CPAN flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASA fasting intervals

Clear liquids: 2 hours; breast milk: 4 hours; infant formula: 6 hours; nonhuman milk or light meal: 6 hours; fatty or fried meal: 8 hours before elective anesthesia.

Aldrete score

Postanesthesia recovery score evaluating activity, respiration, circulation, consciousness, and oxygen saturation; each 0-2, maximum 10. A score of 9-10 generally indicates Phase I discharge readiness.

STOP-BANG screening

OSA risk tool: Snoring, Tiredness, Observed apnea, Pressure (hypertension), BMI >35, Age >50, Neck circumference >40 cm, Gender male. Score 3 or more indicates increased risk.

Phase I PACU handoff

Structured report includes procedure, anesthetic agents, airway management, vital signs, fluids, medications, pain, temperature, allergies, and anticipated complications; ensures continuity and safety.

Malignant hyperthermia history

Ask about prior anesthetic reactions, unexplained fever, rigidity, dark urine, or family history; patients with suspected susceptibility require trigger-free anesthesia and precautions.

MAC definition

Minimum alveolar concentration producing immobility in 50% of patients exposed to surgical stimulus; lower MAC means greater potency, and MAC values are additive.

Succinylcholine dose

Depolarizing neuromuscular blocker given 1-1.5 mg/kg IV; onset 45-60 seconds and duration 5-10 minutes. Avoid in hyperkalemia, burns older than 24 hours, denervation, and malignant hyperthermia susceptibility.

Neostigmine reversal

Anticholinesterase given 0.03-0.07 mg/kg IV, maximum 5 mg, with glycopyrrolate 0.2 mg per 1 mg neostigmine to prevent bradycardia; reverse only with train-of-four monitoring.

Opioid equianalgesia

Approximate parenteral equivalence: morphine 10 mg = hydromorphone 1.5 mg = fentanyl 100 mcg. Use to convert opioids safely, then adjust for age, renal function, and tolerance.

Lipid emulsion for LAST

For local anesthetic systemic toxicity, give 20% lipid emulsion 1.5 mL/kg IV bolus, then infusion 0.25 mL/kg/min; continue life support and repeat bolus if seizures or instability persist.

Mallampati classification

Airway assessment with four classes based on oropharyngeal visibility; Class I shows tonsillar pillars and uvula, Class IV shows only hard palate. Classes III-IV suggest difficult laryngoscopy.

Laryngospasm treatment

Give 100% oxygen with continuous positive airway pressure, jaw thrust, suction, and deepen anesthesia; if severe or persistent, give succinylcholine 0.1-0.5 mg/kg IV.

Capnography esophageal intubation

An esophageal tube produces absent or decreasing end-tidal CO2 waveform; sustained CO2 confirms tracheal placement. Capnography is the standard confirmation method after intubation.

Postoperative hypoxemia causes

Common causes include residual anesthesia, opioid-induced hypoventilation, atelectasis, airway obstruction, laryngospasm, aspiration, pulmonary edema, and pulmonary embolism; assess airway, breathing, and oxygenation first.

Extubation criteria

Awake and following commands, adequate spontaneous ventilation, stable hemodynamics, protective reflexes, and train-of-four ratio greater than 0.9; suction and plan for reintubation if needed.

Mean arterial pressure

MAP equals diastolic pressure plus one-third of pulse pressure, or (systolic + 2 times diastolic)/3; a value of at least 65 mmHg generally supports organ perfusion.

Cardiac output formula

Cardiac output equals heart rate times stroke volume; normal adult value is 4-8 L/min. Cardiac index divides output by body surface area and normally is 2.5-4 L/min/m2.

Orthostatic hypotension

A drop in systolic blood pressure of at least 20 mmHg or diastolic of at least 10 mmHg within 3 minutes of standing; indicates volume depletion or autonomic dysfunction and increases fall risk.

Symptomatic bradycardia

Treat with atropine 0.5 mg IV repeated every 3-5 minutes to a maximum of 3 mg; if ineffective, consider pacing or epinephrine infusion while identifying causes such as hypoxia or drug effect.

Cuff size error

A blood pressure cuff that is too small overestimates pressure, while one too large underestimates it; cuff bladder width should be about 40% of arm circumference.

PONV Apfel score

Predicts postoperative nausea and vomiting using female sex, nonsmoking status, history of PONV or motion sickness, and postoperative opioids; each factor adds one point and higher scores warrant more prophylaxis.

Malignant hyperthermia treatment

Stop triggering agents, give dantrolene 2.5 mg/kg IV and repeat as needed, hyperventilate with 100% oxygen, cool, treat hyperkalemia and arrhythmias, and monitor urine output.

Anaphylaxis epinephrine

Give epinephrine 0.3-0.5 mg intramuscularly in the adult anterolateral thigh, repeat every 5-15 minutes as needed, and support airway, breathing, and circulation with fluids.

LAST presentation

Local anesthetic systemic toxicity begins with tinnitus, metallic taste, agitation, or seizures, then progresses to coma, respiratory depression, and ventricular arrhythmias; stop injection and give lipid emulsion.

Postoperative hematoma airway

After thyroid or neck surgery, expanding hematoma can obstruct the airway; call for help, open the wound, and prepare for emergent intubation or surgical airway.

Shivering after anesthesia

Increases oxygen consumption and carbon dioxide production; treat with forced-air warming, warm fluids, and meperidine when warming alone is insufficient and hemodynamics are stable.

Discharge teaching elements

Include written instructions on medications, pain control, incision care, activity restrictions, diet, follow-up appointments, and specific warning signs requiring immediate medical attention.

Teach-back method

Ask the patient to explain instructions in their own words; this confirms understanding, identifies gaps, and is especially useful for low health literacy.

Informed consent role

The provider obtains consent; the nurse verifies voluntariness, capacity, disclosure, and understanding, witnesses signature per policy, and advocates if concerns exist.

ASPAN standards

Evidence-based perianesthesia nursing standards addressing assessment, monitoring, discharge criteria, staffing, education, and quality; used to guide safe practice across phases of care.

Universal protocol

Preprocedure verification, site marking, and a time-out immediately before the procedure; all team members confirm patient, procedure, site, and consent to prevent wrong-site errors.

Patient advocacy

The nurse speaks up for patient safety and preferences, verifies allergies and identity, ensures informed decisions, and escalates concerns through appropriate channels.