A patient will receive isoflurane (Forane) as an anesthetic for a ...

[anjilletteb]

A patient will receive isoflurane (Forane) as an anesthetic for a surgical procedure. The nurse caring for this patient during the perioperative period knows that, unlike halothane, this agent will not cause:
 
  a. myocardial depression.
  b. muscle relaxation.
  c. rapid induction.
  d. respiratory depression.

Question 2

A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump.
 
  The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do?
  a. Discuss possible opiate dependence with the patient's provider.
  b. Encourage the patient to turn over and cough and take deep breaths.
  c. Note the effectiveness of the analgesia in the patient's chart.
  d. Prepare to administer naloxone and possibly ventilatory support.

[underwood14]

Answer to Question 1

ANS: A
Isoflurane does not cause myocardial depression and does not reduce cardiac output. Isoflurane actually produces more muscle relaxation than halothane. Induction with isoflurane is rapid. Isoflurane causes respiratory depression, as do all inhalation anesthetics.

Answer to Question 2

ANS: D
Opioid toxicity is characterized by coma, respiratory depression, and pinpoint pupils. Although pupils are constricted initially, they may dilate as hypoxia progresses, which also causes blood pressure to drop. This patient has a respiratory rate of fewer than 12 breaths per minute, dilated pupils, and low blood pressure; the patient also is showing signs of central nervous system (CNS) depression. The nurse should prepare to give naloxone and should watch the patient closely for respiratory collapse. Patients with opioid dependence show withdrawal symptoms when the drug is discontinued. When postoperative patients have adequate analgesia without serious side effects, encouraging patients to turn, cough, and breathe deeply is appropriate. This patient is probably relatively pain free, but providing emergency treatment is the priority.

[anjilletteb]

Gracias!

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