Chapter 27 General and Local Anesthetic Agents

Chapter 27  General and Local Anesthetic Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
To decrease sympathetic stimulation in balanced anesthesia type of what agent would be used?
A)
Antihistamines
B)
Antiemetics
C)
Narcotics
D)
Sedative-hypnotics
Ans:
D

Feedback:

Sedative-hypnotics relax the patient, facilitate amnesia, and decrease sympathetic stimulation. Antihistamines decrease the chance of allergic reaction and help dry secretions. Antiemetics decrease the nausea and vomiting associated with gastrointestinal (GI) depression. Narcotics aid in the analgesic and sedative effects.

2.
During what stage of anesthesia would the nurse see the patient’s skeletal muscles relax and return of regular respirations?
A)
Stage 1: Analgesia stage
B)
Stage 2: Excitement stage
C)
Stage 3: Surgical anesthesia stage
D)
Stage 4: Medullary paralysis
Ans:
C

Feedback:

Stage 3 is surgical anesthesia, which involves relaxation of skeletal muscles and return of regular respirations. During this stage, eye reflexes and pupil dilation are progressively lost. Surgery can be safely performed in this stage. Stage 1 refers to the loss of pain sensation; stage 2 involves a period of excitement with sympathetic stimulation (e.g., tachycardia, increased respirations, blood pressure changes); and stage 4 involves deep central nervous system depression with loss of respiratory and vasomotor center stimuli. Death can occur rapidly at this stage if adequate support is not supplied.

3.
The nurse is developing a plan of care for the patient undergoing general anesthesia. What is a priority of care for this patient?
A)
Encourage clear fluids.
B)
Increase oxygen.
C)
Reassure the patient that about safety.
D)
Maintain regular repositioning.
Ans:
D

Feedback:

The patient would need to be moved or turned periodically to prevent skin breakdown and the formation of decubitus ulcers if the surgery lasted longer than an hour. Muscle paralysis resulting from the medications used in general anesthesia would prevent the patient from shifting himself or herself to relieve increase pressure. A patient receiving a general anesthetic would be unconscious, require respiratory support, and be connected to a mechanical ventilator to maintain respirations. Increased oxygen would not be indicated unless oxygen levels were less than adequate, and the patient would not receive anything by mouth eliminating option A. Reassurance would not be necessary for the unconscious patient.

4.
A plan of care formulated by an operating room (OR) nurse includes four nursing diagnoses. Which diagnoses will the nurse include that is directly related to safety?
A)
Deficient knowledge regarding drug therapy
B)
Disturbed sensory perception (kinesthetic, tactile) related to anesthesia
C)
Risk for impaired skin integrity related to immobility
D)
Risk for injury related to central nervous system (CNS) depressive effects of drugs
Ans:
D

Feedback:

The nursing diagnosis, which directly relates to safety, is high risk for injury. The other three options are only indirectly related to safety. While in the OR, the patient under general anesthetic is unable to express safety concerns and must rely completely on the surgeon and OR staff for protection.

5.
What nursing interventions would help minimize the risk of a headache in a patient recovering from spinal anesthesia?
A)
Administer a triptan intramuscularly.
B)
Administer morphine intravenously.
C)
Maintain patient in recumbent position.
D)
Place patient in Trendelenburg position.
Ans:
C

Feedback:

Patients receiving spinal anesthesia should remain in a recumbent position for as long as 12 hours. Triptan would not be effective because it is indicated for treatment of migraine headaches. Morphine would treat the headache but would not prevent it.