Principles of Anesthesia Nursing 1 -
Exam 1 Q4 QUESTIONS AND WELL
UPDATED ANSWERS
Anesthesia care consists of? - ANSWER>>Rendering patients insensible to pain
and managing their condition during surgery or diagnostic procedures
Includes preoperative evaluation and treatment, anesthetic administration,
postoperative care, and other contributions (resuscitation, invasive lines,
ventilatory management, acute and chronic pain relief)
Where does anesthesia care occur? - ANSWER>>Hospitals, free standing surgical
centers, offices (dental), "forward areas" (war/combat zones)
What is the triad of general anesthesia? - ANSWER>>analgesia, hypnosis
(amnesia), & immobility
Types of anesthesia techniques? (4) - ANSWER>>General anesthesia, regional
anesthesia, local anesthesia, and monitored anesthesia care (MAC)
TEFRA 1982 - ANSWER>>Tax Equity and Fiscal Responsibility Act
Direct payment to the CRNA under Medicare Part B
Medical direction payment if 7 conditions were met
3 parts of HIPPA - ANSWER>>Privacy Rule
Security Rule
Electronic Data Exchange
Preoperative phase includes: - ANSWER>>Preop evaluation
Choice of anesthesia
Premedication
,Intraoperative phase includes: - ANSWER>>Physiologic monitoring and vascular
access
General anesthesia (plan for induction, maintenance, and emergence)
Regional anesthesia (plan for type of block, needle, local anesthetic)
Postoperative phase includes: - ANSWER>>Postoperative pain control method
Special monitoring or treatment based on surgery or anesthetic course
Disposition (home, PACU, ward, stepdown, ICU)
Is the CRNA required to accompany the patient to the PACU? - ANSWER>>YES!
General anesthesia - ANSWER>>A reversible depression of the CNS sufficient to
permit surgery to performed without movement, obvious distress, or recall
Preparation: MSMAID - ANSWER>>Machine check
Suction
Monitors
Airway
IV
Drugs
Medications given during preoperative period? - ANSWER>>"Drug of trust"
Versed
Fentanyl
Medications given during induction? - ANSWER>>Propofol (mcg/kg) (sometimes
with lidocaine to reduce burning and reduces sympathetic response of DL)
Etomidate (not as common)
Succinylcholine
Medications given for maintenance of anesthesia? - ANSWER>>Gases/VAA
(Sevoflurane, Isoflurane, Desflurane, etc.)
, Muscle relaxants (Rocuronium, Vecuronium) - may or may not give
Narcotics (Fentanyl, Morphine, Dilaudid)
What are some emergency medications? - ANSWER>>Ephedrine (if BP low and HR
low)
Phenylephrine (if BP low and HR normal)
Robinol/Glycopyrulate (like atropine but not ACLS drug; increases HR)
Succinylcholine (in case of laryngospasm with LMA)
Nitroglycerin (to drop BP fast)
Medications used during emergence? - ANSWER>>Reversal agents (Neostigmine;
usually given with Robinol/Glycopyrulate to increase HR that is lowered by
neostigmine)
-Sugamadex
Narcotics for post-operative pain
Antiemetics (Zofran, scopalamine patch)
What is the purpose of preoxygenation/denitrogenation? - ANSWER>>Air is
mostly nitrogen so you want to give them mostly oxygen so they have the reserve
to give you time needed to intubate
What drugs blunt sympathetic response to DL during induction? -
ANSWER>>Fentanyl
Lidocaine
*Monitored anesthesia care (MAC) becomes general anesthesia when? -
ANSWER>>When you have to support the patient's airway (even a jaw thrust)
*You want to wait to push a paralytic/muscle relaxant until what? -
ANSWER>>You know you can ventilate the patient!
Exam 1 Q4 QUESTIONS AND WELL
UPDATED ANSWERS
Anesthesia care consists of? - ANSWER>>Rendering patients insensible to pain
and managing their condition during surgery or diagnostic procedures
Includes preoperative evaluation and treatment, anesthetic administration,
postoperative care, and other contributions (resuscitation, invasive lines,
ventilatory management, acute and chronic pain relief)
Where does anesthesia care occur? - ANSWER>>Hospitals, free standing surgical
centers, offices (dental), "forward areas" (war/combat zones)
What is the triad of general anesthesia? - ANSWER>>analgesia, hypnosis
(amnesia), & immobility
Types of anesthesia techniques? (4) - ANSWER>>General anesthesia, regional
anesthesia, local anesthesia, and monitored anesthesia care (MAC)
TEFRA 1982 - ANSWER>>Tax Equity and Fiscal Responsibility Act
Direct payment to the CRNA under Medicare Part B
Medical direction payment if 7 conditions were met
3 parts of HIPPA - ANSWER>>Privacy Rule
Security Rule
Electronic Data Exchange
Preoperative phase includes: - ANSWER>>Preop evaluation
Choice of anesthesia
Premedication
,Intraoperative phase includes: - ANSWER>>Physiologic monitoring and vascular
access
General anesthesia (plan for induction, maintenance, and emergence)
Regional anesthesia (plan for type of block, needle, local anesthetic)
Postoperative phase includes: - ANSWER>>Postoperative pain control method
Special monitoring or treatment based on surgery or anesthetic course
Disposition (home, PACU, ward, stepdown, ICU)
Is the CRNA required to accompany the patient to the PACU? - ANSWER>>YES!
General anesthesia - ANSWER>>A reversible depression of the CNS sufficient to
permit surgery to performed without movement, obvious distress, or recall
Preparation: MSMAID - ANSWER>>Machine check
Suction
Monitors
Airway
IV
Drugs
Medications given during preoperative period? - ANSWER>>"Drug of trust"
Versed
Fentanyl
Medications given during induction? - ANSWER>>Propofol (mcg/kg) (sometimes
with lidocaine to reduce burning and reduces sympathetic response of DL)
Etomidate (not as common)
Succinylcholine
Medications given for maintenance of anesthesia? - ANSWER>>Gases/VAA
(Sevoflurane, Isoflurane, Desflurane, etc.)
, Muscle relaxants (Rocuronium, Vecuronium) - may or may not give
Narcotics (Fentanyl, Morphine, Dilaudid)
What are some emergency medications? - ANSWER>>Ephedrine (if BP low and HR
low)
Phenylephrine (if BP low and HR normal)
Robinol/Glycopyrulate (like atropine but not ACLS drug; increases HR)
Succinylcholine (in case of laryngospasm with LMA)
Nitroglycerin (to drop BP fast)
Medications used during emergence? - ANSWER>>Reversal agents (Neostigmine;
usually given with Robinol/Glycopyrulate to increase HR that is lowered by
neostigmine)
-Sugamadex
Narcotics for post-operative pain
Antiemetics (Zofran, scopalamine patch)
What is the purpose of preoxygenation/denitrogenation? - ANSWER>>Air is
mostly nitrogen so you want to give them mostly oxygen so they have the reserve
to give you time needed to intubate
What drugs blunt sympathetic response to DL during induction? -
ANSWER>>Fentanyl
Lidocaine
*Monitored anesthesia care (MAC) becomes general anesthesia when? -
ANSWER>>When you have to support the patient's airway (even a jaw thrust)
*You want to wait to push a paralytic/muscle relaxant until what? -
ANSWER>>You know you can ventilate the patient!
