A client received lidocaine viscous before a gastroscopy was performed. Following the procedure, the nurse places priority on what assessment?
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Solution
Return of the gag reflex
Because the throat is anesthetized, monitor the client for return of the gag reflex before drinking or eating.
The nurse teaching a client who will receive thiopental (Pentothal) as an anesthetic explains that what common adverse effects might occur?
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Solution
Emergence delirium
Emergence delirium could occur postoperatively, and is characterized by hallucinations, confusion, and excitability.
A preoperative patient receives atropine before induction of anesthesia. The nurse caring for this patient understands that this agent is used to prevent:
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Solution
bradycardia.
Atropine, an anticholinergic drug, is used as an adjunct to anesthesia to counter the effects of vagal stimulation, which is caused by surgical manipulations that trigger parasympathetic reflexes, resulting in bradycardia. Atropine is not an anxiolytic. Atropine causes dry mouth and sometimes is used to minimize bronchial secretions.
Early signs and symptoms of local anesthetic toxicity include ALL BUT ONE of the following. Indicate the exception:
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Solution
Hypertension
Manifestations of local anesthetic toxicity typically appear 1-5 minutes after the injection, but onset may range from 30 seconds to as long as 60 minutes. Initial manifestations may also vary widely. Classically, patients experience symptoms of central nervous system (CNS) excitement such as the following: Circumoral and/or tongue numbness, metallic taste, lightheadedness, dizziness, visual and auditory disturbances (difficulty focusing and tinnitus), disorientation and drowsiness.
Which of the following statements about shivering is correct?
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Solution
Shivering can occur in the absence of hypothermia.
Shivering can also appear after surgery. This is known as postanesthetic shivering.
Geneva is reviewing for her upcoming quiz in Pharmacology. She should be aware that local and regional anesthesia act by:
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Solution
Inhibiting depolarization.
When local anesthesia is used, sensation is removed and the area anesthetized by inhibition of depolarization. Choice B is incorrect because the opposite is true. Choices C and D do not occur with local anesthesia.
Mr. Baltazar will be undergoing surgery with general anesthesia. The client should be given which of the following instructions preoperatively?
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Solution
Expect nausea, vomiting, shivering, and pain postoperatively.
These responses should be expected, and the client should be prepared for them. Food is contraindicated before surgery. Urinary retention, not incontinence is likely. Medication is more likely to be held on the day of surgery.
The most dangerous metabolic side effect of general anesthesia that can occur during surgery is:
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Solution
Hyperthermia
Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia.
General anesthetics potentiate the effects of which of the following drugs?
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Solution
Skeletal muscle relaxants
The effects of skeletal muscle relaxants are potentiated with the use of the general anesthetics. Depolarizing agents do not interact with general anesthetics. C and D are general anesthetics.
During surgery, there is an increased potential for arrhythmias when catecholamines are given with:
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Solution
halothane (Fluothane)
Arrhythmias are a result of an interaction that can occur with halothane and catecholamines. Other choices do not interact with halothane to cause arrhythmias.