Intra-operative PT care
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| What is regional anesthesia? | an injection made near a cluster of nerves to numb the area of your body that requires surgery. This may involve numbing of entire limb, such as an arm or leg, or a whole portion of the body such as the entire lower half of the body.
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| Define analgesia | inability to feel pain though conscious
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| Define autonomic stability | relative sympathetic and parasympathetic nervous system homeostasis
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| In regards to intra-op PT care, what is the inability of the muscles to contract or maintain resting tone? | Muscle relaxation
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| True or False: General anesthesia often results in the PT being unable to recall the surgical procedure. | True.
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| What drug competively reverses the effects of narcotics? | Naloxone
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| What drug reverses the effects of Benzodiazepenes? | Romazicor/Flurazenil.
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| What drug reverses the effects of neuromuscular blocking agents? | Anticholinesterases (neostigmine, edropnonium, pyridostigmine).
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| What are the three stages of anesthesia? | Induction phase, Maintenance phase, Emergence phase
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| True or False: Once a reversing medication has been applied, the drug it reversed in the body is permanently neutralized | False. The elimination half life of the reversal drug may be shorter than that of the agent being reversed
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| What potentially fatal reaction to anesthesia presents itself with rapid rise in body temp, tachycardia, tachypnea and muscle rigidity? | Malignant hyperthermia
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| What are the 4 types of regional anesthesia? | Nerve Block, Spinal Anesthesia, Epidural Anesthesia, Intravenous regional anesthesia (Bier Block)
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| What anesthesia is used for major procedures requiring extensive tissue manipulation? | General anesthesia
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| Why is sedation usually used for patients recieving Regional anesthesia? | Sedation is usually used for patient comfort (anxiolysis)
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| What are the two major categories of regional anesthesia? | Central anesthesia, Peripheral anesthesia
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| What part of the spine are drugs distributed to in spinal anesthesia? | Sub-arachnoid space
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| Why must you encourage the PT to drink plenty of water during the post-op evaluation of spinal anesthesia? | To replace leaked CSF.
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| What is a significant complication of a subarachnoid block (SAB)? | Headache.
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| What part of the spine are drugs distributed to in epidural anesthesia? | The epidural space located between the Dura and overlying connective tissue
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| True or False: Only a little anesthetic is required for epidural anesthesia | False. Generally large quantities are required.
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| What is the brachial plexus? | a collection of nerve fibers within a perivascular sheath.
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| What can cause an unintentional migration of spinal anesthesia block? | Improper positioning.
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| What kind of block is a brachial plexus block? | Peripheral nerve block.
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| What is a bier block? | Peripheral IV regional block
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| How is an IV (bier) block performed? | A large volume (50cc) of LA is infused into the veins of an extremity distal to an occlusive tourniquet
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| What must be done in a bier block prior to application of the LA, but after application of the tournequet? | exsanguination of the extremity
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| How quickly does sensation return after the tournequet is removed from a bier block? | within 10 minutes of tourniquet deflation.
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| What happens if the tournequet fails during a IV (bier) block? | Patient receives a potentially toxic dose of local anesthesia very rapidly
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| How is Local anesthisia applied? | Injected or applied topically.
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| What is commonly used in minor surgery? | Local anesthesia.
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| What state of consciousness occurs with regional anesthesia? | The patient is conscious but usually sedated.
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| What is routinely used for procedures that do not require complete anesthesia | Conscious sedation.
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| What are two examples of procedures that would require conscious sedation? | bronchoscopy, pulmonary biopsy
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| Common agents used for conscious sedation | Opioids or Sedatives/Benzodiazepines
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| Who must monitor a the consciously sedated patient? | Continuous monitoring by a RN.
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| Who: *Dons sterile gown and gloves aseptically *Arranges sterile supplies and instruments Checks instruments for proper functioning *Gowns and gloves surgeons as they enter operating room | The scrub nurse
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| Who: Sends for patient at proper time Visits with patient preoperatively, Performs patient assessment Checks medical record for completeness Explains role, verifies operative permit, identifies patient, and answers any questions | Circulating nurse.
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