A client is scheduled to undergo a transurethral resection of the prostate gland (TURP). The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should be particularly alert for early signs of:
A. Convulsions
B. Cardiac arrest
C. Renal shutdown
D. Respiratory paralysis
Correct Answer: D. Respiratory paralysis
If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used, the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside. The patient’s hemodynamics requires monitoring in the immediate post-op period until the resolution of the anesthetic. Nurses and physicians from other fields managing the patient need to be aware of the nature of anesthesia that patient underwent.
Option A: Myoclonus that develops after spinal anesthesia is usually limited to the lower limbs and can involve both the upper and lower limbs unilaterally. There are no convulsions or change in consciousness, and patients generally recover without complications
Option B: Cardiac arrests during spinal anesthesia are described as “very rare,” “unusual,” and “unexpected,” but are actually relatively common. The two largest prospective studies designed to evaluate the incidence of complications during spinal anesthesia reported two arrests in 1881 patients and 26 arrests in 40,640 patients for an overall incidence of seven arrests for every 10,000 (0.07%) spinal anesthetics.
Option C: There is contradictory evidence regarding the effects of anesthetics on renal function. Some studies have shown that the administration of some types of anesthesia during surgery, as well as surgical stress itself, can affect renal function. Indirect effects are more pronounced than the direct effects. However, other studies have shown that some anesthetic drugs induce anti-inflammatory, anti-necrotic, and anti-apoptotic effects that protect against AKI
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