Nokea
A client is prescribed preanesthetic drugs prior to surgery. Which of the following nursing interventions should the nurse perform when caring for this client before the administration of preanesthetic drugs?
- A. Explain postoperative client activities.
- B. Check the client every 5 to 15 minutes.
- C. Assess the respiratory status of the client.
- D. Admit the client to an appropriate unit.
Correct Answer: A
Rationale: When caring for a client prescribed preanesthetic drugs, the nurse should demonstrate, describe, and explain postoperative client activities, such as deep breathing, coughing, and leg exercises. The nurse should check the client every 5 to 15 minutes for emergence from anesthesia, but this is done after the administration of anesthesia, not before. Assessing the respiratory status of the client and admitting the client to an appropriate unit are both postoperative interventions that a nurse should perform. Therefore, these are not performed before the administration of preanesthetic drugs and anesthesia.
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A client admitted for an appendectomy receives methohexital as a general anesthetic. Which of the following would most likely occur as a result of this medication?
- A. Skeletal muscle relaxation
- B. Profound analgesia
- C. CNS depression
- D. Neuroleptanalgesia
Correct Answer: C
Rationale: Methohexital is an ultrashort-acting barbiturate that depresses the CNS to produce hypnosis and anesthesia, but it does not produce analgesia. Skeletal muscle relaxation is caused by skeletal muscle relaxants, halothane, and enflurane. An anesthetic state characterized by profound analgesia is produced by ketamine, which is a rapid-acting general anesthetic. Neuroleptanalgesia is caused by a combination of fentanyl and droperidol.
After teaching a group of students about the stages of general anesthesia, the instructor determines that the teaching was successful when the students identify which of the following as characteristic of the first stage?
- A. Delirium
- B. Analgesia
- C. Respiratory paralysis
- D. Excitement
Correct Answer: B
Rationale: Stage I is characterized by analgesia; stage II is the stage of delirium and excitement, stage III is the stage of surgical analgesia; and stage IV is the stage of respiratory paralysis.
A client scheduled for surgery has to undergo insertion of an endotracheal tube. The nurse understands that which of the following drugs for general anesthesia would most likely be ordered for this client?
- A. Benzodiazepines
- B. Barbiturates
- C. Opioid analgesics
- D. Skeletal muscle relaxants
Correct Answer: D
Rationale: Skeletal muscle relaxants help produce relaxation of skeletal muscles during certain types of surgeries involving the chest or abdomen and are used to facilitate the insertion of an endotracheal tube. Barbiturates are used for the induction of anesthesia. Benzodiazepines are used to relieve anxiety, induce anesthesia, and consciously sedate the client before minor procedures. Opioid analgesics are used to produce neuroleptanalgesia characterized by general quietness, reduced motor activity, and profound analgesia.
A nurse is working in the PACU. Which of the following would be most important for the nurse to do? Select all that apply.
- A. Checking airway patency
- B. Positioning the client to prevent aspiration of secretions
- C. Reviewing the client's surgical and anesthesia records
- D. Checking the client every 15 to 30 minutes for emergence from anesthesia
- E. Checking the client's vital signs
Correct Answer: A,B,C,E
Rationale: Checking airway patency, positioning the client to prevent aspiration of secretions, reviewing the client's surgical and anesthesia records, checking the client every 5 to 15 minutes for emergence from anesthesia, and checking the client's vital signs, IV lines, catheters, drainage tubes, surgical dressings, and casts represent the nurse's responsibilities to a client in the PACU.
For which area on the body would the nurse identify Ambrosia identify that the use of epinephrine with a local injectable drug would be contraindicated? Select all that apply.
- A. Use on a toe
- B. Use on the scalp
- C. Use on the face
- D. Use on the abdomen
- E. Use on a finger
Correct Answer: A,E
Rationale: When the local anesthetic is used on an extremity (such as a toe or finger), the use of epinephrine with a local injectable drug is contraindicated.