2024 INTRO TO NURSE
ANESTHESIA EXAM 1 WITH
CORRECT ANSWERS
Three major barriers to the expansion of the role of surgery in medicine -
CORRECT-ANSWERS-Infection (and its control)
-Hemorrhage and Shock (control and treatment)
-Pain Control
Role of the Surgeon (19th Century) - CORRECT-ANSWERS-bottom of the
medical hierarchy
-Before the 16th century, he was frequently the town barbers
-most surgical interventions were limited to amputations, removal of
superficial growths and tumors, c-sections
ASA Physical Status Classification System - CORRECT-ANSWERS-A six-
category physical status classification system for assessing a patient's risk.
-Standardize how we think about patients
ASA 1 - CORRECT-ANSWERSA normal healthy patient
ASA 2 - CORRECT-ANSWERSA patient with mild systemic disease, well
controlled
Ex: Mild diseases only without substantive functional limitations. Current
smoker, social alcohol drinker,
pregnancy, obesity (30<BMI<40), well-controlled DM/HTN, mild lung disease
ASA 3 - CORRECT-ANSWERSSevere systemic disease, functional limitations
Ex: One or more moderate to severe diseases. Poorly controlled DM or HTN,
COPD, morbid obesity (BMI ≥40), active hepatitis, alcohol dependence or
abuse, implanted pacemaker, moderate reduction of ejection fraction, ESRD
undergoing regularly scheduled dialysis, history (>3 months) of MI, CVA, TIA,
or CAD/stents.
ASA 4 - CORRECT-ANSWERSSevere systemic disease, constant threat to life
Ex: Recent (<3 months) MI, CVA, TIA or CAD/stents, ongoing cardiac
ischemia or severe valve dysfunction, severe reduction of ejection fraction,
shock, sepsis, DIC, ARD or ESRD not undergoing regularly scheduled dialysis
, ASA 5 - CORRECT-ANSWERSA moribund patient who is not expected to
survive without the surgery
Ex: Ruptured abdominal/thoracic aneurysm, massive trauma, intracranial
bleed with mass effect, ischemic bowel in the face of significant cardiac
pathology or multiple organ/system dysfunction
ASA 6 - CORRECT-ANSWERSDeclared brain dead, organ procurement
procedure
ASA in emergencies - CORRECT-ANSWERSThe addition of "E" denotes
Emergency surgery
Types of Regional Anesthesia - CORRECT-ANSWERSSpinal
Epidural
Local Infiltration
Peripheral Nerve Block
Spinal - CORRECT-ANSWERSSingle-injection into the CSF
Smaller dose-profound effects
appropriate space (usually L3-L4, L2-L3, or L4- L5)
Side Effects: Hypotension
Epidural - CORRECT-ANSWERSContinuous, catheter-based, into the epidural
space
Ex: C-section, vaginal delivery, post opt pain after lung surgery
Test Dose: 3ml 1.5% lidocaine + 1:200,000 epi
(used to ensure we are not in the wrong spot, non in CSF or intra-vascular)
Local infiltration - CORRECT-ANSWERSSupplement blocks
Combined Technique
12 hrs: good for post opt. pain control
Peripheral Nerve Block - CORRECT-ANSWERS-Extremities
-injection
-with or without sedation
Informed Consent - CORRECT-ANSWERSElements of Anesthesia Informed
Consent Process:
-Competence and decision-making capacity
-Disclosure of information
-Understanding of disclosed information
-Voluntary Consent
-Documentation
Pain Control (prior to the 19th century) - CORRECT-ANSWERS-Alcohol