A client with an extensive history of alcoholism is having coronary bypass surgery. While administering anesthesia, the certified nurse anesthetist notes that the client requires greater than usual amounts of the drug
The nurse correctly evaluates this response as which phenomenon?
1. The client has developed a resistance to the anesthesia, so it will not work very well.
2. The client has developed a paradoxical reaction to the anesthesia and will require a different drug.
3. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this client.
4. The client had developed cross-tolerance to the anesthesia and will require greater amounts.
Correct Answer: 4
Rationale 1: Resistance refers to the immune system; infections and should not be used interchangeably with tolerance.
Rationale 2: Paradoxical refers to the opposite response; in this case, the client would have become very excitable. There is no evidence of this.
Rationale 3: There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose.
Rationale 4: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This client has a tolerance to alcohol, so he will require additional anesthesia for surgery, since both drugs are CNS depressants.
Global Rationale: With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This client has a tolerance to alcohol, so he will require additional anesthesia for surgery, since both drugs are CNS depressants. Resistance refers to the immune system; infections and should not be used interchangeably with tolerance. Paradoxical refers to the opposite response; in this case, the client would have become very excitable. There is no evidence of this. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose.
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