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Vet Nursing I - Lecture > Final > Flashcards

Flashcards in Final Deck (58):
1

Control hemostasis

Can be straight or curved

Has horizontal serrations extends only 1/2 the length of jaw

 

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Kelly Forcep aka Kelly Hemostatic Forceps

2

Control hemostasis

Serrations on entire Jaw

 

 

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Crile Hemostatic Forcep

3

Clamp large vessels or large tissue masses

approx. 8" long

Jaw is 31/2" long

Long vertical serrations with checkered serrations at the tip

 

 

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Rochester-Carmalt

4

Grasping skin such as Linea alba

Removing tissues from patient such as tumor & skin

 

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Allis Tissue Forceps

5

Used on any vessels that is no long viable to the body such as Uterine stump

Not a true hemostat

 

 

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Ferguson Angiotribe

6


Used to aid the placement of bandages or wound dressings

No teeth

Flat

 

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Adson Dressing Forcep

7

Used in general surgery

In most surgical packs

Has 9 little teeths on tip

 

 

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Adson Brown Thumb Tissue Forcep

8

Has "rat-teeth" on the tip

 

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Adson Brown with Teeth

9

#10 - Most Common

#11 - used for stab incision

#12 - Used for declaw

#15 - Same as #10 but smaller

Larger blades are for large animals

 

 

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Surgical Blades

10

units of measurement are used for photographic documentation

 

 

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Bard Parker Handle

11

Aids in making incisions in the linea alba

Provides a channel for the scalpel to follow to avoid accidental incision of the abdominal viscera

 

 

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Groove Director

12

Used to secure drape on the patient

Penetrating

31/2 or 51/2 inch size

 

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Backhaus Towel Clamp

13

Used to secure drape on the patient

Has balls on tips to prevent excessive penetration into tissue

 

 

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Backhaus Roeder Towelclamp

14

Used to secure drape on the patient

Ideal for small or exotic patients

Smaller and lightweight than Backhaus style towel clamps

 

 

 

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Jones Towel Clamp

15

Locate and exteriorize uterine horns in an ovariohysterectomy

 

 

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Spay Hook

aka

Snook Hook

16


Common needle holder

Comes in different lengths

 

 

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Mayo Hegar

17


Needle holder with built in scissor at the jaw for cutting suture

Comes in different sizes

 

 

 

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Olsen Hegar

18

Retract or deflect tissues away from surgical field

Handheld, double ended

One end is narrow with blunt blade

Other end is toothed, traumatic end

(Teeth may be sharp or blunt)

 

 

 

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Senn Retractor

19

Retract or deflect tissues away from surgical field

Self retraining

Fairly traumatic for soft tissue surgeries

More often in orthopedic and neurological procedures

 

 

 

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Gelpi Rectractor

20


Retract or deflect tissues away from surgical field

Self retaining with teeth (blunt or sharp)

Used generally in orthopedic procedures and also soft tissue surgery

 

 

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Weitlander Rectractor

21

For delicate dissection

Thin, delicate blades

Straight or curved

 

 

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Metzenbaum Dissecting Scissor

22

Used when cutting through large muscles masses, cartilages and other non-delicate tissues

Thick blades

Can be straight or curved

 

 

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Mayo Dressing Scissors

23

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Littauer Suture scissors

24


 

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 Knoles bandage scissor

25

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rochester ochsner

26

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Doyan Intestinal forcep

 

Prevents spillage of bowel

27

28


O2 Flowmeter

Flow rate

 

100ml/kg/min

find (L)

note:  0.5L is minimum

29

resevoir bag


60ml/kg

find in (L)

30

Induction vs maintanence


induction:  50-100ml/kg/min

3-5%

 

Maintanence:  25ml-50ml/kg/min

1.5-2.5%

 

31

O2 tank


psi x 0.3 = L

 

L x min/L/60

32

Wrap Packing


Sterilizing instrument packs are: Cotton, Linen, paper or plastic

Be able to withstand heat, moisture and steam

33

Instruments


Soak in warm water and detergent

Place in ultrasonic cleaner: 12-15 mins

Rinse thoroughly

Blot dry

 

 

34

SURGICAL PACKS


2 HALSTED-MOSQUITO HEMOSTATS, CURVED 5-INCH
2 KELLY or CRILE HEMOSTATS, CURVED 5½-INCH
2 ROCHESTER-CARMALT or 2 KELLY or CRILE HEMOSTATS, STRAIGHT 5½-INCH
1 MAYO-HEGAR NEEDLE HOLDERS, 7-INCH
1 ADSON-BROWN TISSUE FORCEPS
1 THUMB DRESSING/TISSUE FORCEPS
2 ALLIS TISSUE FORCEPS, 6-INCH
4 BACKHAUS or JONES TOWEL CLAMPS, 5½-INCH
1 OPERATING SCISSORS, SHARP-BLUNT CURVED 5-INCH
1 MAYO SURGICAL SCISSORS
1 NO. 3 BLADE HANDLE
1 OVARIOHYSTERECTOMY “SPAY” HOOK
INSTRUMENT TRAY
SALINE BOWL
10 GAUZE SPONGES

35


Gown Pack

 

Make 2


1 Gown

Towel

Indicator strip

36

Drape pack


4 drapes (accordian folder, dog ear)

indicator stripe

37

Instrument pack


Instrument tray

 

Saline bowl

 

10 gauze sq

 

4 towel clamp place on 2 pc of gauze in saline bowl

 

indicator stripe

 

38


Autoclave


121C

15psi

for 10-12 mins, 20 mins recommended

 

Check distilled water level.  Must be halfway b/t min and max

 

39

Circulating nurse vs surgical nurse


circulating:  dirty

 

surgical: must be scrubbed

40


Clipping


Female

Xiphoid process down to pubic bone

1-1.5" off the sides

Midway to the stifles

 

Male

Do not shave pupice or scrotum

shave midway of abdomen down to the stifles

 

 

41


Scrubbing patient

up down circle flip


Scrub (degreaser)

Alcohol

Scrub

Alcohol

Scrub

Alcohol

 

Take to surgical room

Scrub

Alcohol

Paint with betadine

42


Anesthetic machine color


Green - O2

Blue - Desoflurane

Purple - Isoflurane

Yellow - Sevoflurane

43

Rebreathing system

 

 

 

 

A)  Oxygen source with pressure gauge - Oxygen is supplied to the animal. It also is the carrier gas that brings the inhaled anesthetic to the pet.

B)  Pressure reducing valve - This valve decreases the high pressure from the oxygen tank to a usable level.

C)    Flowmeter - This allows the anesthetist to determine the rate the oxygen will flow to the animal.

D)  Oxygen flush valve - This valve allows oxygen to flow directly to the animal bypassing the anesthesia. It is used to quickly increase the amount of oxygen and decrease the anesthesia in the system. This is done at the end of the anesthesia or if the animal is at too deep of a plane of anesthesia during the surgery.

E)   Vaporizer - The vaporizer converts the liquid anesthetic to a gas state and adds controlled amounts of the gas anesthetic to the oxygen that is flowing through the machine.

 F)  Inhalation valve - This allows the gases to flow only to the animal and not back to the vaporizer, by way of a one-way valve.

G) Inhalation hose - This hose carries the gases to the animal.

H)  Connecting port - The rebreathing system has a Y piece which connects the inhalation hose, endotracheal tube, and exhalation hose.

 I)   Endotracheal tube - This tube is placed into the animal's trachea (windpipe) to allow the oxygen and gases to be breathed into the lungs.

J)    Exhalation hose - This hose carries the gases the animal breathed out back to the anesthetic machine.

K)  Exhalation valve - This allows the exhaled gases to flow only into the anesthetic machine, not back to the animal, by way of a one-way valve.

L)    Rebreathing (reservoir) bag - This is an inflatable rubber bag which allows the accumulation of fresh and expired gas during exhalation so that a reservoir of gas is available for the next breath. The bag also acts as a safety device to prevent rapid pressure increases in the system. It can be manually squeezed to 'bag' an animal as needed during surgery to assist breathing.

M)  Pop-off valve - This is a pressure relief valve that allows the release of waste gases and extra pressure from the system into the scavenger hose.

N)   Scavenger hose - This hose carries waste gases (e.g., oxygen, nitrous oxide, inhalation anesthetic, and carbon dioxide) out of the system and out of the building.

O)   CO2 absorber canister - Any gases that do exit through the pop-off valve pass through the carbon dioxide absorber before returning to the animal. The chemicals in the container remove carbon dioxide from the gases that pass through it.
 

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44


Non Rebreathing system

 

The first three parts are the same as with the rebreathing system.

   A) Oxygen source with pressure gauge

  B)  Pressure reducing valve

  C)  Flowmeter

It is at this point that the system changes. The nonrebreathing system does not have each of the parts of a rebreathing system. It does have:

  E)  Vaporizer - The vaporizer converts the liquid anesthetic to a gas state and adds controlled amounts of the gas anesthetic to the oxygen that is flowing through the machine.

   G)  Inhalation hose - The gases exit the vaporizer and go directly into a hose for delivery to the animal.

    H) Connecting port - This connects the inhalation and exhalation hoses to the endotracheal tube.

    I)  Endotracheal tube - This tube is placed into the animal's trachea to allow the oxygen and gases to be breathed into the lungs.

 J)   Exhalation hose - Exhaled gases pass through this tube directly to the reservoir bag.

  L)  Rebreathing (reservoir) bag - Exhaled gases pass into the reservoir bag.

 M)   Pop-off valve - This is a pressure relief valve that allows the release of waste gases and extra pressure from the system into the scavenger hose.

N)    Scavenger hose - Exhaled gases pass from the reservoir bag and out of the system (and building) through the scavenger hose.

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45


pH


Normal Blood:  7.40 = 40 namoMols/liter (H+)

 

measures:  moles / L

 

 

46


Henderson Hasselbalch Equation


pH = pK + log ([HCO3] / [CO2])

 

Interaction b/t CO2 and bicarbonate

47


pCO2

 PaO2

SaO2

Partial Pressure of CO2

 

Arterial blood:  35-45mmHg

Mixed venous PCO2:  42-52mmHG

 

Partial Pressure Oxygen

Arterial Blood:  70-100mmHg

Mixed Venous:  35-40mmHg

Normal Value:  5x% inspired air

Room air:  100mmHg

100% oxygen - 500mmHg

Hypoxemia <60mmHg

 

Oxygen Saturation

Arterial:  >95%

Mixed Venous:  65-75%

Hypoxemia:  <90% saturation

 

 

 

48


Acidosis vs Alkalosis


Acidosis

 

Respiratory Acidosis - Build up of CO2 & High PCO2

Metabolic Acidosis - increase in metabolic acid & loss of bicarbonate

 

Alkalosis

Respiratory Alkalosis - Elimination in CO2 & low PCO2

Metabolic Alkalosis - Loss of acid

 

 

49


Anion Gap

Major anions - major cations

i.e.  (Na+ + K+) - (CL- - HCO3-)

 

High anion gap = loss in bicarbonate and replaced by unmeasured anions (lactic acidosis, ketoacidosis, uremia, toxins)

 

Dogs: 10-18

Cats:  12-19

ECF (extracellular fluid):  20% of body

Treatable Vol.: 30%

50


Awkward Inverse

Hydrogen

pH

Metabolic Acidosis

Hydrogen: When H ion loses an electron to become H+

 

pH: Decrease in pH = increase in acidity

 

Metabolic Acidosis:  Negative base excess.  Decrease in BE = increase acidemia

51


Acid regulation/elimination


Metabolic acids

  • lactic
  • pyruvic
  • keto-acids of diabetic acidosis

main regulators of acid:  lungs & kidneys

 

52


Compensation


Lungs compensate faster

 

Kidneys compensate slower

53

Temperature

Blood/Gas analyzed at 37C

 

CO2 soluble at lower temp

 

Reduces pCO2 about 4.5% per C

 

54

Respiration vs Ventilation


Respiration: Process where O2 is supplied to the tissues and CO2 is eliminated from the tissues

 

Ventilation: Movement of gas in and out of the aveoli

55


Suture Needles

Swaged Needles

  • Less traumatic
  • expensive
  • sterile

Needle point

Taper:

  • Atraumatic
  • Internal organs

Cutting edge:

  • Traumatic
  • Skin

Reverse Cutting:

  • Less traumatic
  • Skin

56


Suture Materials

Monofilament vs Multifilament

Natural vs Synthetic

Monofilament

  • No wicking
  • Poor knot security
  • No tissue reaction
  • has memory
  • Less tissue drag

Multifilament

  • wicks/bacteria
  • good knot securty
  • Has tissue reaction
  • more tissue drag
  • easy handling

Natural - breaks down by phagocytosis

  • Absorbable
  • Gut - 3-5 days
  • Chromic gut - last longer (10-15 days)
  • silk - for opthalmic only
  • collagen- for opthalmic only

Synthetic

  • Vicryl - absorbable, inhibit bacteria, enzyme breaks down
  • Dexon - good knot security
  • PGA - good knot security
  • PDA - monofilament, worse know security, good memory, absorbable 182 days
  • Maxon - monofilament, abosrbable, strong, poor knot security
  • Nylon - poor knot security, mono or multi, good memory

Small Animals:  0 - 3-0

Large Animals:  0 - 3

 

 

 

57


Colloid vs Crystaloid

Crystaloid

Saline (0.9% NaCl)

Lactated ringer

 

Colloid

    Gelatins
    Hetastarch
    Albumin
    Plasma protein fraction
    Dextran

 

58

Respiration vs Ventilation

Respiration:  Transport of O2 and CO2

 

Ventiliation: movement of gas