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Questions and Answers

In patients with OSA who are morbidly obese, what may offer additional benefits compared to waiting to apply positive pressure in the PACU?

  • Asking the patient to bring their own CPAP machine
  • Using higher salt-containing fluid strategies
  • Applying CPAP postextubation in the operating room (correct)
  • Disregarding the risk of fluid shifts
  • What is the potential risk of fluid shifts in patients with OSA?

  • They are less prone to fluid shifts
  • Fluid shifts can worsen airway edema (correct)
  • Fluid shifts have no impact on airway edema
  • Fluid shifts can improve airway edema
  • What is the purpose of applying CPAP immediately postextubation in the operating room for morbidly obese patients with OSA?

  • To offer additional benefits compared to waiting to apply positive pressure in the PACU (correct)
  • To avoid the need for the respiratory therapist to determine the appropriate positive pressure
  • To prevent the use of high salt-containing fluid strategies
  • To enable the equipment to be set up before the patient's arrival in the PACU
  • What is the main purpose of the respiratory therapist's role in caring for patients with OSA who do not have their CPAP machines with them?

    <p>Both a and b</p> Signup and view all the answers

    According to the European Society of Anaesthesiology, what type of guideline did they publish on postoperative delirium?

    <p>Both evidence-based and consensus-based guideline</p> Signup and view all the answers

    What medication did the FDA approve in 2006 for the prevention of postoperative nausea and vomiting?

    <p>Aprepitant (EMEND)</p> Signup and view all the answers

    According to the American Geriatrics Society, what did they publish in 2015 regarding potentially inappropriate medication use in older adults?

    <p>An updated Beers criteria</p> Signup and view all the answers

    What did the American College of Surgeons NSQIP and the American Geriatrics Society publish a best practices guideline on?

    <p>Optimal perioperative management of the geriatric patient</p> Signup and view all the answers

    Which study identified different motor subtypes of postoperative delirium in older adults?

    <p>The study by Robinson et al.</p> Signup and view all the answers

    What did the study by Cole et al. focus on regarding emergence behavior in children following anesthesia?

    <p>Defining the incidence of excitement and agitation</p> Signup and view all the answers

    What type of guideline did the American Geriatrics Society publish in 2015 regarding postoperative delirium in older adults?

    <p>Best practice statement</p> Signup and view all the answers

    What was the focus of the guideline published by the European Society of Anaesthesiology?

    <p>Postoperative delirium</p> Signup and view all the answers

    Which class of antiemetic medication should not be redosed at all?

    <p>Scopolamine, dexamethasone, and aprepitant</p> Signup and view all the answers

    If an adequate dose of antiemetic medication is ineffective, what is the recommended course of action?

    <p>Switch to a different class of antiemetic medication</p> Signup and view all the answers

    Which of the following is NOT listed as a risk factor for postoperative nausea and vomiting (PONV) in the text?

    <p>Age</p> Signup and view all the answers

    How does the likelihood of experiencing PONV relate to the number of risk factors a patient possesses?

    <p>The likelihood increases as the number of risk factors increases</p> Signup and view all the answers

    If a patient has received an initial dose of an antiemetic medication, when is it recommended to redose with the same class of medication?

    <p>It is not recommended to redose with the same class of medication</p> Signup and view all the answers

    Which of the following statements about antiemetic medications is true, according to the text?

    <p>Antiemetic medications from different classes can be combined for better efficacy</p> Signup and view all the answers

    Which of the following statements about the risk factors for PONV is true, based on the information provided in the text?

    <p>The risk factors are additive in their effect on PONV likelihood</p> Signup and view all the answers

    Which of the following statements about antiemetic medication dosing is true?

    <p>Some antiemetic medications should not be redosed at all</p> Signup and view all the answers

    Which of the following is NOT a common cause of respiratory failure in the immediate postoperative period?

    <p>Chronic obstructive pulmonary disease</p> Signup and view all the answers

    What percentage of ischemic events detected on a 12-lead ECG can be reflected by a combination of leads II and V5?

    <p>80%</p> Signup and view all the answers

    What is the recommended method for monitoring high-risk patients in the immediate postoperative period to avoid human error?

    <p>Computerized ST-segment analysis</p> Signup and view all the answers

    What was the incidence of postoperative urinary retention in the PACU according to the study mentioned?

    <p>16%</p> Signup and view all the answers

    Which of the following was NOT identified as a significant predictive factor for postoperative urinary retention?

    <p>Body mass index (BMI) greater than 30</p> Signup and view all the answers

    What is the most effective protection against contrast nephropathy?

    <p>Aggressive hydration with a balanced crystalloid solution</p> Signup and view all the answers

    What was the reported incidence of rhabdomyolysis in the study of 66 consecutive patients undergoing laparoscopic bariatric surgery?

    <p>22.7%</p> Signup and view all the answers

    Which of the following was NOT identified as a risk factor for rhabdomyolysis in the laparoscopic bariatric surgery patients?

    <p>Advanced age</p> Signup and view all the answers

    According to the references provided, which study directly examined the issue of perioperative visual loss?

    <p>American Society of Anesthesiologists task force on perioperative visual loss. Anesthesiology. 2012;116:274.</p> Signup and view all the answers

    Which reference discusses the issue of ICU overflow patients?

    <p>A Joint Position paper on ICU Overflow Patients. Developed by the American Society of PeriAnesthesia Nursing, American Association of Critical Care Nurses, American Society of Anesthesiologists: Anesthesia Care Team Committee and Committee on Critical Care Medicine and Trauma Medicine; 2000.</p> Signup and view all the answers

    Which reference is related to nursing management?

    <p>Petty DS. Nurs Manage. 2000;31(11):42.</p> Signup and view all the answers

    Which reference is specifically related to perianesthesia nursing?

    <p>Walker JR. J Perianesth Nurs. 1999;14(1):35.</p> Signup and view all the answers

    Which reference is related to liver transplantation?

    <p>Mandell MS, et al. Liver Transpl. 2002;8(8):682.</p> Signup and view all the answers

    Which reference is from a British journal?

    <p>Ziser A, et al. Br J Anaesth. 2002;88(4):577.</p> Signup and view all the answers

    Which reference is related to spinal surgery?

    <p>Myers MA, et al. Spine. 1997;22:1325.</p> Signup and view all the answers

    Which reference is related to neurosurgery?

    <p>Beauregard CL, Friedman WA. Surg Neurol. 2003;60(6):483.</p> Signup and view all the answers

    What is the most common cause of transient postoperative arterial hypoxemia in the immediate postoperative period?

    <p>Alveolar hypoventilation</p> Signup and view all the answers

    Which of the following can be used to reverse the sedating effects of opioids and benzodiazepines in adults?

    <p>Naloxone and flumazenil</p> Signup and view all the answers

    Which of the following is NOT listed as a potential cause of postoperative arterial hypoxemia?

    <p>Hyperventilation</p> Signup and view all the answers

    What should be done to identify and treat the cause of upper airway obstruction after successfully opening the airway and ensuring adequate ventilation?

    <p>Identify and treat the underlying cause</p> Signup and view all the answers

    Which of the following is NOT listed as a contributing factor to postoperative arterial hypoxemia in the PACU?

    <p>Increased intrapulmonary shunt due to pneumonia</p> Signup and view all the answers

    What is the purpose of applying CPAP immediately postextubation in the operating room for morbidly obese patients with OSA?

    <p>To improve oxygenation and ventilation</p> Signup and view all the answers

    What is the recommended method for monitoring high-risk patients in the immediate postoperative period to avoid human error?

    <p>The text does not provide this information</p> Signup and view all the answers

    What is the potential risk of fluid shifts in patients with OSA?

    <p>The text does not provide this information</p> Signup and view all the answers

    Which of the following is NOT a common cause of respiratory failure in the immediate postoperative period?

    <p>Increased oxygen demand</p> Signup and view all the answers

    What is the purpose of applying CPAP immediately postextubation in the operating room for morbidly obese patients with OSA?

    <p>To provide additional benefits compared to waiting to apply positive pressure in the PACU</p> Signup and view all the answers

    What is the recommended method for monitoring high-risk patients in the immediate postoperative period to avoid human error?

    <p>No specific recommendation is provided in the text</p> Signup and view all the answers

    What did the American College of Surgeons NSQIP and the American Geriatrics Society publish a best practices guideline on?

    <p>Postoperative delirium in older adults</p> Signup and view all the answers

    What is the potential risk of fluid shifts in patients with OSA?

    <p>The text does not mention any potential risks of fluid shifts in patients with OSA</p> Signup and view all the answers

    Which of the following statements about antiemetic medication dosing is true?

    <p>The text does not provide any information about antiemetic medication dosing</p> Signup and view all the answers

    What should be done preoperatively to provide CPAP in the immediate postoperative period for a patient with OSA?

    <p>The text does not mention any preoperative steps to provide CPAP in the immediate postoperative period for a patient with OSA</p> Signup and view all the answers

    What did the study by Cole et al. focus on regarding emergence behavior in children following anesthesia?

    <p>The text does not mention a study by Cole et al. regarding emergence behavior in children following anesthesia</p> Signup and view all the answers

    What aspect of neuromuscular function should be assessed for patients who received nondepolarizing neuromuscular blocking drugs?

    <p>Muscle strength</p> Signup and view all the answers

    Which monitoring parameter should be immediately available, according to the text?

    <p>Electrocardiographic monitors</p> Signup and view all the answers

    What is a recommended assessment that should be performed on a case-by-case basis for selected patients or procedures?

    <p>Assessment of urine output and voiding</p> Signup and view all the answers

    Why should postoperative hydration be managed accordingly?

    <p>To optimize tissue healing</p> Signup and view all the answers

    Which parameter should be routinely monitored to ensure patient safety?

    <p>Respiratory rate</p> Signup and view all the answers

    Why should cardiovascular parameters like heart rate and blood pressure be routinely monitored?

    <p>To detect early signs of complications</p> Signup and view all the answers

    Why is periodic assessment of mental status important in postoperative care?

    <p>To prevent delirium</p> Signup and view all the answers

    What is the purpose of assessing pain periodically in postoperative patients?

    <p>To ensure patient comfort and satisfaction</p> Signup and view all the answers

    What is the reported incidence range of residual neuromuscular blockade in the postoperative period?

    <p>20% to 40%</p> Signup and view all the answers

    Which muscle group is likely to recover from neuromuscular blockade before the pharyngeal muscles?

    <p>Diaphragm</p> Signup and view all the answers

    Which of the following medications is listed as potentially contributing to prolonged neuromuscular blockade?

    <p>Lidocaine</p> Signup and view all the answers

    Which of the following conditions is not listed as a potential cause of reduced plasma cholinesterase activity?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which of the following medications is listed as potentially inhibiting plasma cholinesterase activity?

    <p>Echothiophate</p> Signup and view all the answers

    What is the recommended dose of Scopolamine for antiemetic use in adult patients?

    <p>1.5 mg transdermal patch</p> Signup and view all the answers

    Which antiemetic medication should be monitored for prolongation of the QT interval after administration?

    <p>Droperidol</p> Signup and view all the answers

    What is the adult dose of Dexamethasone for antiemetic use postoperatively?

    <p>4 mg IV</p> Signup and view all the answers

    What is the primary route of administration for Hydroxyzine as an antiemetic medication?

    <p>IM</p> Signup and view all the answers

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