Exam (elaborations)
Apex Anesthesia: Unit 11 Across the Lifespan
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Apex Anesthesia: Unit 11 Across the Lifespan
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Apex Anesthesia: Unit 11 Across the Lifespan______ is the gold standard to retrieve a foreign body
- 4 complications? Correct Answers Rigid bronchoscopy is the
"gold standard" procedure to retrieve the foreign body.
Complications of Rigid Bronchoscopy:
-Laryngospasm
-Bradycardia during scope insertion
-Post-intubation croup
-Pneumothorax
10 risk factors for postintubation laryngeal edema? Correct
Answers Risk factors (all are from a small airway or airway
trauma:
-Age < 4 years
-ETT is too large
-ETT cuff volume is too high (too much air was injected or N2O
was used during the procedure)
-Traumatic or multiple intubation attempts (one reason not to
use an uncuffed tube)
-Prolonged intubation
-Coughing (cuff rubs against the tracheal mucosa)
-Head or neck surgery
-Head repositioning during surgery
-History of infectious or post-intubation croup
-Trisomy 21
,3 indications for FFP transfusion in the neonate? Correct
Answers The indications for transfusion of FFP mirror the
recommendations set forth by the ASA guidelines. These
include:
-Emergency reversal of warfarin.
-Correction of coagulopathic bleeding with increase PT > 1.5 or
increased PTT.
-Correction of coagulopathic bleeding if > 1 blood volume has
been replaced and coagulation studies are not easily obtained.
FFP is NOT indicated for expansion of intravascular volume.
3 treatment for hypermagnesemia? Correct Answers
Supportive measures
Diuretics (to facilitate excretion of Mg+2)
IV calcium (to antagonize Mg+2)
4 signs and symptoms suggest a congenital diaphragmatic
hernia? Correct Answers CDH is usually diagnosed at birth.
The newborn will have a scaphoid abdomen (sunken in) and
likely experience respiratory distress.
Other findings include:
- Barrel chest
- Cardiac displacement
- Fluid-filled gastrointestinal segments in the thorax
,4 treatment options for uterine atony? Correct Answers Uterine
massage
Oxytocin
Ergot alkaloids
Intrauterine balloon
5 autonomic changes that occur in the elderly. Correct Answers
-Decreased adrenergic receptor density
-Decreased response to catecholamines
-Increased circulating catecholamines as partial compensation
-Reduced ability to increase HR during hypotension (decreased
baroreceptor function)
-Impaired thermoregulation increases the risk of hypothermia
5 side effects of hypermagnesemia? Correct Answers Side
effects:
-Apnea
-Hypotension
-Skeletal muscle weakness ( synergism with nondepolarizers)
-CNS depression
-Reduced responsiveness to ephedrine and phenylephrine
7 signs suggest dehydration in the neonate? Correct Answers
Signs of dehydration:
-Sunken anterior fontanel
-Weight loss (a 10% reduction in the first week is normal)
-Irritability or lethargy
-Dry mucus membranes
, -Absence of tears
-Decreased skin turgor
-Increased hematocrit in the absence of transfusion
7 treatment for a "tet spell" that occurs during the perioperative
period? Correct Answers Perioperative "tet spell" treatment:
-FiO2 100%.
-Intravascular volume expansion.
-Increase SVR with phenylephrine to augment the PVR to SVR
ratio.
-Reduce SNS stimulation to improve dynamic RVOT
obstruction - deepen anesthesia, beta-blockade with a short-
acting agent (esmolol).
-Inotropes worsen RVOT obstruction and are best avoided.
-Avoid excessive airway pressure.
-An infant may be placed in a knee-chest position to mimic
squatting.
8 risk factors for ROP? Correct Answers Key risk factors for
ROP:
Prematurity
Low birth weight
Hyperoxia
Mechanical ventilation
Blood transfusion
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