NR 293 PHARMACOLOGY EXAMS 2 SET
QUESTIONS AND ANSWERS SURE A+
✔✔Describe local Anesthetics? - ✔✔Also called regional anesthetics
Used to render a specific portion of the body insensitive to pain
Interfere with nerve impulse transmission to specific areas of the body
Do not cause loss of consciousness
Interferes with nerve impulses transmission to specific areas of body
Blocks movement of ions thus generation and conduction of nerve impulses. Blocks
movement of NA,K, and Ca ions
Membrane stabilizing alter cell membrane of nerve and inhibit free movement of ions
✔✔What are the type of local anesthesia? - ✔✔Spinal or intraspinal
Intrathecal
Epidural
Infiltration
Nerve block
Topical
Peripheral nerve catheter attached to a pump containing the local anesthetic: Pain
Buster and On-Q pump
✔✔What is the suffix of local anesthesia? - ✔✔"CAines"
,✔✔What are the indications for local anesthesia? - ✔✔Local anesthetics are used for:
Surgical, dental, and diagnostic procedures
Treatment of certain types of chronic pain
Spinal anesthesia: to control pain during surgical procedures and childbirth
Local anesthetics are given by:
Infiltration anesthesia
Nerve block anesthesia
✔✔Describe infiltration anesthesia - ✔✔Minor surgical and dental procedures
Injection of the anesthetic solution intradermally, subcutaneously, submucosally, or
intramuscularly across the path of nerves supplying target area
May be given in a circular pattern around operative area
✔✔why are some local anesthetics used for infiltration combined with vasoconstrictors?
- ✔✔Some local anesthetics used for infiltration or nerve block are combined with
vasoconstrictors:
To prevent systemic absorption of anesthetic
To help confine local anesthetic to injected area
To reduce local blood loss during procedure
✔✔Describe nerve block anesthesia. - ✔✔Used for surgical, dental, and diagnostic
procedures
Also used for therapeutic management of pain
The anesthetic drug is injected directly into or around the nerve trunks or nerve ganglia
that supply the area to be numbed.
✔✔What are some adverse effects of local anesthesia? - ✔✔Usually limited
Adverse effects result if:
Inadvertent intravascular injection
Excessive dose or rate of injection
Slow metabolic breakdown
Injection into highly vascular tissue
Rash, urticaria, edema can lead to anaphylactic shock
Spinal headache can occur
,✔✔What is the treatment for spinal headaches? - ✔✔bed, rest, analgesics, caffeine,
and blood patch
✔✔When teaching a patient about spinal headaches, which statement will the nurse
include?
a.Spinal headaches can be prevented with bed rest after the epidural procedure.
b. Patients who have a spinal headache should have very limited fluid intake.
c. A graft of skin from the patient's hand can be used to seal the leaking area causing
the headache.
d. High Fowler's positioning should be used for patients who have a spinal headache. -
✔✔Correct answer: A
Rationale: Adequate hydration using IV fluids is often used to increase cerebrospinal
fluid pressure. A "blood patch" is often used to help close up or seal the leak. A small
amount of blood is taken from the patient and injected into the epidural space. The
patient should be positioned flat to prevent spinal headache, and if a patient has a
spinal headache, relief is often obtained by lying flat.
✔✔what are some nursing implications for Anesthesia? Assessment - ✔✔Always
assess past history of surgeries and response to anesthesia.
Assess past history, allergies, and medications.
Assess use of alcohol, illicit drugs, and opioids.
Assessment is vital during preoperative, intraoperative, and postoperative phases
Vital signs
Baseline lab work, ECG
Oxygen saturation
ABCs (airway, breathing, circulation)
Monitor all body systems
✔✔What are some nursing implications for anesthesia? implementation - ✔✔Provide
preoperative teaching about the surgical procedure and anesthesia.
Perform close and frequent observation of the patient and all body systems.
During a procedure, monitor vital signs and ABCs.
Watch for sudden elevations in body temperature, which may indicate malignant
hyperthermia.
✔✔What are some nursing implications for anesthesia? evaluation - ✔✔During
recovery, monitor for cardiovascular depression, respiratory depression, and
complications of anesthesia.
Implement safety measures during recovery, especially if motor or sensory loss occurs
because of local anesthesia.
, Reorient patient to his or her surroundings.
Teach the patient about postoperative turning, coughing, and deep breathing.
✔✔What are two classifications of benzodiazepines? - ✔✔Sedative-hypnotic or
ansiolytic
✔✔What is the suffix for benzodiazepines? - ✔✔"-PAms"
✔✔What is the mechanism of action for benzodiazepines? - ✔✔Depress CNS activity
Affect hypothalamic, thalamic, and limbic systems of the brain
Benzodiazepine receptors
-Gamma-aminobutyric acid (GABA)
Do not suppress rapid eye movement (REM) sleep as much as barbiturates do
Do not increase metabolism of other drugs
✔✔What are the drug effects of benzodiazepines? - ✔✔Calming effect on the CNS
Useful in controlling agitation and anxiety
Reduce excessive sensory stimulation, inducing sleep
Induce skeletal muscle relaxation
✔✔What are the indications for benzodiazepines? - ✔✔Sedation
Sleep induction
Skeletal muscle relaxation
Anxiety relief
Anxiety-related depression
Treatment of acute seizure disorders
Treatment of alcohol withdrawal
Agitation relief
Balanced anesthesia
Moderate or conscious sedation
✔✔What are the adverse effects of benzodiazepines? - ✔✔Headache
Drowsiness
Dizziness
Cognitive impairment
Vertigo
Lethargy
Fall hazard for older adults
QUESTIONS AND ANSWERS SURE A+
✔✔Describe local Anesthetics? - ✔✔Also called regional anesthetics
Used to render a specific portion of the body insensitive to pain
Interfere with nerve impulse transmission to specific areas of the body
Do not cause loss of consciousness
Interferes with nerve impulses transmission to specific areas of body
Blocks movement of ions thus generation and conduction of nerve impulses. Blocks
movement of NA,K, and Ca ions
Membrane stabilizing alter cell membrane of nerve and inhibit free movement of ions
✔✔What are the type of local anesthesia? - ✔✔Spinal or intraspinal
Intrathecal
Epidural
Infiltration
Nerve block
Topical
Peripheral nerve catheter attached to a pump containing the local anesthetic: Pain
Buster and On-Q pump
✔✔What is the suffix of local anesthesia? - ✔✔"CAines"
,✔✔What are the indications for local anesthesia? - ✔✔Local anesthetics are used for:
Surgical, dental, and diagnostic procedures
Treatment of certain types of chronic pain
Spinal anesthesia: to control pain during surgical procedures and childbirth
Local anesthetics are given by:
Infiltration anesthesia
Nerve block anesthesia
✔✔Describe infiltration anesthesia - ✔✔Minor surgical and dental procedures
Injection of the anesthetic solution intradermally, subcutaneously, submucosally, or
intramuscularly across the path of nerves supplying target area
May be given in a circular pattern around operative area
✔✔why are some local anesthetics used for infiltration combined with vasoconstrictors?
- ✔✔Some local anesthetics used for infiltration or nerve block are combined with
vasoconstrictors:
To prevent systemic absorption of anesthetic
To help confine local anesthetic to injected area
To reduce local blood loss during procedure
✔✔Describe nerve block anesthesia. - ✔✔Used for surgical, dental, and diagnostic
procedures
Also used for therapeutic management of pain
The anesthetic drug is injected directly into or around the nerve trunks or nerve ganglia
that supply the area to be numbed.
✔✔What are some adverse effects of local anesthesia? - ✔✔Usually limited
Adverse effects result if:
Inadvertent intravascular injection
Excessive dose or rate of injection
Slow metabolic breakdown
Injection into highly vascular tissue
Rash, urticaria, edema can lead to anaphylactic shock
Spinal headache can occur
,✔✔What is the treatment for spinal headaches? - ✔✔bed, rest, analgesics, caffeine,
and blood patch
✔✔When teaching a patient about spinal headaches, which statement will the nurse
include?
a.Spinal headaches can be prevented with bed rest after the epidural procedure.
b. Patients who have a spinal headache should have very limited fluid intake.
c. A graft of skin from the patient's hand can be used to seal the leaking area causing
the headache.
d. High Fowler's positioning should be used for patients who have a spinal headache. -
✔✔Correct answer: A
Rationale: Adequate hydration using IV fluids is often used to increase cerebrospinal
fluid pressure. A "blood patch" is often used to help close up or seal the leak. A small
amount of blood is taken from the patient and injected into the epidural space. The
patient should be positioned flat to prevent spinal headache, and if a patient has a
spinal headache, relief is often obtained by lying flat.
✔✔what are some nursing implications for Anesthesia? Assessment - ✔✔Always
assess past history of surgeries and response to anesthesia.
Assess past history, allergies, and medications.
Assess use of alcohol, illicit drugs, and opioids.
Assessment is vital during preoperative, intraoperative, and postoperative phases
Vital signs
Baseline lab work, ECG
Oxygen saturation
ABCs (airway, breathing, circulation)
Monitor all body systems
✔✔What are some nursing implications for anesthesia? implementation - ✔✔Provide
preoperative teaching about the surgical procedure and anesthesia.
Perform close and frequent observation of the patient and all body systems.
During a procedure, monitor vital signs and ABCs.
Watch for sudden elevations in body temperature, which may indicate malignant
hyperthermia.
✔✔What are some nursing implications for anesthesia? evaluation - ✔✔During
recovery, monitor for cardiovascular depression, respiratory depression, and
complications of anesthesia.
Implement safety measures during recovery, especially if motor or sensory loss occurs
because of local anesthesia.
, Reorient patient to his or her surroundings.
Teach the patient about postoperative turning, coughing, and deep breathing.
✔✔What are two classifications of benzodiazepines? - ✔✔Sedative-hypnotic or
ansiolytic
✔✔What is the suffix for benzodiazepines? - ✔✔"-PAms"
✔✔What is the mechanism of action for benzodiazepines? - ✔✔Depress CNS activity
Affect hypothalamic, thalamic, and limbic systems of the brain
Benzodiazepine receptors
-Gamma-aminobutyric acid (GABA)
Do not suppress rapid eye movement (REM) sleep as much as barbiturates do
Do not increase metabolism of other drugs
✔✔What are the drug effects of benzodiazepines? - ✔✔Calming effect on the CNS
Useful in controlling agitation and anxiety
Reduce excessive sensory stimulation, inducing sleep
Induce skeletal muscle relaxation
✔✔What are the indications for benzodiazepines? - ✔✔Sedation
Sleep induction
Skeletal muscle relaxation
Anxiety relief
Anxiety-related depression
Treatment of acute seizure disorders
Treatment of alcohol withdrawal
Agitation relief
Balanced anesthesia
Moderate or conscious sedation
✔✔What are the adverse effects of benzodiazepines? - ✔✔Headache
Drowsiness
Dizziness
Cognitive impairment
Vertigo
Lethargy
Fall hazard for older adults
