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Anesthesia > exam 4 > Flashcards

exam 4 Flashcards

1
Q

tech job during anesthesia, 2

A

make sure vitals are at acceptable limits, maintain adequate anesthetic depth

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2
Q

lowest acceptable HR under anesthesia

A

lrg= 60, sm=70, cats= 100bpm

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3
Q

pulse strength disappears when systolic pressure is less than

A

60mmHg

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4
Q

mucous membranes become pale during anesthesia because (2)

A

peripheral vasoconstriction, decreased tissue perfusion

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5
Q

examples of peripheral vasoconstriction (3)

A

hypothermia, pain, alpha-2-agonist

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6
Q

causes of decreased tissue perfusion (6)

A

too deep, bradycardia, arrhythmia, cardia arrest, decreased BP, hemorrhage

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7
Q

what things do you watch for regarding respirations during anesthesia (4)

A

res bag, rate, depth, effort

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8
Q

tidal volume decreases by _% during anesthesia

A

25%

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9
Q

ventilation pt does 2 things

A

blow off CO2, prevent atelectesis

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10
Q

what is considered hypoventilation

A

breaths below 8bpm

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11
Q

other causes of hypoventilation (3)

A

too deep, obesity/heavy animal, positional

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12
Q

p wave is

A

atrial depolarization

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13
Q

QRS is

A

ventricular depolarization

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14
Q

T is

A

ventricular repolarization

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15
Q

3 things to look at when looking t rhythem

A

p followed by QRS, distance between everything, waves normal in size and shape

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16
Q

EKG gets heart rate by counting

A

highest peak

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17
Q

sinus arrhythmias are not normal in __, normal in __ rare in _

A

cat, dog, horse

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18
Q

causes of tachycardia (9)

A

too light, pain, drugs, hypoxia, hypotension, anemia, hyperthyroidism, hemorrhage, cardiac dz

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19
Q

if tachycardia is caused by PT being too light, the intervention is (3)

A

turn up vap, more induction drug, more opiod

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20
Q

drugs that can causes tachycardia (3)

A

atropine, ketamine/telazol, epinephrine

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21
Q

if tachycardia is caused by hypoxia (2)

A

increase o2 flow, vent pt

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22
Q

if tachycardia is caused by hypotension, do what(3)

A

turn down vap, fluids, drugs

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23
Q

if tachycardia is caused by anemia/hemorrhage do (2)

A

blood transfusion, give fluids

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24
Q

if tachycardia is caused by hyperthyroidism, give

A

tapazole, methimazole

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25
Q

causes of Bradycardia (5)

A

too deep, drugs, hypothermia, hyperkalemia, addisions dz

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26
Q

drugs that cause Bradycardia (2)

A

alpha-2, high doses of opiods

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27
Q

if bradycardia is caused by hyperkalemia do waht

A

give fluids

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28
Q

tx for bradycardia

A

atropine

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29
Q

sinus bradycardia rates

A

lrg dog <100

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30
Q

what is a 1st* heart block

A

interval between p and qrs

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31
Q

what could happen to a 1st * heart block under anesthesia

A

can turn into 2nd *

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32
Q

what is a 2nd* heartblock

A

some p waves not followed by QRS

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33
Q

2nd* heart block is aka

A

incomplete heart block

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34
Q

what heart rate happens with 2nd* heart block

A

slow HR

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35
Q

2nd * heart block, when auscultating hear

A

p as a missed beat

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36
Q

causes of 2nd* heart block (6)

A

too deep, alpha-2, electroimbalance, acid/base imbalance, myocardial hypoxia, underlying cardiac DZ

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37
Q

if 2nd* heart block is caused by electro/ acid-base imbalance, do what?

A

give fluids

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38
Q

if 2nd* heart block is caused by myocardial hypoxia, do what?

A

ventilate

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39
Q

general rule with arrhythmias, do what? (2)

A

turn down vap, ventilate pt

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40
Q

drug of choice for 2nd* heart block

A

atropine

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41
Q

what is a 3rd* heart block?

A

QRS prolonged, P unrelated

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42
Q

severe 2nd* can turn into what?

A

3rd* heart block

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43
Q

common cause of pulse deficit?

A

VPC

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44
Q

causes of VPC (10)

A

too deep, drugs, electrolyte/acid-base imbalance, myocardial hypoxica, cardiac dz, GDV, splenic masses, cardiac bruising, breed, stress/pain

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45
Q

tx for vpc

A

lidocaine bolus or drip

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46
Q

Ventricular tachycardia is considered when

A

3 or more VPC in a row

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47
Q

what kind of heart rate with Vtach?

A

high heart rate

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48
Q

heart rate of v fib

A

300-600

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49
Q

cardiac output with v.fib

A

little to none

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50
Q

hyperkalemia looks like what on a EKG

A

tall spiked T waves, low heart rate

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51
Q

tall and wide waves also mean

A

myocardial hypoxia

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52
Q

reasons for hyperventilation (4)

A

too light, surgical stimulation, metabolic acidosis, breathing problem

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53
Q

3 reasons for hypoventilation

A

increase vaporizer, more induction drug, increased opiods

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54
Q

tx for hypoventilation

A

ventilate pt

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55
Q

when an animal is hypothermic they require __ aneshetic gas

A

less

56
Q

a hypothermic animal and overdosing

A

can easily overdose on anesthetic cases

57
Q

for ever 2 degrees F that the body drop, what happens to mac value

A

decreases by 5%

58
Q

shivering increase O2 demands by

A

60%

59
Q

anesthesia causes __metabolic rate thus__

A

decreased, less heat generated

60
Q

reasons for hypothermia (4)

A

reduced metabolic rate, vasodilation, shaved fur, open body cavity

61
Q

if take temp in nose, what do you add?

A

1 degree

62
Q

most important monitor

A

blood pressure

63
Q

Blood pressure determined by 3 things

A

cardiac output, vascular resistance, blood volume

64
Q

cardiac output equals

A

stoke volumed X HR

65
Q

normal systolic BP

A

100-160mmHg

66
Q

normal diastolic BP

A

60-100mmHg

67
Q

best indicator of tissue perfusion

A

mean arterial pressure

68
Q

normal mean arterial pressure

A

80-120mmhg

69
Q

considered hypotensive when less than what for systolic, mean, diastolic

A

s=80, m=60, d=40

70
Q

inadequate perfusion most damaging to which organs (3)

A

kidney, heart, brain

71
Q

3 causes of hypotension

A

excessive anesthetic depth, drugs, blood loss

72
Q

anesthetic drugs do 3 things to cause hypotension

A

vasodilation, bradycardia, decrease cardiac output

73
Q

drugs that cause vasodilation (3)

A

ace, inhalant anesthetics, alpha-2-agonists

74
Q

interventions for hypovolemia (3)

A

turn down gap, bolus of fluids or change type, drugs

75
Q

for hypovolemia can administer

A

crystalloids or colliods

76
Q

for hypovolemia give surgical fluid rates as a

A

bolus, all at once

77
Q

for hypovolemia can give double surgical rates (20mls/kg) for how long. how many times

A

15 mins, twice

78
Q

drugs that can be used for hypovolemia

A

inotrope, chronotrope, vasopressor

79
Q

common drug (generic names) to treat hypotension (3)

A

dopamine, dobutamine, ephedrine

80
Q

dopamine does what (3)

A

+ ino, +chrono, increase renal profusion and urine output

81
Q

how is dopamine administered

A

ug/kg/min given CRI

82
Q

dobutamine does what (2)

A

+ino, lower chrono

83
Q

how is dobutamine administered

A

ug/kh/ml cri

84
Q

dobutamine drip is common in

A

equine anesthesia

85
Q

ephedrine does what (3)

A

+ vasopressor, lower ino, lower chrono

86
Q

how is ephedrine administered?

A

IV

87
Q

how long does ephedrine last

A

20 minutes

88
Q

2 ways to measure BP

A

direct and indirect

89
Q

2 ways to measure BP indirect

A

doppler, oscillometer

90
Q

doppler monitors consist of

A

amplifier (machine), probe (crystal), cuff (manometer and bulb)

91
Q

doppler cuff can be placed

A

limbs or tail

92
Q

width of cuff should be

A

40% around circumference of limb or tail

93
Q

probe, which side do you put gel on

A

concave side

94
Q

where is doppler probe placed?

A

over shaved artery

95
Q

what arteries could doppler be placed on

A

metacarpal artery, metatarsal artery, coccygeal artery

96
Q

woosh sound of doppler correlates with what?

A

blood rushing through the artery

97
Q

doppler uses what kind of technology

A

ultrasound technology

98
Q

doppler measures what

A

systolic BP and pulse

99
Q

systolic is when you hear

A

the first woosh

100
Q

doppler works best on

A

long straight legged hairless dogs

101
Q

doppler on awake pt do..

A

3x then take an average

102
Q

doppler is not very accurate in

A

cats

103
Q

in cats doppler reading may be closer to __ add__

A

MAP, add 14mmHg

104
Q

for cats keep doppler above

A

80mmgh

105
Q

probes are __ and should be kept __ when not in use

A

fragile, blank

106
Q

what is a oscillometer

A

has cuff that inflates and deflates, senses oscillations of pulse

107
Q

oscillometer can display

A

all there values map, s, d

108
Q

which indirect method of finding BP is more expensive

A

oscillometer

109
Q

oscillometer works better for

A

cats, but need to change setting

110
Q

direct way to get BP

A

direct arterial pressure

111
Q

direct arterial blood pressure is most common in

A

equine anesthesia

112
Q

direct arterial pressure, catheter is placed in 3 possible spots

A

dorsal metatarsal, femoral, facial artery

113
Q

for direct arterial pressure, what is the catheter connected to?

A

to manometer or transducer by fluid filled tubing

114
Q

capnograph measures 3 things

A

ETCO2, InCO2, RR

115
Q

capnograph gives an estimation of CO2 dissolved in the

A

plasma

116
Q

most common capongraph is __ and attached __

A

side stream capnography, between ET tube and anesthetic breathing system

117
Q

inspirationCO2 should be _ unless __

A

0, CO2 absorbing granules are exhausted or flow rate not high enough on non rebreather

118
Q

want ETCO2 to be what during anesthesia

A

35-45mmhg

119
Q

decrease ET CO2 indicates what

A

decreased amounts of CO2 dissolved in the blood (hypocapnia)

120
Q

decreased ET CO2 can be caused by (3)

A

increase RR, ET tube in esophagus, resp arrest

121
Q

pulse oximetry measures

A

SpO2, % hgb saturated with oxygen, and pulse

122
Q

PaO2 is___ and determines ___

A

dissolved oxygen in the blood, SPO2

123
Q

pulse ox measures ___ signals across _ using light

A

pulsatile, perfused tissue

124
Q

wavelength of light used for pulse ox is (2)

A

red and infrared

125
Q

reduced Hg absorbs

A

red light

126
Q

oxyHb absorbs

A

infrared light

127
Q

pulse ox only measures

A

arterial blood

128
Q

plethysmograph is

A

wave form, tells pulse strength

129
Q

on plethysmograph, what does the dicrotic notch tell you

A

when aortic valve closes

130
Q

pulse ox probe should be placed where

A

thin hairless non-pigmented area

131
Q

room air pulse ox

A

95-97%

132
Q

anesthesia pulse ox

A

98-100%

133
Q

pulse ox borderline, hypoxia, cyanosis

A

90-95%, 90%, 85%

134
Q

reasons for decrease pulse ox with the probe (2)

A

dry tongue, pinches tongue

135
Q

reasons for decrease pulse ox, perfusion (2)

A

hypotension, peripheral vasoconsriction

Anesthesia (4 decks)

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