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Lehne's Pharmacology CH 27 questions with verified answers
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Lehne's Pharmacology CH 27 questions with verified answers
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Lehne's Pharmacology CH 27"Have you or any family members ever suffered a reaction to anesthesia?" - ANS-The nurse
is completing a preoperative database on a client scheduled for back surgery the next day.
Which question is most important to ask to possibly prevent an adverse patient outcome?
1. it has a very high MAC and cannot be used alone to produce general anesthesia
2. it has high analgesic potency, and therefore is frequently combined with other general
anesthetics to supplement their analgesic effects - ANS-How does nitrous oxide differ from
other general anesthetics?
128 mg - ANS-The nurse performs the change-of-shift checks that include verifying pump
setting for the ordered propofol infusion. The nurse notes that the order is for 2 mg/kg/hr.
The most recent weight measurement for the patient was 64 kg. The nurse notes that the
pump should be infusing how many mg per hour?
60% to 80% by lungs; 20% hepatic - ANS-Elimination of Halothane
A 40-year-old male with a history of bipolar disorder - ANS-The student nurse prepares to
administer ketamine to a patient. The supervising nurse questions this administration for
which patient?
Absence of anxiety
Analgesia
Sedation - ANS-A cataract surgery patient receives midazolam and fentanyl. The nurse
would expect these medications to produce which effects?
analgesia
general anesthetic - ANS-Opioids enhance ____ and reduce the required dosage of _____
Analgesics
Antiemetics
Muscarinic antagonists
Halothane
Enflurane
Desflurane
Sevoflurane
Nitrous oxide
Obsolete inhalation anesthetics - ANS-Examples of Postanesthetic Medications
analgesics - ANS-reduce sensitivity to pain but do not reduce consciousness
Analgesics, CNS depressants, and CNS stimulants can influence the amount of anesthetic
required to produce anesthesia
Opioids allow for a reduction
CNS depressants add to the depressant effects of anesthesia - ANS-Drug Interactions of
General Anesthetics
balanced anesthesia - ANS-the use of several drugs to ensure that induction of anesthesia
and muscle relaxation are adequate
, Benzodiazepines: Diazepam - ANS-Induction with intravenous diazepam [Valium]
Unconsciousness within 1 minute
Very little muscle relaxation
Benzodiazepines: Midazolam - ANS-Unconsciousness within 80 seconds
Can cause dangerous cardiorespiratory effects
Blood pressure (BP) of 86/52 mm Hg - ANS-A patient is receiving isoflurane [Forane]. Which
physical assessment finding is the most likely to be a potential adverse effect of this drug?
Blood pressure for hypotension - ANS-The emergency department has sent a patient to the
OR for emergency surgery including general anesthetic with isoflurane. The family has just
arrived, and the nurse has learned that the patient has been taking the calcium channel
blocker amlodipine (Norvasc). This information needs to be communicated to the OR and
PACU. Because of the similarity in effects of isoflurane and amlodipine, what is the priority
assessment?
Breathing - ANS-The nurse is caring for a patient in the postanesthesia care unit (PACU).
What is the highest priority assessment by the nurse?
Breathing - ANS-What is the priority assessment when a patient has received propofol?
Can cause profound respiratory depression
Can cause hypotension
Risk of bacterial infection - ANS-Adverse Effects of Propofol
consciousness and sensibility to pain, temperature, and taste - ANS-General anesthesia
involves the absence of:
Decreased respiratory rate - ANS-The patient has received isoflurane [Forane] as a general
anesthetic. What should the nurse closely observe the patient for during the immediate
postoperative period?
Desflurane - ANS-Tachycardia and hypertension can occur if blood levels drop suddenly
Desflurane [Suprane] - ANS-Nearly identical in structure to isoflurane
Indicated for maintenance of anesthesia in adults and children
Used for induction of anesthesia in adults
Discard any unused solution within 6 hours - ANS-The nurse is caring for a patient who is
receiving intravenous propofol [Diprivan]. Which action by the nurse is most appropriate?
Droperidol - ANS-May prolong QT interval
Enflurane - ANS-Can induce seizures
Enflurane - ANS-Has pharmacologic properties very similar to those of halothane
Sensitizes the myocardium to catecholamines
Newer agents now preferred
Enhances transmission at inhibitory synapses
Depresses transmission at excitatory synapses
Except for nitrous oxide, all of the agents used today enhance the activation of receptors for
gamma-aminobutyric acid, which is the principal inhibitory transmitter in the central nervous
system (CNS) - ANS-Molecular mechanism of action of Inhalation Anesthetics
Etomidate - ANS-Potent hypnotic agent
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