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20 Cards in this Set
- Front
- Back
Before the patient is fully responsive, pain is often manifested as
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postoperative restlessness.
Serious systemic disturbances (such as hypoxemia, acidosis, or hypotension), bladder distention, or a surgical complication (such as occult intraabdominal hemorrhage) should always be considered as well. |
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Intense shivering causes
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precipitous rises in oxygen consumption, CO2
production, and cardiac output. These physiological effects are often poorly tolerated by patients with preexisting cardiac or pulmonary impairment. |
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Hypoventilation in the PACU is most commonly due to
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the residual depressant
effects of anesthetic agents on respiratory drive. |
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Is an indication for immediate endotracheal intubation in patients suffering
from hypoventilation. |
Obtundation, circulatory depression, or severe acidosis
|
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is the most common cause of hypoxemia
following general anesthesia. |
Increased intrapulmonary shunting from a decreased functional residual
capacity relative to closing capacity |
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most common cause of hypotension in the PACU.
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Hypovolemia is by far the most common cause of hypotension in the PACU
|
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3X usually responsible for cases of postoperative hypertension.
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Noxious stimulation from incisional pain, endotracheal intubation, or bladder
distention |
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Following an inhalational-based anesthetic, the speed of emergence is directly
proportionate but inversely proportionate to |
Following an inhalational-based anesthetic, the speed of emergence is directly
proportionate to alveolar ventilation but inversely proportionate to the agent's blood solubility |
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Recovery from most intravenous anesthetic agents is dependent primarily
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redistribution rather than on elimination half-life
|
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Postoperative nausea and vomiting (PONV)
The highest incidence appears to be in |
young women; studies suggest nausea is more common
during menstruation |
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commonly precedes or coincides with emesis.
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Increased vagal tone manifested as sudden bradycardia
|
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Intravenous droperidol dosage
|
0.625–1.25 mg (0.05–0.075
mg/kg in children) |
|
droperidol now carries a 2001 Food and Drug
Administration (FDA) "black box" warning |
indicating that it can prolong the QT interval
and has been associated with fatal cardiac arrhythmias |
|
Nearly all anesthetics, particularly volatile agents cause hypothermia by
|
decrease the normal vasoconstrictive response to
hypothermia. Shivering in such instances represents the body's effort to increase heat production and raise body temperature and may be associated with intense vasoconstriction. |
|
Hypoventilation, which is generally defined as a
Significant hypoventilation is usually clinically apparent only when the PaCO2 is greater than |
PaCO2 greater than 45 mm Hg
60 mm Hg or arterial blood pH is less than 7.25. |
|
the most
sensitive test for assessing the adequacy of reversal. |
The ability to sustain a head-lift for 5 s
|
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Antagonism of opioid-induced depression with naloxone is a two-edged sword;
|
the abrupt
increase in alveolar ventilation is usually also associated with sudden pain and sympathetic discharge. The latter can precipitate a hypertensive crisis, pulmonary edema, and myocardial ischemia or infarction. If naloxone is used to increase respiration, titration with small increments (0.04 mg in adults) may avoid complications by allowing partial reversal of the respiratory depression without significant reversal of the analgesia. |
|
A chest tube
should be inserted for any symptomatic pneumothorax or one that is greater than |
15–
20%. |
|
Hypotension is usually due to
|
decreased venous return to the heart, left ventricular
dysfunction, or, less commonly, excessive arterial vasodilatation. Hypovolemia is by far the most common cause of hypotension in the PACU. |
|
Significant hypotension is
usually defined as a |
20–30% reduction of blood pressure below the patient's baseline
level and indicates a serious derangement requiring treatment |