Chapter 9 st

temporary cessation of breathing, especially during sleep.

the action or process of drawing breath.

Abnormally slow breathing.

monitoring of the concentration of exhaled carbon dioxide in order to assess physiologic status or determine the adequacy of ventilation during anesthesia.

breathlessness or shorthess of breath; labored or difficult breathing.

normal, good, unlabored breathing, sometimes known as quiet breathing or resting respiratory rate.

arterial sounds heard through a stethoscope applied to the brachial artery distal to the cuff of a sphygmomanometer that change with varying cuff pressure and that are used to determine systolic and diastolic blood pressure.

the measuring of oxygen saturation of the blood by means of an oximeter. Normal levels are 95 – 100%

aka cricoid pressure is a technique to reduce the risk of the aspiration of stomach contents during induction of general anesthesia. Pressure applied to the cricoid cartilage, to prevent regurgitation or to make the vocal cords easier to visualize during tracheal intubation in the anesthetized patient.

is a common office test used to assess how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale.

A patient without organic, physiological, biochemical, or psychiatric disturbances.

A patient with mild to moderate systemic disease disturbance controlled hypertension, history of asthma, anemia, smoker, controlled diabetes, mild obesity, age less than 1 or greater than 70.

A patient with severe systemic disturbances or disease, angina, post-myocardial infarction (MI), poorly controlled hypertension, symptomatic respiratory disease, massive obesity.

A patient with severe systemic disease, disorders that are life threatening: unstable angina, congestive heart failure, debilitating respiratory disease, hepatorenal failure.

a patient who is near death and is not expected to survive with or without the surgical procedure.

Brain-dead patient on life support for the purposes of organ procurement.

Applied when doing emergency surgery.

Patient goes from conscious to unconscious. Airway management critical.

Surgical intervention occurs during this phase.

Surgical intervention is complete.  Extubation occurs during this phase after the return of the “gag” reflex.  Might require administration of reversal agents.

Patient returns to the optimum level of consciousness and well-being.

Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. The endotracheal tube is placed when the patient is put under for surgery. It is inserted into the trachea.

Antibiotic (cefazolin) it fights bacteria in the body, it treats bacterial infection, administered through IV or injection, side effects may be Swelling, redness, pain, or soreness at the injection site may occur. This medication may also rarely cause loss of appetite, nausea, vomiting, diarrhea, or headache.

local anesthesia Aminoamides – it blocks the generation and the conduction of nerve impulses, has a longer onset of action and longer duration, Side effects may be Allergic reactions: Erythema, Urticaria, Edema, Bronchoconstriction, Hypotension also Systemic toxicity: Numbness of tongue, Lightheadedness, Visual disturbances, Twitching, Seizures, Coma, and Respiratory arrest.

histamine 2 (H2) blockers, Inhibits hydrochloric acid secretion in the stomach, it treats gastric/duodenal ulcers, and gastroesophageal reflux disease (GERD), surgical use to prevent gastric ulcer formation/ gastritis. Side effects are headache, dizziness, drowsiness, depression, agitation, breast swelling or tenderness (in men), joint or muscle pain, skin rash, diarrhea, nausea, or constipation.

Dantrolene is a muscle relaxant. It works by restoring a normal level of calcium in the muscles, which helps to prevent or reduce severe high body temperature. It is used to treat malignant hyperthermia. Common side effects are Decreased grip strength; dizziness; drowsiness; flushing; headache; nausea; light-headedness; tiredness; voice changes; weakness (eg, muscle weakness).

it is an antianxiety- sedative/tranquilizer, aka valium, it depresses the CNS by potentiating the effects of GABA, it reduces anxiety related to surgery, depressed CNS side effects.

is an adrenergic aka adrenalin, causes vasoconstriction, resulting reduced blood flow, the surgical use is topical hemostasis; added to local anesthesia to prolong effect. Side effects are Faster, irregular (wrong) or “pounding” heartbeat, Throbbing headache, Paleness, Feelings of over excitement, anxiety, or fear, Weakness or shakiness, Dizziness, Nausea and vomiting, Sweating.

it is an anticoagulant, it prevents clot formation, it is used for treatment/prevention of DVT, thrombosis, pulmonary embolus, the surgical use is to prevent blood clot formation during vascular procedures or during placement of intravascular devices. The side effects are easy bleeding and bruising;pain, redness, warmth, irritation, or skin changes where the medicine was injected; itching of your feet; or, bluish-colored skin.

Keflex (cephalexin) is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body. Keflex is used to treat infections caused by bacteria, including upper respiratory infections, ear infections, skin infections, and urinary tract infections. Side effects are antibacterial side effects.

Cefazolin is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body. Cefazolin is used to treat many kinds of bacterial infections, including severe or life-threatening forms. Antibiotic side effects.

Inducing anesthesia (lack of sensation or feeling) before surgery or certain procedures that do not require skeletal muscle relaxation. It may also be used for other conditions as determined by your doctor. Ketamine is an anesthetic. It works in the brain to inhibit painful sensations.  Side effects are Loss of appetite; nausea; vomiting.

it is an local anesthetic that is used to treat cardiac dysrhythmias, side effects are parasympathetic.

it is a Hyperosmotic agent, it is used to hinder reabsorption of water by the kidneys, Preventing or treating excess body water in certain kidney conditions, reducing swelling of the brain, or reducing pressure in the eye, side effects are Increased urination; nausea; runny nose; vomiting.

it is narcotic antagonist, Naloxone blocks or reverses the effects of opioid medication, including extreme drowsiness, slowed breathing, or loss of consciousness. Narcan, Can cause abrupt onset of pain leading to tachycardia and hypertension, Effect declines after 30 minutes and patient needs to be monitored for opioid rebound respiratory depression.

it is a vasodilator that causes smooth muscle relaxation, it is used to dilate arteries during cardiac and peripheral vascular procedures. Side effects are Constipation; diarrhea; dizziness; headache; loss of appetite; pain, swelling, or redness at injection site; stomach upset.

it is an antibiotic that inhibits cell wall synthesis during multiplication, treat bacterial infections. Side effects are Hypersensitivity reactions possible, Nausea, Vomiting, Colitis, Tissue damage (when applied topically or by irrigation)

is an anticoagulation antagonist, it reverses the effect of heparin, side effects are a sudden fall in blood pressure, bradycardia, pulmonary hypertension, dyspnea, or transitory flushing and a feeling of warmth.

it is a hemostatic agent, it speeds the conversion of fibrogen to fibrin to promote clot formation, surgical use is topical hemostasis. Side effects are Difficulty breathing, pain in the chest, groin, or legs, especially the calves, severe, sudden headache, slurred speech, sudden loss of coordination, sudden, severe weakness or numbness in the arm or leg, sudden, unexplained shortness of breath, vision changes.

are painkillers, drugs that reduce pain.

are used to suppress abnormal rhythms of the heart (cardiac arrhythmias).

are drugs that treat or prevent bacterial infections.

is a drug that is effective against vomiting and nausea.

are a class of agents that block histamine release from histamine-1 receptors and are used to treat the symptoms of an allergic reaction.

Used to limit parasympathetic nervous system responses such as salivation and bradycardia.   Two most common are atropine sulfate and glycopyrrolate (robinul).

Actions, Anesthetize. Promote diffusion and absorption of anesthetic agent. Reduce intraocular pressure. Facilitate lens removal. Maintain a deep anterior chamber. Prevent or control infection. Reduce inflammation and possibility of infection. Adverse Reactions Irritation, Conjunctivitis, Swelling, Redness.

a drug that temporarily paralyzes the ciliary body, allowing a doctor to fully measure a patient’s vision problem.

Drugs that constrict the pupil.

is an agent that induces dilation of the pupil.

A gel injected into the anterior chamber during ophthalmic surgery to maintain the depth of the chamber, protect the corneal endothelium, and stabilize the vitreous.

an agent that promotes rapid labor by stimulating contractions of the myometrium.

To reduce inflammation and possible postoperative edema at operative sites.

ORAL ROUTE, INJECTION ROUTES, SUBLINGUAL AND BUCCAL ROUTESRECTAL ROUTE, VAGINAL ROUTE, OCULAR ROUTE, OTIC ROUTE, NASAL ROUTE, INHALATION ROUTE, NEBULIZATION ROUTE, CUTANEOUS ROUTE, TRANSDERMAL ROUTE

Disseminated intravascular coagulation (ko-ag-u-LA-shun), or DIC, is a condition in which blood clots form throughout the body's small blood vessels. These blood clots can reduce or block blood flow through the blood vessels, which can damage the body's organs. In DIC, the increased clotting uses up platelets (PLATE-lets) and clotting factors in the blood. Platelets are blood cell fragments that stick together to seal small cuts and breaks on blood vessel walls and stop bleeding. Clotting factors are proteins needed for normal blood clotting. With fewer platelets and clotting factors in the blood, serious bleeding can occur. DIC can cause internal and external bleeding. Internal bleeding occurs inside the body. External bleeding occurs underneath or from the skin or mucosa. (The mucosa is the tissue that lines some organs and body cavities, such as your nose and mouth.) DIC can cause life-threatening bleeding.

malignant hyperthermia, Fatal hypermetabolic state of muscle activity, Genetically transmitted, more in males than females Signs and symptoms - Muscle rigidity, Increased CO2, Tachycardia, Rapid increase in body core temp.

Genetically transmitted trait, Prolonged effect of depolarizing neuromuscular blockade agents, Treatment is respiratory support until the body eliminates agent, Use non-depolarizing neuromuscular agents on patient’s with history or family history

Induced secondary to tissue damage, significant blood loss, or infectionSigns and symptoms: Reduced cardiac output, Tachycardia, Hypotension, Diminished urinary output