Patient Controlled Epidural Analgesia (Pcea) Post-test

1. Prior to ambulating a patient with a PCEA, you should:

Stop the epidural infusion prior to ambulating the patient

Not worry about these symptoms

Notify the anesthesiologist immediately

Prior to ambulating a patient with a patient-controlled epidural analgesia (PCEA), it is important to assess their lower extremities for any changes in sensory or motor function. This is because the epidural infusion can cause numbness, heaviness, or other changes in the lower extremities. These symptoms may indicate complications such as nerve damage or spinal cord compression. Therefore, it is crucial to notify the anesthesiologist immediately so that appropriate action can be taken to ensure the safety of the patient. Stopping the epidural infusion may also be necessary depending on the severity of the symptoms.

Explanation

Prior to ambulating a patient with a patient-controlled epidural analgesia (PCEA), it is important to assess their lower extremities for any changes in sensory or motor function. This is because the epidural infusion can cause numbness, heaviness, or other changes in the lower extremities. These symptoms may indicate complications such as nerve damage or spinal cord compression. Therefore, it is crucial to notify the anesthesiologist immediately so that appropriate action can be taken to ensure the safety of the patient. Stopping the epidural infusion may also be necessary depending on the severity of the symptoms.

2. A sudden increase in a patient's sedation level may be due to the migration of the epidural catheter into the spinal space.

True

False

A sudden increase in a patient's sedation level may be due to the migration of the epidural catheter into the spinal space. This is because the epidural catheter is designed to deliver medication into the epidural space, which is outside the spinal space. If the catheter migrates into the spinal space, it can result in a higher concentration of medication reaching the spinal cord, leading to increased sedation levels.

Explanation

A sudden increase in a patient's sedation level may be due to the migration of the epidural catheter into the spinal space. This is because the epidural catheter is designed to deliver medication into the epidural space, which is outside the spinal space. If the catheter migrates into the spinal space, it can result in a higher concentration of medication reaching the spinal cord, leading to increased sedation levels.

3. Signs and symptoms that may be observed during an epidural emergency are:

Diminished or loss of consciousness

Respiratory distress or arrest

Cardiac arrest

Severe symptomatic hypotension

A & B only

All of the above (A,B,C,D)

During an epidural emergency, various signs and symptoms may be observed. These include diminished or loss of consciousness, respiratory distress or arrest, cardiac arrest, and severe symptomatic hypotension. The correct answer, "All of the above (A,B,C,D)," indicates that all of these signs and symptoms may be present during an epidural emergency.

Explanation

During an epidural emergency, various signs and symptoms may be observed. These include diminished or loss of consciousness, respiratory distress or arrest, cardiac arrest, and severe symptomatic hypotension. The correct answer, "All of the above (A,B,C,D)," indicates that all of these signs and symptoms may be present during an epidural emergency.

4. Which one do you like? 1. If an epidural catheter is inserted at the bedside on the unit,

The epidural cart/ bag must be present

The anesthesiologist tech must be present to support placement

The anesthesiologist will remain at the bedside until the patient is stable

None of the above

All of the above except D

The correct answer is "All of the above except D". This means that all of the statements mentioned in options A, B, and C are true, except for option D. This implies that if an epidural catheter is inserted at the bedside on the unit, the epidural cart/bag must be present, the anesthesiologist tech must be present to support placement, and the anesthesiologist will remain at the bedside until the patient is stable.

Explanation

The correct answer is "All of the above except D". This means that all of the statements mentioned in options A, B, and C are true, except for option D. This implies that if an epidural catheter is inserted at the bedside on the unit, the epidural cart/bag must be present, the anesthesiologist tech must be present to support placement, and the anesthesiologist will remain at the bedside until the patient is stable.

5. During your shift you need to assess and document the following :

PCEA charting is the same as PCA charting

The correct answer is the first option because it includes all the necessary assessments that need to be done during the shift. It mentions the assessment of the site and dressing condition, flow/patency, and safety. It also includes the assessment of vital signs, pain, neurological status, respiratory status, adverse effects, and verification of settings. Additionally, it mentions the need to check EtCO2 if it is ordered. This option covers all the important assessments that need to be documented during the shift.

Explanation

The correct answer is the first option because it includes all the necessary assessments that need to be done during the shift. It mentions the assessment of the site and dressing condition, flow/patency, and safety. It also includes the assessment of vital signs, pain, neurological status, respiratory status, adverse effects, and verification of settings. Additionally, it mentions the need to check EtCO2 if it is ordered. This option covers all the important assessments that need to be documented during the shift.

6. When a patient is receiving PCEA infusion:

Anticoagulants may be given without the anesthesiologist’s consent

Systemic narcotics need not be consented by the anesthesiologist

The surgeon or anesthesiologist will specify the exact time when anticoagulants can begin after catheter removal

None of the above

All of the above

During a patient's PCEA (Patient-Controlled Epidural Analgesia) infusion, the administration of anticoagulants requires the consent of the anesthesiologist. Systemic narcotics, on the other hand, do not require the anesthesiologist's consent. However, when it comes to the initiation of anticoagulants after catheter removal, the exact timing will be specified by either the surgeon or the anesthesiologist. Therefore, the correct answer is "the surgeon or anesthesiologist will specify the exact time when anticoagulants can begin after catheter removal."

Explanation

During a patient's PCEA (Patient-Controlled Epidural Analgesia) infusion, the administration of anticoagulants requires the consent of the anesthesiologist. Systemic narcotics, on the other hand, do not require the anesthesiologist's consent. However, when it comes to the initiation of anticoagulants after catheter removal, the exact timing will be specified by either the surgeon or the anesthesiologist. Therefore, the correct answer is "the surgeon or anesthesiologist will specify the exact time when anticoagulants can begin after catheter removal."