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CRNA Board Review--Volatile Agents
CRNA Board Review
18
Nursing
Graduate
12/23/2009

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Cards

Term
What determines volatile agent potency?
Definition
Lipid solubility
Term
Which volatile agent has the least effect on BP?
Definition
Sevoflurane
Term
Which agent has the least effect on SVR?
Definition
Sevo or Halothane
Term
Which agent(s) has the least effect on Cardiac Output?
Definition
Iso/Des
Term
Which agent(s) increase HR the most? The least?
Definition
Most=enflurane>iso/des, least = sevo
Term
Which agent most sensitizes the heart to catecholamine effects?
Definition
Halothane
Term
What law explains why liquids at lower temps are more soluble to gases?
Definition
Le Chatelier's Law
Term
What property determines the speed of onset of a volatile agent?
Definition
blood solubility
Term
What is another name for the blood:gas solubility coefficient?
Definition
The Ostwald solubility coeffecient
Term
Give the 4 volatile agent FA/FI ratios (% equilibrated after 30 minutes)
Definition
N20--99
Des--91
Sevo--85
Iso--73
Term
Why does N20 come on faster than Des despite having a higher B:G coefficient?
Definition
Due to the concentration effect
Term
How long does it take N20 to equilibrate with all tissues in the body?
Definition
2.5 hours
Term
What law accounts for N20 causing distention of gas cavities?
Definition
Fick's Law of Diffusion
Term
What law accounts for the concentration effect of N20?
Definition
Fick's
Term
Explain the concentration effect
Definition
When switching from room air to N20, because N20 is much more blood soluble than N2, it enters the bloodstream from the alveoli much faster than N2 can leave the bloodstream into the alveoli. This causes the alveoli to shrink; the shrinking causes an increase in N20 concentration in the alveoli (same amount of agent, smaller space), and this leads to a equilibration time....HIGHER CONCENTRATIONS OF N20 EQUILIBRATE FASTER THAN LOWER CONCENTRATIONS
Term
Explain the concentration effect and second gas effect
Definition
When switching from room air to N20, because N20 is much more blood soluble than N2, it enters the bloodstream from the alveoli much faster than N2 can leave the bloodstream into the alveoli. This causes the alveoli to shrink; the shrinking causes an increase in N20 concentration in the alveoli (same amount of agent, smaller space), and this leads to a equilibration time....HIGHER CONCENTRATIONS OF N20 EQUILIBRATE FASTER THAN LOWER CONCENTRATIONS. This same principle explains the 2nd gas effect; the 2nd gas used will also have a higher concentration due to the shrinking of the alveoli
Term
How long does it take to double the volume of a closed gas space when 75% N20 is delivered?
Definition
10 minutes
Term
What are the vapor pressures of Iso, Des, and Sevo?
Definition
Iso = 240
Des = 669
Sevo = 170
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