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Using a vasoconstrictor (epinephrine) with a local anesthetic does what
- Allows for the use of less anesthetic
- Causes local vasoconstriction
- Can cause adverse effects from systemic absorption of the vasoconstrictor
- Delays systemic absorption
- Reduces blood flow to the affected area
- Reduces the risk of toxicity
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When a pt is receiving a local anesthetic with epinephrine, the nurse should carefully assess for which effects from the epinephrine??
Rapid pulse and rising BP
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A pt who has a known allergy to chloroprocaine should not receive
Tetracaine
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Cocaine differs from other ester-type local anesthetics in that it
causes intense vasoconstriction
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A pt received intracenous regional anesthetic containing lidocaine without epinephrine when he had ankle surgery. At what point would the pt be at greatest risk for bradycardia, hypotension, and respirator depression from the lidocaine
when the pt is in the postanesthesia unit
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Epinephrine is a vasoconstrictor that is often combined with lidocaine to???
Delay systemic absorption of the lidocaine
As a vasoconstrictor it would have decreased the blood seepage
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Epinephrine should not be used in areas supplied by
end arteries, such as fingers or toes because of possible tissue necrosis from lack of arterial blood flow.
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Do not apply cold until the local anesthesia has
“worn off.”
Perception of temperature is impaired, and impaired circulation or frostbite could occur. Rest and elevate the joint. Do not apply cold for longer than 20-minute periods.
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Use of over-the-counter (OTC) topical lidocaine on open wounds increases the risk of
systemic toxicity.
Discuss the use of OTC analgesics, such as acetami- nophen with the prescriber. If a topical anesthetic is used, choose the lowest concentration and apply in a thin film only to intact skin surrounding the nail
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General anesthesia (aka anaesthesia) involves the absence of
conciousness and sensibility to pain, temperature, and taste
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What are the agents included in a balanced anesthetic
short-acting barbiturates for induction of anesthesia,
neuromuscular blocking agents for muscle relaxation,
opioids and nitrous oxide for analgesic,
inhalation agents to maintain a state of unconsciousness.
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The primary goal of using multiple agents to achieve anesthesia is to
permit full anesthesia with less adverse effects
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Inhalation anesthetics depress what and enhance what
Depress transmission at excitatory synapses
Enhance transmission at inhibitory synapses
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Nitrous Oxide has an extremely high minimum alveolar concentration (MAC). Because of this ...
Surgical anesthesia cannot be obtained with nitrous oxide
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A pt has received succinylcholine during surgery. A priority nursing outcome during nursing care in the PACU is
temperature will be 36.5 to 37 C
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The nurse should assess all post op pt who have received inhaled anesthesia for
Wheezing
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Desfluane adverse effect
Tachycardia and hypertension can occur if blood levels drop suddenly
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Enflurane adverse effect
can induce seizures
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Halothane adverse effect
May prolong QT interval
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Isoflofluane adverse effect
hypotension can occur from vasodilation
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Ketamine adverse effect
Delirium and psychotic symptoms can occur post op or days or weeks after surgery
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Propofol adverse effect
high risk of bacterial infection
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Sevoflurance adverse effect
Can produce heart and fire in administration apparatus
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Nitrous oxide is widely used in surgery because
it has significant analgesic effects without significant cardiac or respiratory depression
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The nurse is caring for a pt who has just received the first IV dose of pentazocine (talwin). Which of the following, if present within minutes of injecting the drug, would be a reason for the nurse to contact the prescriber immediately
Drowsiness
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ACE inhibitors
prevent conversion of angiotensin I to angiotensin II
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Aldosterone
Block angiotensin II receptors
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ARBs
Prevent activation of angiotensin receptors
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Beta Blockers
Suppress renin release by the kidneys
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