AORN PERIOP 101 2022 – Questions and Answers

AORN PERIOP 101 2022 – Questions and Answers All the following professionals are qualified to provide anesthesia to a patient EXCEPT: a) anesthesiologist b) CRNA c) anesthesiology assistant d) operating surgeon Correct Ans - d) operating surgeon Of the following, which is not used to secure airway: a) ET tube b) LMA c) nasal cannula d) oral airway Correct Ans - c) nasal cannula The perioperative team should know the location of equipment stored in the OR and in the department. Equipment that the anesthesia provider may request includes: a) video laryngoscopy devices b) fiberoptic bronchoscopes c) suction tips and devices d) all of the above Correct Ans - d) all of the above General Anesthesia Correct Ans - a drug-induced reversible state of unconsciousness, it includes amnesia, analgesia, loss of responsiveness, decreased stress response, and loss of skeletal muscle reflexes to varying degree Regional Anesthesia Correct Ans - an injection of local anesthetics near nerve fibers to cause reversible loss of sensation over an area of the body, common examples include spinal, epidural, and peripheral nerve blocks Monitored Anesthesia Care (MAC) Correct Ans - when an anesthesia provider monitors the patient, administers sedatives and other agents as needed, and provides medical services as needed Moderate Sedation Correct Ans - the administration of sedative, analgesic, and/or anxiolytic agents by a physician or under physician supervision. Depending on state laws and hospital policies, a perioperative nurse may be able to administer this type of anesthesia Local Anesthesia Correct Ans - The infiltration or topical administration of agents to anesthetize a part of the body. It is typically used for minor procedures, does not involve an anesthesia provider, and does not involve sedation. A perioperative nurse monitors the patient and provides supportive care if needed. The phases of general anesthesia, in order, are: a) induction, maintenance, emergence b) emergence, maintenance, induction c) maintenance, emergence, induction d) induction, emergence, maintenance Correct Ans - a) induction, maintenance, emergence Propofol Correct Ans - IV induction agent etomidate Correct Ans - IV induction agent methohexitol Correct Ans - IV induction agent IV induction agent Correct Ans - ketamine sevoflurane with or without nitric oxide Correct Ans - inhaled induction agent Succinylcholine Correct Ans - short-acting muscle relaxant cisatracurium Correct Ans - intermediate-acting muscle relaxant atracurium Correct Ans - intermediate-acting muscle relaxant rocuronium Correct Ans - intermediate-acting muscle relaxant vecuronium Correct Ans - intermediate-acting muscle relaxant pancuronium Correct Ans - long-acting muscle relaxant isoflurane Correct Ans - used for inhalation maintenance desflurane Correct Ans - used for inhalation maintenance total iv anesthesia (TIVA) Correct Ans - a technique for maintaining anesthesia using infusions of short-acting IV agents without inhalation anesthetics. Propofol and remifentanil are often used for TIVA. Reversal agent for succinylcholine Correct Ans - none! neostigmine Correct Ans - reversal for muscle relaxant (except succinylcholine) edrophonium Correct Ans - reversal for muscle relaxant (except succinylcholine) sugammadex Correct Ans - reversal agent for rocuronium, vecuronium, and pancuronium flumazenil Correct Ans - reversal agent for benzos (midazolam) naloxone Correct Ans - reversal agent for narcotics (fentanyl) which of the following type of airway maintenance usually requires muscle relazants? a) spontaneous respiration b) mask ventilation c) laryngeal mask airway d) endotracheal intubation Correct Ans - d) endotracheal intubation When should cricoid pressure be released? a) if the patient coughs b) when the patient loses consciousness c) if the anesthesia provider cannot see the vocal cords d) after the cuff of the ET tube is inflated and the position is confirmed Correct Ans - d) after the cuff of the ET tube is inflated and the position is confirmed lidocaine Correct Ans - local anesthetic bupivacaine Correct Ans - local anesthetic ropivacaine Correct Ans - local anesthetic tetracaine Correct Ans - for long-acting spinal anesthesia epinephrine (anesthesia) Correct Ans - added to increase density and duration of a regional block bicarbonate (anesthesia) Correct Ans - sometimes added to reduce the acidity of the local anesthetic and speed the onset of the block Spinal Anesthesia Correct Ans - the subarachnoid space is entered and local anesthetic is injected directly into the spinal canal, pt sitting or lateral Epidural Anesthesia Correct Ans - the anesthesia care provider finds the space between the ligamentum flavum and dura, this space is identified by a loss of resistance as the needle is advanced, a single dose of anesthetic can be injected, or a catheter can be placed IV regional anesthesia (Bier Block) Correct Ans - used for procedures on hand, wrist, or forearm (double tourniquet method) Local Anesthetic System Toxicity (LAST) Correct Ans - can occur if unsafe amount of local anesthetic enters bloodstream, can occur slowly as med is absorbed over time, or quickly if accidentally injected into blood vessel CAN PROGRESS TO SEIZURES AND CARDIAC OR RESP ARREST Symptoms of LAST Correct Ans - -ringing in ears -tingling lips -metallic taste in mouth -dizziness Sedation can be used with any of the following types of anesthesia except: a) regional anesthesia b) monitored anesthesia care c) general anesthesia d) local anesthesia Correct Ans - d) local anesthesia Malignant Hyperthermia (MH) Correct Ans - a rare but potentially life-threatening complication of anesthesia, triggered by inhaled general anesthetic agents and the muscle relaxant succinylcholine Complications of MH Correct Ans - it can lead to cardiac arrest, brain damage, organ failure, and death increased end-tidal CO2 Correct Ans - most specific sign of MH Dantrolene Correct Ans - drug used to treat MH Hypothermia Correct Ans - a core body temperature 36c (96.8F) Which of the following is associated with increased risk for hypothermia? a) female sex b) higher than normal body weight c) hyperthyroid d) hypertension Correct Ans - a) female sex Identify the active warming devices a) circulating water garments b) cotton blankets c) forced-air warming devices d) increased ambient room temperature e) surgical drapes d) warmed IV fluids Correct Ans - a) circulating water garments c) forced-air warming devices d) increased ambient room temperature f) warmed IV fluids Which of the following would be an appropriate action for the perioperative nurse when assisting with anesthesia? a) administer the muscle relaxant reversal agent if needed? b) apply cricoid pressure if needed during intubation c) document anesthetic agents used, dose, route, and time d) extubate the patient Correct Ans - b) apply cricoid pressure if needed during intubation Which of the following is NOT included in basic monitoring of the patient for anesthesia? a) pulse oximetry b) ECG c) arterial line d) blood pressure Correct Ans - c) arterial line Which drug is used to reverse valium and midazolam? a) neostigmine b) pancuronium c) flumazenil d) succinylcholine Correct Ans - c) flumazenil