NURS 581 - Exam 2 Study Guide 2024. Questions With Correct Answers. Latest Update 2024 update. Guaranteed.

NURS 581 - Exam 2 Study Guide 2024. Questions with Correct Answers. Latest Update 2024 update. Guaranteed GRADED A+. 1. What is SCIP?: Surgical Care Improvement Project: publishes guidelines that are meant to improve surgical outcomes For example: - BG levels pre/post-op - meds to hold/continue during preop - stress hormone management - abx to incision (1 hour) - electric clippers for hair removal 2. What is the prevelance of current anesthesia-related deaths? How many of those are preventable? Name some common causes of preventable deaths (4 total): 1: 26,000 (in the 1940s, used to be 1: 650) 1/3 of these deaths are preventable; caused by: 1) inadequate IV access 2) improper airway 3) wrong anesthetic technique 4) inadequate crisis management Preparation and vigilence is key every case 3. What type of hospital would you expect to use preanesthesia clinics vs. phone call the night before?: Preanesthesia clinic - larger, urban hospitals Phone call the night before - small rural hospitals (usually done by preop nurse) 4. When assessing for difficult airway history, what is something you should ask every patient?: Did a previous anesthesia provider ever say you were a difficult airway? If so, did they right a letter explaining this in more detail? 5. When asking about family history, what are two syndromes should alert anesthesia providers?: From anesthesia, did any of your family members die or have any serious ADR such as fever? 1) Malignant hyperthermia 2) A-typical acetylcholinesterase 6. How long before surgery should patients quit smoking? What are some associated risks with smokers? (3 total): 12-48 hours - reduces HR, BP, carbon monoxide levels, and circulating catecholamines (Reality: patients usually smoke right before surgery) Associated risk with smokers: - irritable airway - delayed wound healing - 6-8 weeks after quitting = copious secretions from the return of cilia function7. When should you get a urine pregnancy test prior to surgery?: All females of childbearing age with a functioning uterus 8. Give an example of each functional level within the Metabolic Equivalents of Functional Capacity (MET).: 1 kilocalorie per kg per hour 1 kcal/kg/hr (would be equivalent to sitting on the couch for one hour) ***e4 MET indicates better surgical outcomes (can they climb a flight of stairs without dyspnea, chest discomfort?) 9. More examples of MET from power point for reference *great test questions here*: 10. What are some basic allergies that could cause problems during any OR procedure?: Egg white allergy (but egg yolk allergy is ok with propofol) Iodine Latex (caution with spina bifida patients) 11. What would you instruct your patient during preop if they were on the following medications? ACEI BB Antiarrythmic Steroids Seizure meds Parkinson meds Anti-platlets (Aspirin, Plavix) Insulin (PO vs. Subq) Anticoagulants Antidepressants: ACEI - continue BB - continue unless HR 55 day of sx Antiarrythmic - continue Steroids - continue + extra stress dose as indicated Seizure meds - continue Parkinson meds - continue Anti-platlets - HOLD unless artificial valve, vascular/cardiac sx Insulin (PO vs. Subq) - hold PO, hold rapid-acting, half other subq insulin doses Anticoagulants - HOLD Antidepressants - continue (except MAOIs, d/c 2 weeks prior to sx) 12. Acute vs Chronic ETOH; how would you modify your anesthetic plan for either?: Acute: may require less anesthetics Chronic: may require more anesthetics; tx with long-acting benzo's - barbituate tolerance - hypnotic tolerance 13. CAGE Method: 1) Do you feel you should Cut down on your alcohol consumption? 2) Have people Annoyed you by criticizing your drinking habits? 3) Have you ever felt Guilty about your drinking? 4) Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (Eye-opener) 14. Special considerations for the following illicit drugs? Cocaine/Meth Opioids Marijuana: Cocaine/Meth - depleted catecholamines; refractory HTN - dysrhythmias - increased anesthetics for acute intoxication Opioids - have chronic pain pts take opioids morning of sx - higher analgesic doses post-op Marijuana - labile BP 15. In general, instruct patients to stop taking herbs/supplements 2 weeks prior to sx; especially for what supplements?: St John's Wort - many medication interactions Garlic - interferes with platlet aggregation = bleeding risk