AORN Peri-Op 101 Final Exam Review
What factors should be considered before determining what anesthetic to use for a particular patient?
1. Patient/Surgeon Preference
2. Surgical Procedure
3. Physiological Status
4. Patient Age
5. Post-op Recovery Time
6. Length of Surgery
7. Position of Patient
8. Patient's Previous Experiences with Anesthesia.
What are the types of anesthesia?
1. General Anesthesia
2. Regional Anesthesia
3. Local Anesthesia
4. Monitored Anesthesia Care (MAC)
General Anesthesia
A reversible state of unconsciousness, consisting of amnesia, analgesia, and muscle relaxation.
Regional Anesthesia
A reversible loss of sensation, which is achieved by injection of a local anesthetic to block the nerve fivers from
transmitting impulses. Example: Spinal Block
Local Anesthesia
Functions like regional anesthesia but usually applies to a smaller area or a single body part such as a finger or
a toe.
Monitored Anesthesia Care
Consists of intravenous medication and concurrent local infiltration of tissue at the surgical site.
What are the three phases of anesthesia?
1. Induction
2. Maintenance
3. Emergence
Induction Phase of Anesthesia
This phase begins with the administration of anesthesia and lasts until the surgical incision is made.
Maintenance Phase of Anesthesia
This phase begins with the surgical incision and lasts until near completion of the procedure.
Emergence Phase of Anesthesia
This phase starts as the patient begins to awaken and ends upon exiting the operating room.
, How can a patient's airway by maintained?
Not all patients who have general anesthesia need to be intubated. Depending upon the length of the surgical
procedure, the anesthesia care provider may opt to use mask ventilation or a laryngeal mask airway (LMA),
which provides many advantages including comfort for the patient and a faster recovery.
What are the NPO guidelines?
Ingested Material:Minimal Recommended Fasting Times
Full meals, greasy foods : 8 hours
Light meals or infant formula : 6 hours
Breast milk : 4 hours
Clear Liquids : 2 hours
How does the perioperative nurse assist with induction of anesthesia?
1. Starting IVs
2. Setting up monitoring equipment such as an arterial line
3. Double-checking blood
4. Obtaining warming blankets and emergency equipment as necessary
5. Applying cricoid pressure.
What is a bier block?
IV Regional Anesthesia. Used for procedures on the hand, wrist or forearm.
How is a bier block performed?
1. IV placement in the extremity which will have the surgery.
2. Placement of double tourniquet
3. Limb exsanguination
4. Inflation of the proximal cuff
5. Local anesthetic is injected
6. If cuff discomfort occurs, the distal cuff is inflated then the proximal cuff is deflated
7. Anesthetic lasts until both cuffs are deflated.
Role of the peri-operative RN for Bier Blocks
1. Maintain the tourniquet times.
2. Ensure tourniquet is deflated slowly to prevent a bolus of local anesthetic from entering the circulation.
What are the signs of Malignant Hyperthermia (MH)?
1. Sudden, unexplained tachycardia and
2. Rise in end-tidal CO2 production
3. Hypercarbia
4. Dangerously high body temperature
5. Hyperkalemia
What factors should be considered before determining what anesthetic to use for a particular patient?
1. Patient/Surgeon Preference
2. Surgical Procedure
3. Physiological Status
4. Patient Age
5. Post-op Recovery Time
6. Length of Surgery
7. Position of Patient
8. Patient's Previous Experiences with Anesthesia.
What are the types of anesthesia?
1. General Anesthesia
2. Regional Anesthesia
3. Local Anesthesia
4. Monitored Anesthesia Care (MAC)
General Anesthesia
A reversible state of unconsciousness, consisting of amnesia, analgesia, and muscle relaxation.
Regional Anesthesia
A reversible loss of sensation, which is achieved by injection of a local anesthetic to block the nerve fivers from
transmitting impulses. Example: Spinal Block
Local Anesthesia
Functions like regional anesthesia but usually applies to a smaller area or a single body part such as a finger or
a toe.
Monitored Anesthesia Care
Consists of intravenous medication and concurrent local infiltration of tissue at the surgical site.
What are the three phases of anesthesia?
1. Induction
2. Maintenance
3. Emergence
Induction Phase of Anesthesia
This phase begins with the administration of anesthesia and lasts until the surgical incision is made.
Maintenance Phase of Anesthesia
This phase begins with the surgical incision and lasts until near completion of the procedure.
Emergence Phase of Anesthesia
This phase starts as the patient begins to awaken and ends upon exiting the operating room.
, How can a patient's airway by maintained?
Not all patients who have general anesthesia need to be intubated. Depending upon the length of the surgical
procedure, the anesthesia care provider may opt to use mask ventilation or a laryngeal mask airway (LMA),
which provides many advantages including comfort for the patient and a faster recovery.
What are the NPO guidelines?
Ingested Material:Minimal Recommended Fasting Times
Full meals, greasy foods : 8 hours
Light meals or infant formula : 6 hours
Breast milk : 4 hours
Clear Liquids : 2 hours
How does the perioperative nurse assist with induction of anesthesia?
1. Starting IVs
2. Setting up monitoring equipment such as an arterial line
3. Double-checking blood
4. Obtaining warming blankets and emergency equipment as necessary
5. Applying cricoid pressure.
What is a bier block?
IV Regional Anesthesia. Used for procedures on the hand, wrist or forearm.
How is a bier block performed?
1. IV placement in the extremity which will have the surgery.
2. Placement of double tourniquet
3. Limb exsanguination
4. Inflation of the proximal cuff
5. Local anesthetic is injected
6. If cuff discomfort occurs, the distal cuff is inflated then the proximal cuff is deflated
7. Anesthetic lasts until both cuffs are deflated.
Role of the peri-operative RN for Bier Blocks
1. Maintain the tourniquet times.
2. Ensure tourniquet is deflated slowly to prevent a bolus of local anesthetic from entering the circulation.
What are the signs of Malignant Hyperthermia (MH)?
1. Sudden, unexplained tachycardia and
2. Rise in end-tidal CO2 production
3. Hypercarbia
4. Dangerously high body temperature
5. Hyperkalemia
