Flash Cards

Clinical exam 4

Question Answer
Complete recovery of swallowing reflex takes ____ after return of consciousness after propofol anesthesia 15 min
15 mg of valium depresses the swallowing reflex up to _____ 4 hrs
Versed depresses swallowing reflex up to ____ after return to normal state of consciousness 2 hrs
In healthy adult males, administration of ____% nitrous oxide as a sedative caused marked depression of swallowing reflex 50%
Opioids & benzos together have marked _____ reponse to the respiratory responsiveness synergistic
Besides hypoxia, airway obstruction, & death, other possible disadvantages include (there are 6): lack of control over the airway, technique failure, pt dissatisfaction, surgeon dissatisfaction, excitement, prolonged recovery
In a normal awake subject, upper airway collapse is prevented by __________ that holds open the pharynx, larynx, & trachea upper airway dilator muscle tone
Upper airway dilator muscle tone is exquisitely sensitive to ______ drugs sedative-hypnotic drugs
When airway tone decreases, the diameter of the airway is _____ & airway resistance is markedly _______. Which law is this? diameter is reduced, resistance is increased. Poiseuille's Law
In the alveolar gas equation, if PACO2 increases from 40 to 80 d/t hypoventilation, PAO2 will decrease from 100 to _____ 50
What is the alveolar gas equation? PAO2 = FiO2(Pb – Ph20)-(PaCO2/R)
What is the normal partial pressure of water (Ph20)? 47 mmHg
What are the 5 causes of hypoxemia? Low FiO2, hypoventilation, V/Q mismatch, diffusion abnormalities, pulmonary right-to-left shunt
What are the 2 causes of hypercarbia? hypoventilation & V/Q mismatch
What is the mechanism of action of benzos? benzos enhance the chloride gating function of GABA by fascilitating the binding of this inhibitory neurotransmitter to its receptor
GABA receptors are found throughout ____, with concentrations in ________ CNS, cerebral cortex
Actions of GABA on CNS include (4 things): alterations in sleep, anxiety, memory & (in larger doses) hypnosis
Enhancement of GABA causes ________ disinhibitory behavior (pt may become less cooperative)
Which ion channel function is enhanced by benzos? Chloride channel (benzos enhance Cl- gating fxn of GABA by facilitating the binding of this inhibitory NT to its receptor)
Sedation is defined as….. a pharmacologically induced depression of consciousness consisting of varying degrees of amnesia, anxiolysis & analgesia tailored to the pt's needs for the procedure. Continuum is from minimal (light) sedation through deep sedation/GA
Minimal sedation is defined as….. a drug-induced state during which pts respond normally to verbal commands. Although cognitive fxn & physical coordination may be impaired, airway reflexes, & ventilatory & CV fxns are usually unaffected
Moderate sedation is also called _______ _______ conscious sedation
Moderate sedation is defined as….. a drug-induced depression of consciousness; pts respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are req'd to maintain a patent airway, & spont vent is usually adequate. CV fxn maintained
Reflex withdrawal from a painful stimulus (is / is not) considered a purposeful response is not
Deep sedation/analgesia is defined as….. a drug-induced depression of consciousness; pts cannot be easily aroused, but respond purposefully following repeated or painful stimulation. Spont vent may be inadequate. May have impaired ability to maintain airway. CV fxn usually maintained
General anesthesia is defined as … drug-induced LOC. Pts are not arousble, even to painful stimulation. Ability to maintain vent fxn is often impaired. Often req assistance to maintain patent airway & may need positive pressure ventilation. CV fxn may be impaired
5 Goals of sedation from American Academy of Pediatrics are: – to guard pt's safety & welfare.
– minimize discomfort & pain.
– minimize negative psychological responses to treatment by providing analgesia, & maximize amnesia potential
– control behavior
– return pt to state of safe discharge

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