

Respiratory depression Signup and view all the answers

Which nursing intervention is crucial after administering inhalation anesthetics?

Providing postoperative oxygen and encouraging deep breaths. Signup and view all the answers

Which of the following statements about local anesthesia is accurate?

It can be delivered by topical application or local infiltration. Signup and view all the answers

What defines the term 'moderate sedation'?

Reversible loss of consciousness with maintained reflexes. Signup and view all the answers

Which anesthetic agent is most common for induction?

Propofol Signup and view all the answers

What is a contraindication for using Propofol?

Allergy to eggs or soybean oil Signup and view all the answers

What role do adjunct medications like Fentanyl play in anesthesia?

They offer analgesia. Signup and view all the answers

Which of the following is an effect of benzodiazepines?

Reduce preoperative anxiety Signup and view all the answers

What is a primary use for anticholinergics in anesthesia?

To alleviate bradycardia risk Signup and view all the answers

What adverse effect can result from rapid administration of benzodiazepines?

Cardiac or respiratory arrest Signup and view all the answers

What is the primary purpose of neuromuscular blocking agents in surgery?

To provide muscle relaxation Signup and view all the answers

Which adjunct medication is specifically known for inducing sedation?

Promethazine Signup and view all the answers

What is a significant side effect of opioids used in anesthesia?

Respiratory depression Signup and view all the answers

Why is it important to have a patient sign consent before sedation?

To demonstrate patient understanding and acceptance of risk Signup and view all the answers

Which of the following sequences describes the steps in pre-procedure nursing care for moderate sedation?

Educate about medications, determine last time client ate, perform full assessment. Signup and view all the answers

What is a major risk associated with systemic toxicity during moderate sedation?

Restlessness and altered speech. Signup and view all the answers

Which of the following is NOT a characteristic of moderate sedation?

Client remains unconscious. Signup and view all the answers

During a procedure utilizing moderate sedation, which action should be prioritized by the nursing staff?

Monitor the client's vital signs closely. Signup and view all the answers

Which of the following medications is used as a reversal agent for opioids?

Naloxone Signup and view all the answers

Which of the following actions should be prioritized in the event of malignant hyperthermia?

Apply a cooling blanket and ice to vital areas Signup and view all the answers

What type of anesthetic technique is characterized by an injection into the epidural space and aims to block sensory pathways while preserving motor function?

Epidural anesthesia Signup and view all the answers

What complication may arise from spinal anesthesia that concerns the patient's respiratory function?

Respiratory depression or arrest Signup and view all the answers

Which recommendation would help minimize adverse events in anesthesia?

Develop guidelines and protocols Signup and view all the answers

Which adverse anesthetic event falls under the category of drug error?

Administering the wrong drug Signup and view all the answers

During a procedure, what might indicate a lack of adequate care planning?

Inadequate management of patient safety Signup and view all the answers

What is a notable benefit of local anesthesia when vasoconstrictors are used concurrently?

Decreases the risk of systemic toxicity Signup and view all the answers

Which factor is a common cause for delayed identification of adverse events in anesthesia?

Stress and fatigue among staff Signup and view all the answers

What should be monitored closely after administering spinal anesthesia to prevent CSF leaks?

Patient's head position and hydration status Signup and view all the answers

What is the primary purpose of nerve and field blocks in anesthesia?

To provide localized pain relief Signup and view all the answers

Study Notes

Anesthesia Overview

Anesthesia results in reversible loss of consciousness by inhibiting neuronal impulses in the central nervous system.
General anesthesia involves either a single agent or a combination, leading to CNS depression with analgesia, amnesia, and unconsciousness.
Local anesthesia is delivered topically or via infiltration while regional anesthesia blocks multiple peripheral nerves in a defined area.

Risk Factors

Older adults are more sensitive to anesthetics and have quicker onset of cardiac and respiratory issues.
Pre-existing conditions such as family history of malignant hyperthermia, respiratory and cardiac diseases, and substance use disorders increase risks during anesthesia.
Allergies to ester-type anesthetics and peripheral circulation alterations contribute to local anesthesia risks.

General Anesthesia Medications

Inhalants include halothane, isoflurane, and nitrous oxide. Important to provide postoperative oxygen and encourage deep breaths.
IV agents consist of benzodiazepines, etomidate, propofol (most commonly used), ketamine, and short-acting barbiturates.

Balanced Anesthesia

Involves using a combination of agents for hypnosis, amnesia, analgesia, and muscle relaxation.
Example regimen may include propofol for induction, fentanyl for analgesia, and pancuronium for muscle relaxation.

Adjunct Medications

Opioids: Fentanyl and sufentanil provide sedation and pain relief but can cause respiratory depression and prolonged awakening.
Benzodiazepines: Diazepam and midazolam alleviate anxiety and promote amnesia but require careful titration to avoid respiratory risks.
Antiemetics: Ondansetron and promethazine reduce nausea, while the latter can induce sedation.
Anticholinergics: Atropine and glycopyrrolate decrease salivation and the risk of bradycardia during surgery.
Sedatives: Pentobarbitol is used for pre-anesthesia sedation, with respiratory depression as a notable risk.
Neuromuscular Blocking Agents: Succinylcholine and vecuronium cause skeletal muscle relaxation, requiring ventilation support.

Patient Safety Protocols

Secure informed consent and pre-sedation voiding.
Ensure patient safety by lowering the bed and raising side rails.
Continuously monitor during sedation including airway status, vital signs, and laboratory values.

Complications of Anesthesia

Malignant Hyperthermia: An inherited condition triggered by certain anesthetics inducing severe hypermetabolic reactions leading to muscle rigidity and hyperthermia.
Symptoms include increased CO2 levels, blocked airway, dysrhythmias, and skin mottling.
Immediate nursing actions involve surgery termination, dantrolene administration, and cooling patient down.

Moderate Sedation

Achieved through the use of opioids and sedatives allowing for relaxation while maintaining awareness and airway reflexes.
Medications include morphine, fentanyl, midazolam, propofol, with reversal agents like naloxone and flumazenil.
Used in minor surgical, diagnostic, and procedural settings.

Spinal vs. Epidural Anesthesia

Spinal Anesthesia involves injection into the subarachnoid space causing full sensory and motor block with potential complications like hypotension and CSF leaks.
Epidural Anesthesia targets the epidural space preserving motor function but can also lead to complications like severe hypotension.

Local Anesthesia

Involves topical or injection methods with risks such as systemic toxicity, characterized by restlessness and tachycardia potentially leading to cardiac arrest.

Pre and Intra-Procedure Nursing Care

Thorough assessment and education regarding procedure and anesthesia.
Continuous presence and monitoring of the client during procedures.

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Description

This quiz covers essential concepts in anesthesia, including types, risk factors, and medications used in conjunction with anesthesia and sedation. It also addresses nursing care for clients, complications related to different anesthesia methods, and the nurse's role in moderate sedation.