POST-ANESTHESIA QUESTIONS AND
CORRECT ANSWERS
Bronchospasm causes ✅✅ANSW--Asp
-Pharyngeal or tracheal suctioning
-ET intubation
-Histamine release from meds
-Allergic response
----seen more with asthma and COPD
Bronchospasm Tx ✅✅ANSW--Decrease airway irritability and promote bronchial dilation
-Beta 2 agonist
-Anticholinergics
-IV and inhaled lidocaine to attenuate histamine
-Steroids if underlying cause is inflammatory
Diffusion Hypoxia ✅✅ANSW--Rapid diffusion of N2O into the alveolar that transiently decreases
PaO2 and PaCO2
-In the absence of supplemental O2, can result in hypoxia for 5-10 min after N2O cessation
Increased venous mixture ✅✅ANSW--Typically r/t low CO state and is d/t mixing of desaturated
venous blood with oxygenated arterial blood
-Normally 2-5% of blood is shunted thru the lungs
-Low CO returns blood to heart severely desated
-Shunt fraction increases in condition that impeded oxygenation
-Mixing of deserted shunted blood in combo with impeded oxygenation greatly increases admixture
V/Q mismatch and shunt ✅✅ANSW--HPV compensatory attempt to improve V/Q matching
where vessels constrict in poorly vented areas to areas of better vent
,-HPV inhibited by PNA, sepsis, vasodilators (nitro, nipride, dobutamine), volatiles >1MAC
True Shunts ✅✅ANSW--Don't respond to O2:
---Atelectasis (most common)
---Pulm edema
---Gastric asp
---PNA
Decreased Diffusion Capacity ✅✅ANSW--Suggest the presence of underlying Lund dz:
--emphysema
---ILD
---PF
---Pulm HTN
O2 increase ✅✅ANSW-each l/min = 0.04 increase in FiO2
CV complications ✅✅ANSW--MI most common after non-cardiac sx
-most common underlying cause of sudden cardiac arrest is ischemia and/or LVD
-Long QT syndrome
Hypertrophic cardiomyopathy ✅✅ANSW--most common cause of sudden cardiac arrest in young
athletes
--keep contractile down, preload increased and after load increased
Long QT syndrome ✅✅ANSW--Another cause of sudden CA in young athletes
----sudden death d/t syncope, sz, and VT
----Recommended to keep HR < 130 (so use B-blockers)
--Can cause cardiac arrest with intubation and the use of ketamine, pancuronium, or anything that
increases the SNS
, Hypotension ✅✅ANSW--BP < 20% of Baseline
-Most common cause is hypovolemia
-Assess for bleeding and bolus, If no response to 300-500 bolus then consider myocardial
dysfunction
----MI, tamponade, embolism=low CO
Hypoperfusion S/S ✅✅ANSW--Disorientation
-Nausea
-LOC
-CP
-Oliguria
-Anuria`
Hypoxia ✅✅ANSW-Can cause lactic acidosis
HoTN cause ✅✅ANSW--Low SVR d/t histamine release or vasodilation meds
-Tachydysrhythmia, conduction block
-Too large a cuff
-Allergic Reaction
-Sepsis
Allergic Reaction ✅✅ANSW--Consider in case of refactory HoTN even with absence of rash or
bronchospasm
-Increased serum tryptase confirms
-Succ's or Roc
Sepsis ✅✅ANSW--Urinary tract manipulation and biliary tract procedures are that can result in
sudden onset of severe systemic HoTN
-Usually accompanied by fever and rigor
-Blood Cx should be drawn
HTN ✅✅ANSW--20% above bsl
CORRECT ANSWERS
Bronchospasm causes ✅✅ANSW--Asp
-Pharyngeal or tracheal suctioning
-ET intubation
-Histamine release from meds
-Allergic response
----seen more with asthma and COPD
Bronchospasm Tx ✅✅ANSW--Decrease airway irritability and promote bronchial dilation
-Beta 2 agonist
-Anticholinergics
-IV and inhaled lidocaine to attenuate histamine
-Steroids if underlying cause is inflammatory
Diffusion Hypoxia ✅✅ANSW--Rapid diffusion of N2O into the alveolar that transiently decreases
PaO2 and PaCO2
-In the absence of supplemental O2, can result in hypoxia for 5-10 min after N2O cessation
Increased venous mixture ✅✅ANSW--Typically r/t low CO state and is d/t mixing of desaturated
venous blood with oxygenated arterial blood
-Normally 2-5% of blood is shunted thru the lungs
-Low CO returns blood to heart severely desated
-Shunt fraction increases in condition that impeded oxygenation
-Mixing of deserted shunted blood in combo with impeded oxygenation greatly increases admixture
V/Q mismatch and shunt ✅✅ANSW--HPV compensatory attempt to improve V/Q matching
where vessels constrict in poorly vented areas to areas of better vent
,-HPV inhibited by PNA, sepsis, vasodilators (nitro, nipride, dobutamine), volatiles >1MAC
True Shunts ✅✅ANSW--Don't respond to O2:
---Atelectasis (most common)
---Pulm edema
---Gastric asp
---PNA
Decreased Diffusion Capacity ✅✅ANSW--Suggest the presence of underlying Lund dz:
--emphysema
---ILD
---PF
---Pulm HTN
O2 increase ✅✅ANSW-each l/min = 0.04 increase in FiO2
CV complications ✅✅ANSW--MI most common after non-cardiac sx
-most common underlying cause of sudden cardiac arrest is ischemia and/or LVD
-Long QT syndrome
Hypertrophic cardiomyopathy ✅✅ANSW--most common cause of sudden cardiac arrest in young
athletes
--keep contractile down, preload increased and after load increased
Long QT syndrome ✅✅ANSW--Another cause of sudden CA in young athletes
----sudden death d/t syncope, sz, and VT
----Recommended to keep HR < 130 (so use B-blockers)
--Can cause cardiac arrest with intubation and the use of ketamine, pancuronium, or anything that
increases the SNS
, Hypotension ✅✅ANSW--BP < 20% of Baseline
-Most common cause is hypovolemia
-Assess for bleeding and bolus, If no response to 300-500 bolus then consider myocardial
dysfunction
----MI, tamponade, embolism=low CO
Hypoperfusion S/S ✅✅ANSW--Disorientation
-Nausea
-LOC
-CP
-Oliguria
-Anuria`
Hypoxia ✅✅ANSW-Can cause lactic acidosis
HoTN cause ✅✅ANSW--Low SVR d/t histamine release or vasodilation meds
-Tachydysrhythmia, conduction block
-Too large a cuff
-Allergic Reaction
-Sepsis
Allergic Reaction ✅✅ANSW--Consider in case of refactory HoTN even with absence of rash or
bronchospasm
-Increased serum tryptase confirms
-Succ's or Roc
Sepsis ✅✅ANSW--Urinary tract manipulation and biliary tract procedures are that can result in
sudden onset of severe systemic HoTN
-Usually accompanied by fever and rigor
-Blood Cx should be drawn
HTN ✅✅ANSW--20% above bsl
