CAPA Perianesthesia Complications & Emergency Response 2

Question 1

A patient develops urticaria, hypotension, and wheezing minutes after receiving IV antibiotics in the PACU. What is the FIRST-LINE treatment?

Accepted Answer

Epinephrine 0.3 mg IM into the anterolateral thigh

Answer

Epinephrine is the first-line treatment for anaphylaxis, addressing vasodilation, bronchoconstriction, and angioedema through alpha and beta adrenergic receptor activation.

Question 2

Local anesthetic systemic toxicity (LAST) most characteristically presents initially with which symptom cluster?

Accepted Answer

CNS excitation: perioral numbness, tinnitus, and metallic taste

Answer

LAST progresses in a predictable sequence with CNS excitation symptoms — perioral numbness, tinnitus, metallic taste, restlessness — preceding cardiovascular toxicity.

Question 3

What is the definitive treatment for refractory cardiac arrest caused by local anesthetic systemic toxicity (LAST)?

Accepted Answer

20% lipid emulsion (intralipid) IV bolus

Answer

20% lipid emulsion acts as a 'lipid sink,' sequestering lipophilic local anesthetic from cardiac tissue, and is the definitive ASRA-recommended treatment for LAST cardiac arrest.

Question 4

What is the correct initial bolus dose of 20% lipid emulsion (intralipid) for LAST per ASRA guidelines?

Accepted Answer

1.5 mL/kg IV over 2-3 minutes

Answer

ASRA guidelines recommend 1.5 mL/kg of 20% lipid emulsion as an IV bolus over 2-3 minutes, followed by a continuous infusion of 0.25 mL/kg/min.

Question 5

Which patient factor MOST significantly increases the risk of pulmonary aspiration in the perianesthesia period?

Accepted Answer

History of GERD combined with inadequate preoperative fasting

Answer

GERD increases gastric acid presence and inadequate fasting increases gastric volume, together significantly elevating the risk of regurgitation and aspiration.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Perianesthesia Complications & Emergency Response 2