anesthesia case study

have read thru the chapter i was just stummed over a couple of questions. this class is called pharmcology for nurses...its a nursing class within the program. can you tell me how well i did and if i need to make any revisions. also number 1,7 i did not get. (i guess i dont know to think like a nurse yet) thanks for you help.

Mr. Smith is a 65 year old male with a history of lung cancer. He is 5’8’’, and weighs 240 pounds. He currently has a productive cough, and admits to smoking for 40 years. He has a history of lung cancer, and hypertension, which is treated with a mild diuretic. He is presently admitted to the hospital to await surgery for a thoracotomy at 1000 today.



1. Mr. Smith’s daughter asks you why her dad is getting a medication before his thoracotomy surgery. The doctor has ordered meperidine HCl (Demerol) 50 mg IM and glycopyrrolate (Robinul) 0.35mg IM on call to surgery. Describe what you would explain to the family about the drugs that were ordered for Mr. Smith.


2. List five categories of drugs used in balanced anesthesia?
Anticolinergics
Tranquilizers
Hypnotics and sedatives
Analgesics
Neuroleptanalgesics



3. What is the purpose of the five categories of drugs used in balanced anesthesia?
The purpose is to decrease motor activity, easy handling, inhibits vomiting, decrease GI secretions, cyclogeia and relax urinary tract.


4. What is the benefit of balanced anesthesia?
Balanced anesthesia allows us to minimize patient risk and maximize patient comfort and safety. The objectives of balanced anesthesia are to calm the patient, minimize pain, and reduce the potential for adverse effects associated with analgesic and anesthetic agents

5. What are at least 5 nursing responsibilities of giving preanesthetics?
To decrease anxiety.
To increase effectiveness of an incomplete anesthetic
To prevent undesirable actions of anesthetics such as salvation and bradycardia and post anesthetic vomiting.
To facilitate smooth and rapid induction and recovery.


6. What are three goals for Mr. Smith receiving general anesthetic?
Provide rapid and complete loss of sensation
Depressing most nervous activity in the brain
To have muscle relaxation



7. A nurse at your facility complains that she was asked to fill out an incident report because she did not give a preanesthetics drug on time. The nurse states she gave the drug 10 minutes before her client was taken to surgery. Is this a potentially serious error, and if so, explain why it is potentially dangerous for her client?


8. Discuss the responsibilities of the nurse in the postanesthesia (PACU) area after Mr. Smith has completed his surgery.
1. Mr. smith has to stay in the PACU until she have become awake and alert, usually (30-60 mins)with autonomously stable vital signs.
2. Mr. Smith is to be observed continually so that any difficulties that develop as they emerge from anesthesia are quickly recognized.

3. Every 15 minutes (or more often), the nurse records Mr. Smith vital signs, blood oxygen saturation, level of consciousness, independence of breathing, and ability to make voluntary movements.

4. Nurses monitor Mr. Smith continually, provide direct care, and notify the anesthesiologist immediately of any problems


9. Discuss the responsibilities of the nurse on the receiving floor after Mr. Smith is released from the PACU.
1. Is Mr. Smith awake, oriented, and able to call for help if it becomes necessary
2. Does Mr. Smith have clear airways, can breathe autonomously, and are maintaining a satisfactory level of blood oxygenation
3. Have active airway protection reflexes
4. Has he been physiologically stable with acceptable vital signs for 15–30 minutes
5. Assessed Mr. Smith to ensure no actively bleeding and have no apparent postsurgical complications.