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SUM'20 - Advanced Principles > Exam 3 - Review > Flashcards

Flashcards in Exam 3 - Review Deck (201)
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91

Hypotensive effects of citrate-induced hypocalcemia can be minimized by administering how much calcium gluconate for each milliliter of blood transfused??

(1 to 2 mg IV) / for each mL of blood transfused

92

CDH - The most common findings include displacement of the

heart and fluid-filled gastrointestinal segments into the thorax - both stomach and bowel are often present

93

CDH - These infants can have profound hypoxemia, which reflects the

RIGHT -TO-LEFT shunting through the ductus arteriosus; the cause is persistent fetal circulation resulting from lung parenchymal and vascular hypoplasia with resultant high pulmonary vascular resistance.

94

For patients with CDH, Adequate sedation is achieved in an effort to minimize increases in

pulmonary vascular resistance

95

Apnea of Prematurity is diagnosed if an infant exhibits

•apnea of longer than 15 to 20 seconds, -apnea associated with a heart rate of less than 80 to 100 beats per minute, or -apnea associated with significant decreases in oxygen saturation

96

Intraoperative oxygen saturation goals for preterm infants undergoing surgery have well established guidelines, True or false?

False there are no established guidelines for specific intraoperative oxygen saturation goals

97

For CDH - Venous access should be avoided in the

lower extremities, because venous return may be impaired as a result of compression of the inferior vena cava following reduction of the hernia ***

98

with CDH is N2O okay to use?

 Nitrous oxide should be avoided, because its diffusion into loops of intestine present in the chest may result in distention with subsequent compression of functional lung tissue (we don’t want NO to expand in a closed space)

99

the most frequent congenital anomaly of the esophagus ***

Esophageal atresia (EA) is

100

For EA - what should be avoided?

Endotracheal intubation is avoided, if possible, because of the potential to worsen distention of the stomach, which can lead to gastric rupture

101

For EA - Awake intubation with spontaneous ventilation allows

optimal positioning of the endotracheal tube while minimizing the risk of ventilatory impairment associated with gastric distention resulting from positive pressure ventilation and passage of gases through the fistula

102

with EA - Proper placement of the tracheal tube is critical; it should be above the carina but below

the TEF (fistula)***

103

EA - Intraoperative insensible and third-space fluid losses should be replaced with crystalloid at a rate of

6 to 8 mL/kg/hr

104

EA - Blood loss may be replaced with 5% albumin and packed red cells to maintain a hematocrit of higher

than 35%***

105

Gastroschisis requires urgent

repair

106

If inspiratory pressures are greater than _______ primary closure is not recommended

25 to 30 cm H2O or intravesical or intragastric pressures are greater than 20 cm H2O,

107

In Hirschsprung's Disease Anesthesia can be maintained with a mixture of

air, oxygen, volatile agent, and muscle relaxant.

108

In Hirschsprung's Disease Anesthesia Extra care should be taken in positioning, since these operations can be

quite lengthy

109

In Hirschsprung's Disease Extubation at the end of surgery is

routine ***

110

in Anorectal Anomolies, Intravenous catheters should be placed in upper extremities, because

surgical positioning of the legs may impede venous flow or limit access to the intravenous catheter insertion sites

111

for an anorectal anomolies with significant abd distention, what type of intubation should be employed?

RSI

112

one of the most common gastrointestinal abnormalities appearing in the first 6 months of life

Pyloric stenosis

113

Initial tx of Pyloric Stenosis is aimed at repletion of IV Volume, electrolyte correction and Acid/Base abnormalities. Further resuscitation is given as

5% dextrose in 0.45% NaCl at 1.5 times the maintenance rate

114

for patients with pyloric stenosis, what is the preferred induction plan?

-awake intubation or by use of -RSI after administration of hypnotic and succinylcholine

115

Early signs and symptoms of this disease are often nonspecific and include recurrent apnea, lethargy, temperature instability, and glucose level instability.

Necrotizing Enterocolitis (NEC)

116

NEC - Surgery is reserved for neonates for whom medical management fails, as evidenced by

bowel perforation, sepsis (peritonitis), and progressive metabolic acidosis indicating bowel necrosis

117

Intraoperative care of a critically ill newborn w/NEC is often more a resuscitation effort than management of

general anesthesia ***

118

for the infant with NEC, if not already intubated, induction should proceed with full-stomach precautions and awareness of the infant's

depleted intravascular volume and possible impaired contractility

119

For NEC - Maintenance of anesthesia is generally limited to the use of

short-acting iv opioids (fentanyl) as tolerated, muscle relaxation, and replenishment of intravascular volume as needed

120

cornerstone TX for biliary atresia is a Kasai's operation (portoenterostomy) and what?

liver transplantation