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Anesthesia

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D. The operating surgeon
All of the following professionals are qualified to provide anesthesia EXCEPT:

A. Anesthesiologist
B. Certified Registered Nurse Anesthetist
C. Anesthesiologist Assistant
D. The operating surgeon
A. General anesthesia
D. Monitored anesthesia care
Which of the following types of anesthesia require an anesthesia professional? Check all that apply

A. General anesthesia
B. Local anesthesia
C. Moderate sedation
D. Monitored anesthesia care
A. Induction, Maintenance, Emergence
The phases of general anesthesia, in order, are:

A. Induction, Maintenance, Emergence
B. Emergence, Maintenance, Induction
C. Maintenance, Emergence, Induction
D. Induction, Emergence, Maintenance
D. Endotracheal intubation
Which of the following type of airway maintenance usually requires muscle relaxants?

A. Spontaneous respiration
B. Mask ventilation
C. Laryngeal mask airway
D. Endotracheal intubation
C. Naloxone
Fentanyl can be reversed with which of the following agents?

A. Neostigmine
B. Sugammadex
C. Naloxone
D. Flumazenil
1. Clear liquids - 2 hours
2. Breast milk - 4 hours
3. Infant formula - 6 hours
4. Nonhuman milk - 6 hours
5. Light meal - 6 hours
6. Fried foods, fatty foods, meat - 8 hours
NPO Guidelines from the American Society of Anesthesiologists include how many hours for each liquid?

1. Clear liquids
2. Breast milk
3. Infant formula
4. Nonhuman milk
5. Light meal (toast and a clear liquid)
6. Fried foods, fatty foods, meat
First find the thyroid cartilage, which is usually far more prominent. The cricoid cartilage is the first ring below the thyroid cartilage.
The easiest way to find the cricoid cartilage.
The occlude the esophagus and prevent aspiration.
Why is cricoid cartilage used?
D. After the cuff of the ET tube is inflated and the position is confirmed.
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.
Blocks motor and sensory nerve conduction, preventing both pain and movement of the affected area.
What is the purpose of regional anesthesia?
Patients with a BMI over 29 and patients older than 35 years of age.
Women at risk for hypotension after initiation of regional anesthesia include:
To reduce the acidity of the local anesthetic and speed the onset of the block.
Why is bicarbonate sometimes added to local anesthetics?
To increase the density and duration of a regional block.
Why is epinephrine sometimes added to local anesthetics?
The placement of local anesthetics near the spinal cord.
What is neuraxial anesthesia?
What is the difference between Spinal Anesthesia and Epidural Anesthesia?
During spinal anesthesia procedure the subarachnoid space is entered and local anesthetic is injected directly into the spinal canal. During epidural anesthesia the provider finds the space between the ligament flavum and dura. This space is identified by a loss of resistance as the needle is advanced.
Intravenous regional anesthesia. Can be used on the hand, wrist, or forearm.
1. An IV is placed in the operative arm, usually in the back of the hand, avoiding the incision site.
2. A double tourniquet is applied around the upper arm
3. The arm is raised and exsanguinated
4. The proximal tourniquet cuff is inflated
5. Local anesthetic is injected into the IV
6. If cuff discomfort occurs, the distal cuff (over the anesthetized area) is inflated and the proximal cuff is deflated.
What is a Bier Block?
A. Epidural anesthesia
Which type of anesthesia involves an injection into the space between the ligamentum flavor and the dura?

A. Epidural anesthesia
B. General anesthesia
C. Spinal anesthesia
D. Bier block
A. Flumazenil. A benzodiazepine receptor antagonist.
Which medication will reverse benzodiazepine overdose?

A. Flumazenil (Romazicon)
B. Naloxone (Narcan)
C. Neostigmine
D. Sugammadex
Ringing in the ears, tingling around the lips, metallic taste in the mouth. Can progress to seizures and respiratory or cardiac arrest. Occurs if unsafe amounts enter the bloodstream.
What are the signs of Local Anesthetic Systemic Toxicity (LAST)?
D. Local anesthesia
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
A. Sudden rise in temperature
C. Increase in end-tidal CO2
D. Increased oxygen demand
Based on your knowledge of malignant hyperthermia, identify the symptoms that indicate a patient is experiencing an MH episode. Check all that apply.

A. Sudden rise in temperature
B. Sudden relaxation of muscles
C. Increase in end-tidal CO2
D. Increased oxygen demand
A. Low birth weight infants
C. Congestive heart failure
Patient-related factors that can contribute to hypothermia include: Check all that apply.

A. Low birth weight infants
B. Hyperglycemia
C. Congestive heart failure
D. Male gender
A. Elderly patients
B. Infants
Which types of patients are at increased risk for perioperative hypothermia? Check all that apply.

A. Elderly patients
B. Infants
C. Men
D. Obese patients
B. Apply cricoid pressure if needed during intubation
Which of the following would be an appropriate action for the preoperative 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
C. Arterial line
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
C. Flumazenil
Which drug is used to reverse valium and midazolam?

A. Neostigmine
B. Pancuronium
C. Flumazenil
D. Succinylcholine
A. Applying cricoid pressure
Which method is used to prevent aspiration during endotracheal intubation?

A. Applying cricoid pressure
B. Inserting a nasal/oral airway
C. Laryngoscopy
D. Invasive techniques
C. Calm the patient
How can the preoperative nurse assist the anesthesia provider with placement of a spinal or epidural block?

A. Inject local anesthetic
B. Threat the catheter through the needle
C. Calm the patient
D. Identify landmarks for insertion of the needle
D. Bolus of anesthetic
During intravenous regional anesthesia (Bier Block), the tourniquet should be deflated slowly to prevent which of the following from entering the circulation?

A. Bacteria
B. Lymphatic fluids
C. Thrombus
D. Bolus of anesthetic
B. Unexplained increases in end-tidal CO2
What is the most consistent indicator of malignant hyperthermia during a surgical intervention?

A. Tachycardia
B. Unexplained increases in end-tidal CO2
C. Elevated temperature
D. Sustained muscle contraction
D. Moderate sedation
Depending on state laws and hospital policies, which of the following types of anesthesia can be performed without a professional anesthesia provider?

A. General anesthesia
B. Regional anesthesia
C. Monitored anesthesia care
D. Moderate sedation
A. Family history of problems related to anesthesia
Which assessment factor is important to include when screening patients for potential risk of malignant hyperthermia?

A. Family history of problems related to anesthesia
B. Patient's age
C. Patient's use of herbal and vitamin supplements
D. Patient's use of over-the-counter medications