Author Question: Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated ... (Read 43 times)

dmcintosh · **on:** Jun 25, 2018

Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated shoulder. What action does the nurse anticipate?

a. Securing an airtight fit for the inhalation mask
b. Starting a 20-gauge IV in the patient's unaffected arm
c. Obtaining a nonocclusive dressing to place over the administration site
d. Teaching the patient about epidural patient-controlled anesthesia (PCA) use

Question 2

Which action will the nurse take immediately after surgery for a patient who received ketamine (Ketalar) as an anesthetic agent?

a. Administer higher doses of analgesic agents.
b. Ensure that atropine is available in case of bradycardia.
c. Question the order for benzodiazepines to be administered.
d. Provide a quiet environment in the postanesthesia care unit.

Animal_Goddess · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
For MAC, IV sedatives, such as the benzodiazepines, are administered. Therefore the patient needs IV access. Inhaled, epidural, and topical agents are not included in MAC. An occlusive dressing would be placed over a topical agent such as eutectic mixture of local anesthetics (EMLA) cream.

Answer to Question 2

ANS: D
Hallucinations are an adverse effect associated with the dissociative anesthetics such as ketamine. Therefore the postoperative environment should be kept quiet to decrease the risk of hallucinations. Because ketamine causes profound analgesia lasting into the postoperative period, higher doses of analgesics are not needed. Ketamine causes an increase in heart rate. Benzodiazepine may be used with ketamine to decrease the incidence of hallucinations and nightmares.