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PONV Risk Factors and Management

Total questions: 13

Worksheet time: 16mins

Name
Class
Date
1.

Pro-Emetic Receptors

receptor stimulation by acteylcholine (proemetic neurotransitter) evokes emesis

Serotonin (5HT3)

receptor (located in the brainstem) stimulation by vestibular hyperactivity triggers activation of histaminergic neuronal system, evoking emesis

Acetylcholine (M1)

activation leads to release of emetic neurotransmitters and/or peptides (dopamine, cholecystokinin, glutamate, acetylcholine, substance P, 5-HT)

Histamine (H1)

receptor stimulation by substance P excites neurons in the area postrema evokes emesis

Dopamine (D2/3)

receptor (loacted throughout the dorsal vagal, vagal nerves, and GI tract) stimulation by various stimuli evokes emesis

Substance P Neurokinin NK1 (NK1R)

2.

Olivia is scheduled for a laparoscopic cholecystectomy and is concerned about the risk of postoperative nausea and vomiting (PONV). Which of the following are risk factors for PONV that Olivia should be aware of?

a)

Volatile anesthetics

Nitrous oxide

Postoperative opioids

b)

<50 years of age

c)

Male Gender

d)

Laparoscopic

Bariatric

Gynecological

Cholecystectomy

e)

Smoker

3.

TRUE/FALSE

Jackson is preparing an anesthesia plan for a patient and wants to minimize the risk of postoperative nausea and vomiting (PONV). He considers using sugammadex instead of neostigmine for the reversal of neuromuscular blockade as a risk mitigation strategy. Is this approach correct?

a)

TRUE

b)

FALSE

4.

Non-pharmacologic Management

Categorize the following

Pericardium 6 acupunction point (PC6) motion sickness band

supplemental crystalloids

carbohydrate loading

aromatherapy

ginger

supplemental oxygen

chewing gum

Recommended
Questionable efficacy
5.

Organize these options into the right categories

Categorize the following

Scopalomine

droperidol

haloperidol

metoclopramide

aprepitant

fosprepitant

rolapitant

ondansetron

granisetron

dolasetron

palonsetron

5-HT3 Antagonists
NK1R Antagonists
Antidopaminergics
Anticholinergics
6.

Organize these options into the right categories

Categorize the following

scopalomine

Aprepitant

Fosaprepitant

Rolapitant

Dimenhydrinate

dolasetron

granisetron

ondansetron

droperidol

haloperidol

metoclopramide

End of surgery
At induction
Prior to surgery
Timing not efficacious or not indicated
7.

Samuel is a patient with 2 risk factors for chemotherapy-induced nausea and vomiting. Which of the following is not an appropriate medication regimen for him?

a)

ondansetron

b)

ondansetron + dexamethasone

c)

ondansetron + palosetron

d)

aprepitant + ondansetron

e)

aprepitant + dexamethasone

8.

TRUE/FALSE

During a preoperative meeting, William's anesthesiologist considers administering dexamethasone at induction to help reduce William's risk of postoperative nausea and vomiting (PONV). Is this an effective strategy?

a)

FALSE

b)

TRUE

9.

TRUE/FALSE

Samuel is an anesthesiologist who wants to minimize the incidence of PONV in his patients. Avoiding volatile anesthetics can help him achieve this goal.

a)

FALSE

b)

TRUE

10.

TRUE/FALSE

Emma is recovering from surgery and her doctor decides to use opioid-sparing analgesic techniques for her pain management. This approach has no impact on Emma's risk of experiencing postoperative nausea and vomiting (PONV).

a)

FALSE

b)

TRUE

11.

TRUE/FALSE

Samuel, a patient scheduled for surgery, is concerned about postoperative nausea and vomiting (PONV). His doctor decides to administer 5-HT3 antagonists as part of his care plan. This is an effective measure to reduce the risk of PONV.

a)

FALSE

b)

TRUE

12.

TRUE/FALSE

Aria is preparing for surgery and her doctor explains that her hydration status can influence the likelihood of experiencing postoperative nausea and vomiting (PONV). Is it true that hydration status has no influence on the incidence of PONV?

a)

FALSE

b)

TRUE

13.

TRUE/FALSE

Charlotte is scheduled for surgery and her doctor suggests using regional anesthesia instead of general anesthesia to help decrease the likelihood of PONV. Can regional anesthesia techniques help decrease the likelihood of PONV compared to general anesthesia?

a)

TRUE

b)

FALSE