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NURS 6901 TEST 4; QUESTIONS AND VERIFIED ANSWERS
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NURS 6901 TEST 4; QUESTIONS ANDVERIFIED ANSWERS
What does unilateral damage to the RLN sound like? - ANSWER Hoarseness, +/-
stridor
What does bilateral damage to the RLN sound like? - ANSWER Aphonia,
respiratory distress possible
How do you do succ in an obese individual? - ANSWER You dose it based on
TBW (due to the increased amount of pseudocholinesterase)
How do you dose Roc in an obese individual? - ANSWER You dose it based on
IBW/LBW (it is water soluble, obese individuals have lower water volumes)
How do you dose propofol in an obese individual? - ANSWER Induction doses are
based on IBW, maintenance doses is based on TBW
What is the ventilatory strategy for someone with obstructive lung disease? -
ANSWER These individuals have a harder time getting air out, so you want to
decrease their I:E ratio to 1:2.5-3
What is the risk of a retrobulbar block? - ANSWER Severe bradycardia
How do you mitigate severe bradycardia in a retrobulbar block? - ANSWER
Pre-administer an anticholinergic??
What are the nerves (and limbs) affected with a retrobulbar block? - ANSWER
Five and dime reflex
CN V (Trigeminal): Afferent
CN C (Vagus): Efferent
What should you consider about N2O? - ANSWER N2O is 34x more soluble than
nitrogen and will cause volume to expand
What are the electrolyte complications associated w/ a
, parathyroidectomy/thyroidectomy? - ANSWER Hypocalcemia! (Ca less than 6)
Symptoms include:
-Paresthesia
-Seizures/tetany
-Hypotension
-EKG changes (prolonged QT, arrhythmias)
-Chvostek's sign
-Trousseau's sign
How do you treat or prevent hypocalcemia in a thyroidectomy/parathyroidectomy?
- ANSWER Serial calcium levels
Calcium gluc vs Ca Cl
Re-implantation of parathyroid
Calcium supplements
What is an important consideration for induction with
thyroidectomy/parathyroidectomy? - ANSWER 1. Do not paralyze the patient, the
surgeon will want to test nerves/vocal cord movement
2. NIM tube
What is the timing of jet ventilation? - ANSWER Inspiration is 1 sec and expiration
should last at least 3 seconds
What is the psi for jet ventilation for an adult? - ANSWER Start at 20 psi and
increase until there is adequate inspiration/expiration
<50
What is the psi for jet ventilation for a child? - ANSWER Start at 5-10, increase
until there is adequate chest rise/inspiration and expiration
<30
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