Exam 3 Flashcards Preview

Surgery & Anaesthesia - NSULA Vet Tech Program Spring 2016 > Exam 3 > Flashcards

Flashcards in Exam 3 Deck (229):
1

What are five risk factors for anesthesia emergency?

o Breed
o Patient health
o Experience skills of the vet team
o Case circumstances
o Owner idiosyncrasy

2

Define laryngeal eversion.

edges of larynx are depressed or are everted

3

What issues arise when surgically correcting an elongated soft palate?

o Surgical correction with complications of swelling and incorrect length
o Too short causes food in the nares
o Too long does not solve the problem

4

How do you determine the correct ET tube size?

o Palpate to check size - Should not be tight going down
o Septum of the nares

5

What is one complication of the ET tube being too tight?

scrapes mucosal surface causing a postoperative cough

6

What is one factor in determining the order of surgical procedures?

most life threatening goes first

7

What must one evaluate before performing a procedure which requires anesthesia?

must weigh risks and benefits - benefits must outweigh risks

8

What is the number one reason for anesthetic emergencies?

human error

9

What are five examples of human mistakes which may lead to an emergency?

o Lack anesthesia and drug familiarity
o Wrong drugs administered
o Preoccupied or in a hurry
o Fatigue
o Inattentiveness

10

What are four symptoms/warning signs that a patient has a diaphragmatic hernia?

o Internal organs displaced into the thorax
o Skinny abdomen
o Muffled heart sounds
o Dyspnea

11

What are two examples of drugs that come in different dosage strengths?

Xylazine, Butorphanol

12

What is a potential route of administration drug complication that may occur with aggressive dogs?

aggressive dogs may be dosed IM in emergency situations, but if there is a struggle the vein may be hit

13

What is the second most common reason for emergencies?

equipment failure

14

What are six potential anesthesia machine equipment problems?

o CO2 absorber exhausted
o Decreased O2 flow
o Misassembled
o ET tube problems
o Vaporizer problems
o Pop off valve

15

How often should the CO2 absorber be changed?

every ten hours

16

What are five symptoms of CO2 absorber exhaustion in the patient?

o Hypercapnia because of the increased CO2 buildup
o Increased HR and RR
o Brick red MM
o Arrhythmias
o No reflexes

17

What are four possible reasons for decreased O2 flow?

o Tank runs out (change at 500 psi though 2-3 more surgeries could be done)
o Valves are closed
o Flow meter ball is lodged in the flow meter tube
o Obstruction or leak

18

What is one symptom of decreased O2 flow in the patient?

appears cyanotic when O2 has stopped

19

What should the tech's reaction to reduced O2 flow be?

o Disconnect the nonrebreathing circuit because room air has 20% oxygen (better than 0%)
o Leave a rebreathing circuit connected as long as the reservoir bag is full (there is still oxygen in it)

20

What percentage of O2 is found in room air?

20%

21

What percentage of 02 is administered by the vaporizer?

100%

22

What are four potential problems with the endotracheal tube?

o Twisting or kinking
o Material in tubes
o Bad positioning
o Blockage

23

How do you prevent twisting and kinking of the ET tube?

detach before flipping the animal

24

What drug increases the risk of material being trapped in the tube?

atropine in cats

25

What may occur when the ET tube is positioned too far past the bifurcation and the thoracic inlet?

only one bronchus is oxygenated and the other side dies

26

What does blockage of the ET tubes cause?

respiratory arrest

27

How does a tech check ET tube placement?

o Bag the patient to check for a rising chest - Abdominal rising means the ET tube is down the esophagus and into the stomach

28

What should a tech do if there is no rise of the chest or abdomen when bagging the patient to check placement of the ET tube?

disconnect and feel for air coming from the ET tube

29

What should the tech do when there is no air coming from the disconnected ET tube?

o Remove and replace the tube
o Suction the accumulation if this is the problem

30

What are six potential issues with the vaporizer?

o Wrong anesthetic
o Tipping machine over
o Dial is stuck and jammed
o 2 vaporizers on
o Over filling the vaporizer
o Increased room temperatures in non-precision vaporizers

31

What is one potential problem with the pop-off valve?

it is closed

32

What happens when the pop-off valve is closed?

o The bag will be tense and tight
o The patient will not exhale
o Decreased venous return decreasing heart rate, deceased cardiac output, rapid decrease blood pressure, and possible rapid death

33

What should the tech's reaction be if the reservoir bag is too full?

o Open pop off valve
o Decrease O2 flow
o Disconnect from machine if correction is taking too long

34

How does a tech change the O2 concentration in the reservoir bag?

dump the bag three times

35

What are three common patient types that require a special drug protocol?

o C-section
o Brachycephalic
o Geriatric

36

Define balanced anesthesia.

o Using more than one drug (using a preanesthetic) to decrease the amount of gas needed

37

What five patient factors need to be considered for geriatric patients?

o Aging (how quickly certain breeds age)
o Organ function
o Stress response decrease
o Increased hypothermia risk
o Increased risk of overhydration

38

What is one example of a dog breed that ages slowly?

Chihuahua

39

What is one example of a dog breed that ages quickly?

Great Dane

40

What consideration should be made for the heart when choosing an anesthetic agent?

decreased cardiac function calls for isoflurane (decreased heart effects)

41

What is the role of the liver in metabolizing anesthetic agents?

metabolizes injectable agents

42

What is the role of the lungs in metabolizing anesthetic agents?

removes anesthetic gas through blow off

43

What is the role of the kidneys in metabolizing anesthetic agents?

excretes (does not metabolize!) injectable agents

44

What is different about the kidney's metabolism and secretion mechanism in the cat?

kidneys completely remove the agents

45

Explain anesthetic redistribution.

o Anesthetic goes from the machine to the patient’s lungs where diffusion across capillary walls increases the concentration in the blood stream
o The anesthetic then travels to the highly vascularized tissues such as the brain
o Then the agents are pulled into the fats and muscle of the body which are poorly vascularized
o This decreases the concentration in the brain causing the animal to “wake up” even though there is still adequate anesthetic in the body
o The liver cannot metabolize the agents fast enough to eliminate the drugs completely before redosing

46

Why do older dogs have a higher hypothermia risk?

lost insulation (low body fat content)

47

Why do older dogs have a higher risk for overhydration?

impaired heart circulation and decreased kidney function

48

What anesthetic should be used for a patient with liver problems?

inhalation induction (mask, chamber, or cage)

49

What is the safest minimum age to begin anesthesia induction?

8 weeks

50

Why are pediatric patients at higher anesthetic risk?

o Decreased liver function pathway
o Increased hypothermia and overhydration risk
o Difficulty intubating
o Fasting avoidance
o Catheterization problems

51

What is the safest way to induce a pediatric patient?

isoflurane mask

52

Why are pediatric patients not fasted?

hypoglycemia, dehydration risk

53

When is hypoglycemia most likely to occur in a pediatric patients, and what patients are at greatest risk?

patients less then 6 months old (especially toy breeds) fasted longer then 8 hours

54

Besides hydration, what must be checked in pediatric patients before surgery?

blood sugar

55

What is the most common problem in pediatric patients?

hypoglycemia

56

What is the most common problem in brachycephalic dogs?

tendency for airway obstruction

57

What causes airway obstruction in brachycephalic dogs?

o Stenotic nares
o Elongated soft palate
o Everted laryngeal ventricles
o Small, short trachea

58

When should stenotic nares be examined?

at the patient's first exam

59

What may cause bradycardia in a brachycephalic dog?

increased vagal tone which causes increased vagal response inducing bradycardia

60

How is vagal tone decreased?

o Use anticholinergics for preanesthetics which prevent bradycardia and secretions
o Proxygenate before drugs
o Induce rapidly

61

Why should brachycephalic dogs be induced rapidly?

to avoid stage 2 (excitatory stage)

62

What special instructions are suggested for brachycephalic patients?

leave the ET tube in as long as possible - until they chew or pick up the head

63

What is the anesthetic drug of choice for sighthounds?

propofol

64

Why is propofol the drug of choice for sighthounds?

o Sight hounds lack body fat so drugs will have a larger effect on them
o Propofol is eliminated quickly through liver metabolism
o Because there is less fat and muscle to absorb the drug from the blood stream, rapidly metabolized drugs are a good thing for sight hounds (little to no redistribution)

65

What drug is not given to sighthounds?

barbiturates because there is no redistribution to decrease concentration of the agents in the brain and blood

66

How are obese patients dosed?

for ideal body weight, not current body weight

67

What are three anesthetic complications associated with obesity?

o Difficult for accurate dosing (guessing the dose by weight)
o Poor distribution of anesthetics
o Respiratory difficulty

68

Why is respiration compromised in obese patients?

fat takes up space where the lungs and diaphragm normally would expand

69

How should obese patients be treated before surgery?

o Preoxygenate
o Induce rapidly (injectable and inhaled)

70

How is respiration supplemented in obese patients?

o Assisted PPV when needed
o Delay extubation (maintain airway until completely recovered to breathe on own)

71

How should all patients be placed in the cage during recovery from anesthesia?

o Face towards the cage door
o Propped so that the nose is not obstructed by the cage wall or bedding

72

What four complications are c-section patients at increased risk for?

o Heart workload increases
o Compromised respiration
o Vomiting and regurgitation
o Hemorrhage

73

Why is workload to the heart increased in c-section patients?

there are puppies inside that require blood flow so the heart works overtime to compensate

74

Why is respiration compromised in c-section patients?

uterus takes up abdominal space restricting diaphragm space for contraction

75

Why is there an increased hemorrhage risk for c-section patients?

uterus is highly vascularized

76

What are five special considerations in the care of c-section patients?

o IV fluids
o Clip prior to induction with patient on the left side
o Preoxygenate
o Give lowest effective dose of drugs
o Avoid certain drugs

77

Why are c-section patients given IV fluids?

a lot of fluid is lost and blood pressure must be maintained

78

Why are c-section patients clipped while laying on their left side and prior to induction?

o if placed on their back the additional weight on the caudal vena cava would compromise blood flow to dam and puppies
o decreases the amount of anesthetic to the puppies

79

What five drugs are avoided in c-section patients?

o Pentobarbitol
o Ketamine
o Diazepam
o Ace
o Xylazine

80

How are c-section patients induced?

o Mask
o Propofol

81

What are three common breeds of c-section patient?

English bulldogs, pug, French bulldog

82

Why are c-sections common in these breeds?

puppies have large heads when compared to the birth canal

83

What problems may occur with c-section puppies?

agents can cross the placenta which reduces respiratory and CDVS function

84

What are five ways reduced respiratory and CDVS function can be prevented in c-section puppies?

o Use reversal agents
o Use doxopram
o Administer oxygen with face mask
o Administer atropine for bradycardia
o Keep warm

85

When should the puppies be allowed to nurse?

ASAP once the mother has recovered enough to put the puppies out of danger

86

What calls for the use of doxopram in c-section cases?

the use of narcotics

87

When does doxipram work?

only when there was an initial respiratory effect

88

What are two ways that the bladder may be emptied in the c-section patient?

o Normal outside urination
o Intraoperatively
o NOT MANUAL EXPRESSION

89

What three things should be done before trauma patients are induced if they are stable enough to have them done?

o Radiographs
o Examinations
o ECG

90

How is respiration examined in trauma patients?

o Auscultation
o Observation

91

What can be done if there is a complete oxygen exchange loss from blood or fluid filled lungs?

nothing

92

Fluid in the chest calls for what treatment?

thoracocentesis

93

When do cardiac arrhythmias occur in trauma patients?

within 3 days

94

What are two common signs that occur with trauma in many of the cases?

o Shock
o Hemorrhage

95

What are two other potential internal problems with trauma patients?

o Internal injury
o CNS problems

96

What three clinical signs indicate internal injury or CNS problems in trauma patients?

o Swelling
o Cerebral edema
o Glaucoma

97

How are patients with a diaphragmatic hernia positioned

patients will try to keep their front ends up

98

How are diaphragmatic hernia patients treated for surgery?

o Rapid intubation
o Rapid induction (IV)
o Respiration is supported right away

99

How are diaphragmatic hernia patients bagged?

o Lower than normal patient respiration because we are more efficient at breathing than the patient
o q5s

100

What are two symptoms of left heart failure?

o Lung edema
o Crackles

101

What considerations should be taken with a left heart failure anesthetic patient?

o Gas should be used because of increased margin of safety
o No fluids are given because of too much accumulation that has occurred
o For anesthesia give the lower end of the formula (2ml/lb/hr)

102

What are four potential CDVS problems?

o Compromised circulation
o Pulmonary edema
o Arrhythmias
o Tachycardia

103

What are four ways to prevent CDVS problems?

o Alleviate pulmonary edema
o Preoxygenate
o Avoid agents that depress CDVS function
o Avoid overhydration

104

Are heart murmurs always bad?

no because the dog has a normal sinus arrhythmia

105

What are three potential respiratory disease problems?

o Poor tissue oxygenation
o Anxiety leading to difficulty in restraint
o Respiratory arrest (COMMON)

106

What are two problems caused by anxiety in the patient with respiratory disease?

o They are not getting air so they panic
o Anxiety decreases the amount of air getting to the lungs

107

How are patients with existing respiratory disease treated?

o Reduce handling stress
o Preoxygenate
o Use injectables
o Avoid mask
o Rapid intubation
o Assisted PPV if needed
o Close monitoring in recovery

108

Why might hepatic disease be overlooked on a chem panel?

without secretions there are no indications of liver disease even though the liver is dead

109

What are five potential complications in a liver disease patient?

o Metabolism of injectables is delayed
o Clotting factors are decreased
o Hypoproteinemia
o Anemia
o Icterus

110

How can you tell if clotting factors are decreased?

o The patient will drip after being stuck or cut
o BMBT

111

How should decreased clotting factors be treated prior to surgery?

administer blood or plasma transfusion

112

Why might a patient with liver disease not wake up from anesthesia?

the drug cannot be metabolized so it is not broken down and stays in the bloodstream

113

Why is decreased protein a problem?

less binding of drugs so more free drug exerts its effect

114

Why are liver disease patients icteric?

cannot conjugate bilirubin properly

115

How are patients with existing liver disease treated for surgery?

o Preanesthetic blood work
o No injectables
o Prolonged recovery

116

How much isoflurane is metabolized?

3%

117

How much sevoflurane is "blown off"?

99%

118

What are three potential renal disease problems?

o Delayed inj excretion
o Electrolyte imbalances
o Dehydration

119

What are four common electrolyte imbalances seen in the renal patient?

o Hypokalemia
o Hyperkalemia
o Hyperphosphatemia
o Metabolic acidosis

120

Why are renal patients commonly dehydrated?

they are both polydipsic and polyuric, and eliminate more then they take in

121

How should the renal patient be treated for surgery?

o Rehydrate
o Renal function test
o Correct electrolyte imbalances
o Avoid injectables

122

Urinary tract obstruction occurs most commonly in what species?

male cats

123

Cats can have problems with just _____.

crystals

124

In how much time can a urinary tract obstruction be fatal in the cat?

3 days of obstruction in lateral recumbency

125

What five problems may occur with urinary tract obstruction?

o Azotemia
o Acidosis
o Dehydration
o Hyperkalemia
o Bradycardia

126

What two drugs should be avoided in cases of renal disease?

o IM ketamine
o Barbiturates

127

What gas is used in cases of renal disease?

sevoflurane

128

What deficiency is important to correct when present?

hyperkalemia

129

Why might a catheter get hung in the urethra?

a stone present may block catheter advancement

130

Why might a catheter be passed?

to relieve an obstruction ASAP

131

What should be done after the obstruction is relieved?

fluid therapy

132

What happens after a prolonged obstruction?

ruptured bladder

133

What type of epi can be used in a crash cart?

epi that can be safely stored at room temprature

134

If there is an emergency protocol or if there is a life threatening emergency what can the tech do in most states?

Act to save the animal in the vet’s absence

135

What are eight common complications during surgery?

o Animal will not stay under
o Animal is too deep
o Pallor
o Hypotension
o Dyspnea and cyanosis
o Tachypnea
o Respiratory arrest
o Cardiac arrest

136

What eleven things should be checked if the animal will not stay under?

o Vaporizer setting
o Oxygen setting
o Anesthetic in vaporizer
o ET tube placement
o Cuff inflation/deflation
o Breath holding in the patient
o Respiration depth
o Machine function and assembly
o Oxygen flow rate adequacy
o Agonal breathing in the patient
o Patient assessment

137

What two types of patient require PPV every five minutes if they are deficient?

o Toy breeds
o Obese patients

138

What are ten signs that an animal is too deep?

o Respiration is 2 seconds
o Bradycardia (

139

How can CRT be normal in a dead patient?

the capillaries will pool with blood

140

What is the first thing you check in a patient that is too deep?

vital signs other then mucous membranes

141

What drug USED TO be given to stabilize mucous membranes?

corticosteroids

142

What is the appropriate response to a big decrease in heart rate?

atropine

143

What are four reasons a patient might be too deep?

o High vaporizer setting
o High inj dose
o Inj given IV rather then IM
o Preexisting problem

144

What are seven ways increased anesthetic depth is treated by the technician?

o Turn vaporizer to 0 if needed
o Inform vet
o Bag with pure O2 q5s
o IV fluids
o External heat
o Drugs as ordered by vet
o Decrease and watch for arousal

145

What are six causes of pallor?

o Pre-existing anemia
o Surgical blood loss
o Vasodilation
o Hypotension
o Hypothermia
o Pain

146

What are three ways pallor is treated by the technician?

o Ascertain anesthetic depth
o Monitor vitals
o Consult vet

147

What four things might the vet order for pallor treatment?

o IV fluid therapy
o Blood transfusion
o Corticosteroids (IV)
o Pain management

148

What are five possible causes of hypotension?

o Preexisting conditions like trauma
o Surgical blood loss
o Deep anesthesia
o Drugs
o Circulatory shock

149

What two common drugs can cause hypotension?

o Ace
o Xylazine

150

What are ten ways that hypotension may be treated by the technician?

o Check CRT
o Check pulse quality
o HR
o Hypothermia
o BP
o Rapid IV fluids with shock
o Reduce anesthetic depth
o Give 100% oxygen
o Supplement heat
o Drugs as ordered by vet

151

What blood pressure readings indicate hypotension?

o Systolic:

152

What fluid administration rates are used for rapid shock fluid treatment in the dog?

20 ml/kg/1st 15 min to max of 90 ml/kg/1st hour

153

What fluid administration rates are used for rapid shock fluid treatment in the cat?

10 ml/kg/1st 15 min to max of 45-65 ml/kg/1st hour

154

What are three types of fluids that may be given IV?

o Colloids
o Blood transfusions
o Crystalloids

155

What are four potential sources of supplemental heat?

o Warm towels
o Heating pads
o Rice socks
o Hot water bottles

156

What five things do a cyanotic patient indicate?

o Not enough oxygen
o Not enough CO2 elimination
o Hypoxia
o Pulse oximetry

157

What are six potential causes of respiratory distress?

o Lack of oxygen supply
o Too full reservoir bag
o Respiratory disease
o Airway obstruction
o Heavy drapes or constricting bandage
o Too deep

158

What are five ways that dyspnea may be treated by the technician?

o Check oxygen delivery
o Turn off vaporizer and bag q5s
o IV fluids
o Emergency drugs
o Observation for cardiac arrest

159

What three things need to happen when bagging the patient?

o Observe for chest rise and fall with bagging
o Bag until MM color improves and pulse ox reaches 90-95%
o Tracheotomy with complete obstruction

160

What is done in the event of cardiac arrest?

CPR with chest compressions

161

What drug class commonly induces tachypnea?

opioids

162

Why might a patient in the surgery room have a spike in heart rate?

stimulation with too light anesthesia

163

What are two ways that deep anesthesia causes tachypnea?

o Low oxygen
o High carbon dioxide

164

When is it OK to see the heart rate spike?

when the ovarian pedicle is clamped

165

What temperature change can increase heart rate?

hyperthermia

166

When is increased temperature OK to induce increased heart rate?

small animals

167

What are three ways tachypneal may be treated by the technician?

o Assess anesthetic depth
o Check CO2 absorber and capnography for hypercapnia
o Vitals ok: wait 1-2 minutes to see if the patient can self-correct

168

What does tachypnea due to pain indicate?

analgesia should be administered

169

What does tachypnea due to obesity indicate?

assisted PPV

170

How is anesthetic depth assessed?

Reflexes such as palpebral reflex present

171

What are five signs of hypercapnia?

o Tachycardia
o Hyperventilation
o Sweating
o Hypertension
o Brick red MM

172

When may respiration stop during surgery?

o After induction
o After prolonged bagging

173

What is the first thing that should be done if respiration stops?

o Check other vitals (HR, MM, pulse strength)
o Check pulse ox (> 95% is good)
o Deliver occasional breaths q30s for 1-2 minutes while observing for respiration return

174

What are three potential causes of respiratory arrest?

o Anesthetic overdose
o Cesation of O2 flow
o Pre-existing respiratory disease

175

What also may occur with respiratory arrest?

abnormal vitals

176

What seven steps should the technician take to treat respiratory arrest?

o Inform vet
o Turn off vaporizer
o Intubate and connect to 100% O2
o Check HR with ECG is possible
o Check O2 flow and airway
o Bag q5s until stable
o IV fluids and drugs as ordered by vet

177

What are four alternative methods of getting oxygen to the patient besides the 100% O2 method?

o Ambu-Bag (positive pressure pushed into patient)
o Mouth to ET tube
o Mouth to muzzle (close nose and breathe into mouth)
o Tube tracheostomy

178

What drug may be given to stimulate respiration?

doxopram

179

Define cardiac arrest.

sudden cessation of effective circulation and ventilation

180

What are eight signs of cardiac arrest?

o Loss of consciousness in 10-15 seconds
o No heart beat
o No palpable pulse
o BP

181

What does asystole look like on an ECG?

flat line

182

What does ventricular fibrillation look like on an ECG?

wavy pattern

183

What does electromechanical dissociation look like on an ECG?

Normal QRS complexes without a heart beat

uncommonly, normal ECG without heartbeat

184

What are the ABCDEF steps to cardiac arrest response?

o Airway
o Breathing
o Circulation
o Drugs
o ECG
o Fluids

185

What is the CPR protocol?

o 15 compressions
o 2 breaths
o OR as many compressions in a minute without the breaths

186

How long do you have before the brain is damaged permanently from oxygen deprivation?

4 minutes

187

What are the four team member jobs in CPR?

o Compressions
o Bagging
o Response, pulse, and ECG assessor
o Drugs as ordered and record keeper

188

Which job may be neglected if needed?

record keeper (should try to do it as soon as the drugs are administered)

189

What is noted on the record first in cases of cardiac arrest?

time of arrest

190

What method can be used to establish an airway?

intubation

191

How should respiration be supplemented in CPR?

bag with 100% O2 q5s

192

What should happen when the patient is bagged?

chest rises with inhalation and falls with exhalation

193

What recumbency is the patient placed in for CPR?

right lateral

194

How is the chest compressed for CPR?

1/3 chest diameter of chest wall 1-2 times per second

195

How are wide chested dogs placed for CPR?

on their backs

196

What are two examples of wide chested breeds?

o English bull dog
o French bulldog

197

What are the two things that are done by CPR to induce circulation?

(these are debated as to which actually occurs)

o Force blood through the heart
o Inducing blood flow with pressure changes

198

What do compressions cause during CPR?

o Each compression should cause a palpable femoral pulse
o MM color should improve

199

How can breaths be administered during CPR?

o Simultaneously with compressions
o 10-15 compressions at every 2 breaths

200

What is one alternative to external cardiac compressions?

internal cardiac compressions (sterile hand directly grasping the heart)

201

When might internal compressions be performed?

o After 2 minutes of ineffective external compressions
o Immediately with chest trauma, pericardial effusion, or hypovolemia

202

How are internal compressions performed?

o Quick shave
o Alcohol rinse
o Sticky drape
o Skin incision between 7-8 rib
o Gloved hands grasp heart
o 80 compressions per min
o Lavage
o Close chest
o Observe

203

How are fluids administered during cardiac arrest?

o Rapidly through IV catheter prn to expand blood volume

204

What nine drugs may given during cardiac arrest?

o Epinephrine
o Corticosteroids
o Dopamine
o Dobutamine
o Doxopram
o Atropine
o Lidocaine
o Sodium bicarbonate
o Anesthetic reversal agent

205

Why is sodium bicarb contraindicated?

an accidental alkalosis will occur if too much sodium bicarb is administered

206

What is the drug of choice to treat cessation of the heart?

epinephrine

207

What two alternate routes exist for drug administration during cardiac arrest?

o Intratracheal through the ET tube with a double dose
o Injected into base of tongue

208

How is the patient cared for post cardiac arrest?

o Monitored
o Support vital function
o Oxygenation
o Heat supplement

209

What are four common complications of cardiac arrest recovery?

o Repeated arrest
o Disseminated intravascular coagulation (DIC)
o Acute renal failure secondary to epinephrine shutting down the blood flow
o Cerebral edema

210

What is DIC (disseminated intravascular coagulation)?

o Commonly called death is coming or dead in cage
o Comes secondary to cancer or end stage heart worm disease
o Causes coagulation in the vessels and uses up clotting factors which causes the patient to bleed everywhere else
o Will look bruised even though coagulant is there

211

What happens with cerebral edema?

o Brain swells
o Possibly cause blindness

212

What are six potential anesthetic recovery problems?

o Regurgitation and vomiting
o Anesthesia in unfasted patient
o Post anesthesia seizures and excitement
o Dyspnea in cats
o Dyspnea in dogs
o Prolonged recovery

213

What are the complications of regurgitation and vomiting while under anesthesia?

o Risk of esophagitis
o Aspiration pneumonia

214

How is vomiting responded to in an unconscious patient lacking an ET tube?

o Head lower than the body
o Clean oral cavity
o Assist respiration as needed

215

How is vomiting responded to in an unconscious patient with an ET tube?

o Ensure cuff inflated
o Head lower than body

216

How is vomiting responded to in a conscious patient?

assist as required

217

How is an unfasted patient treated?

o Rapid induction and intubation
o Avoid head down positioning
o Suction made available
o Antiemetics adm but up to vet

218

What does excitement look like?

o Paddling
o Vocalization
o Agitation
o Confusion

219

How is excitement treated?

o Reassure and calm
o Occasional anesthetic and analgesic administration
o Cover the cage of cats that are crazy and give Valium to calm

220

What do seizures look like?

o Twitching
o Uncontrolled violent movements

221

What three drugs are given for seizures?

o Diazepam
o Phenobarbital
o Pentobarbital

222

What are two causes of dyspnea in cats?

o Laryngospasm from intubation or extubation
o Laryngeal edema

223

What does dyspnea sound like?

o Stridor
o Wheezes
o Cyanotic
o Losing consciousness

224

What must be done if the patient is turning blue or losing consciousness?

intubate

225

If you are unable to intubate, what must be done?

tracheotomy

226

What six things might cause dyspnea in the dog?

o Foreign objects
o Fluid
o Mucus
o Laryngeal edema
o Post operative tissue swelling
o Tracheal collapse

227

What does dyspnea look and sound like in a dog?

o Stridor
o Cyanosis after tube removal

228

How is dyspnea in the dog treated?

assist in airway clearance and oxygenate as needed

229

What seven things does prolonged recovery require?

o Vet’s examination
o Constant observation or frequent monitoring
o IV fluids
o Good nursing care
o Turn frequently
o Warm patient
o Use reversal agent