NURS 582 Exam 4 Study Guide Questions WITH Complete Solutions

What is neuraxial anesthesia? What surgery can it be used for? Advantages? (7) correct answer: Neuraxial anesthesia refers to spinal, epidural, and caudal Can be used for any surgery below the neck Advantages 1) reduces doses of sedatives during GA = reduced postop morbidity and mortality 2) reduced PONV 3) reduced atelectasis 4) sympathectomy => improved blood flow to tissues while parasympathetic still active (active gut) 5) suppressed neuroendocrine response => less MI, PE, DVT risk 6) improved immunity 7) OB -> maternal bonding; skin to skin therapy Spinal Anesthesia What are other names for spinal anesthesia? (2) General use (3) correct answer: Spinal can also be called subarrachnoid or intrathecal; CSF administration Uses 1) can be continuous, but most commonly a one-time injection 2) Adjunct with general anesthesia 3) Intraop or postop for pain What is the only absolute contraindication for neuraxial anesthesia? What must be explained prior to neuraxial anesthesia? (5) correct answer: Informed consent Funks and Fieldman Must accurately explain: 1) nerve damage = sensation, motor, PNS dysfunction 2) not effective -> GA 3) too effective -> ventilatory compromise and GA 4) mortality risk 5) PDHD and blood patch possibility If refused: must inform risks for refusing as well The anesthetist must be ready for what if attempting an awake case with neuraxial anesthesia? correct answer: Always be set up for the possibility of general anesthesia What documentation is required during neuraxial anesthesia? (13) correct answer: 1) Risks and benefits (DO THIS FIRST) 2) Pre-existing neurological abnormalities (do you have tingling or numbness in your fingers or toes) 3) If there is an exacerbation or problem, must be explained and documented 4) equipment check 5) PPE (make family do this too if present) 6) monitors used 7) patient position 8) skin prep-type 9) type of needle and size 10) level of block 11) ***technique*** epidural -> loss of resistance and absence of CSF spinal -> presence of CSF 12) ***agent, dose and test dose*** epidural -> test spinal -> no test 13) response The spine is fundamentally composed of ______ and ______. The spine has ____ pairs of spinal nerves How many vertebra bones and spinal nerves from the following? Cervical? Thoracic? Lumbar? Sacrum? Coccyx? correct answer: The spine i