Anesthesia and Patient Safety in the OR Flashcards

Intraoperative awareness (unintended consciousness during general anesthesia) is most effectively monitored using which technology?

Answer: Bispectral Index (BIS) monitor measuring processed EEG

The Bispectral Index (BIS) processes EEG signals to provide a numerical depth-of-anesthesia estimate, with values of 40–60 indicating adequate anesthesia for most surgical procedures.

A patient receiving epidural analgesia develops sudden hypotension, bradycardia, and respiratory distress after a bolus dose. The CRNFA should recognize this as which complication?

Answer: Total spinal (high spinal block with hemodynamic collapse)

Total spinal (accidental intrathecal injection of an epidural dose) causes rapid-onset profound hypotension, bradycardia, and respiratory failure requiring immediate vasopressor and airway support.

Which intraoperative physiologic parameter, if consistently below 95%, requires immediate intervention by the surgical team?

Answer: SpO2 (pulse oximetry oxygen saturation)

SpO2 below 95% indicates hypoxemia requiring immediate airway and ventilatory assessment; the lower alarm limit on most anesthesia monitors is set at 95%.

The CRNFA should ensure that which safety device is applied before draping to minimize risk of patient movement causing injury during positioning under anesthesia?

Answer: Safety strap or padded restraint securing the patient to the table

A safety strap or padded restraint must be applied across the patient's thighs before draping to prevent falls if the patient moves, is inadvertently bumped, or the table is repositioned.

Which anesthetic technique provides excellent analgesia for total knee arthroplasty while allowing early ambulation and reducing opioid requirements?

Answer: Femoral nerve block or adductor canal block (regional anesthesia)

Femoral nerve or adductor canal blocks provide targeted knee analgesia while preserving quadriceps strength for early mobilization and significantly reducing systemic opioid requirements.

When a patient is placed in the steep Trendelenburg position for robotic pelvic surgery, which physiologic change should the CRNFA anticipate and assist the anesthesia team in managing?

Answer: Increased airway pressures and decreased functional residual capacity requiring ventilator adjustments

Steep Trendelenburg shifts abdominal contents cephalad, compressing the diaphragm, increasing airway pressures, decreasing FRC, and requiring higher ventilator pressures to maintain adequate oxygenation.