POTPOURRI
During the first hour of GA the core temp can drop by 1-3 degrees C.
True or False
True
Which complication is seen in 10% of TAVR patients
Complete Heart block
Name 3 important instructions to give a patient post ear surgery
•Keep water out of operated ear
•No heavy lifting >10lbs
•No nose blowing
•Keep mouth open when sneezing, to avoid excess pressure
•Dizziness is normal
•Some numbness to ear, tongue, altered taste are normal
You are emptying a foley of a patient who received bladder chemo, what PPE do you wear?
Double glove, face mask with a shield, chemo gown
Pain and POSS scores should be charted with each vital sign.
True or False
True
GA obliterates normal thermoregulatory response and impairs vasoconstriction, what is an important measure to start in preop to combat this?
Active Warming
What percentage of strokes are a result of a clot travelling from the left atrial appendage
20
40
60
90
90
What does FESS stand for?
Functional Endoscopic Sinus Surgery
Your patient is s/p a TURP and is constantly complaining of the need to void, a catheter is in place and draining well what other medication may be helpful
B&O suppository
Your patient has an epidural and the team wants to start a PCA who do you need to consult prior to starting the PCA
APS
What is the PACU policy for vital sign frequency
q 15 x 6, then if stable q 30 x 4, then hourly
Post Cardiac intervention your patient complains of acute onset of back pain, hypotension, and tachycardia, these signs indicate?
retroperitoneal bleed
Your patient is post sinus surgery, and has persistent clear watery drainage from the nose or salty tasting drainage down the throat, what does this indicate?
CSF leak
Your patient is s/p a kidney transplant from a living donor, his prior hours urine output was 1200, what rate will you run you IVF at?
999
Your patient has a chest tube, when they cough you see bubbling in the chamber, what does this indicate
Air leak
Your patient BP is 180/90 with a heart rate of 55, what anti hypertensive medication should you give
Hydralizine
Post cardiac intervention patients have a HOB restriction of 45 degrees
True or False
False
30 degrees
Your patient is s/p a DL and suddenly has audible inspiratory stridor, increased respiratory effort, paradoxical respiratory effort, oxygen desaturation and appears scared, what do you do?
Apply positive pressure with bag and mask these are signs of a laryngospasm
Your patient is receiving CBI where and how do you document
I&O flow sheet
Add rows, add group
type continuous bladder irrigation
select
CBI intake
CBI output (subtract from intake)
True urine
What dose of Naloxone will you give in PACU
0.04 mg (40mcg)in 2-3 minute interval till desired effect
What is the reversal agent for midazolam
flumazenil
Your patient goes into Afib with RVR, anesthesia decides to start an amiodarone gtt, what is needed in addition to the medication, tubing, and IV pump?
0.22 micron filter
ideally amiodarone should be run through a central line
What are the components of the trach travel bag?
(There are 7 components)
•Travel
resuscitation bag and mask, spare tracheostomy tube (same size as the current tracheostomy tube), empty 10mL syringe, appropriately sized suction catheter, pink saline bullet, obturator (if available) and sterile gloves.
–RN must travel with a fresh trach
A patient is experiencing flank pain, hematuria, and nausea what are these hallmark signs of?
Kidney stones
How long should an initial ketamine infusion run before the rate is adjusted
1 hour