FINAL EXAM

Question 1

Identify exhausted CO2 granules

Answer 1

purple, hard (do not crumble), can get warm

Question 2

How do you properly leak test an anesthetic machine?

Answer 2

turn on O2 connect the scavenging unit, desired breathing system tubing, and reservoir bag.
close the pop off valve or exit port completely but don’t overtighten.
Cover the patient end w/ thumb or hand
use theO2 flush valve to pressurize the system
dont overfill

Question 3

Identify common areas for leaks in anesthesia machines

Answer 3

oxygen flowmeter
rubber components (cracked gaskets)
Co2 canister
pop off valve
vaporizer inlet or outlet connections
vaporizer is full and cap is loose

Question 4

Describe the proper way to clean an OR and maintain aseptic conditions.
–Why must an OR be uncluttered?
– Why do we use dedicated cleaning equipment in the OR?
– Know the proper order and way to clean each part of the OR

Answer 4

It needs to be uncluttered to avoid surfaces collecting dust and bacteria
use dedicated equipment to avoid moving bacteria and contaminants into the sx area
top to bottom floor is a circle patterm from in to out. new rag after cleaning the table and lights

Question 5

Identify the proper time, temperature and pressure for autoclaving wrapped packs

Answer 5

121 C (250 F) at 15-30 psi for 9-15 min based on manufacture settings

Question 6

Describe how to properly load an autoclave as well as the importance of the venting process

Answer 6

load the pack with no sides touching the autoclave sides. Packs should not be stacked and room should be left around them to sterilize properly
venting will help remove the excess moisture and help bring down the temp and pressure slowly, avoids condensation from forming

Question 7

Describe the proper way to store and rotate packs.

Answer 7

labeled with a date when they should be used by or when they are considered outdated. checked and rotated each time the sx area is stocked Items with expiration dates that are the shortest, should be rotated so that they are used first

oldest packs first, new packs in the back, closed cabinet / open cabinet

Question 8

Describe how to utilize an esophageal stethoscope

Answer 8

premeasure the tube from the patient’s side (from the heart to the snout) mark the landmark
lubricate the tube and advance the end over the top of the dog’s tongue left of the ett. Should advance with little resistance

Question 9

Describe what information an esophageal stethoscope will give you.

Answer 9

the heart rate and how the lungs sound.

Question 10

Be able to calculate a manual HR

Answer 10

count the heart rate X 15 seconds and multiply by 4

Question 11

Know the following vital signs for ANESTHETIZED patients according to your Anesthetic Monitoring Quick Guide
HR for dogs, cats, cattle, and horses
RR for dogs, cats, cattle, and horses
Normal mm color and CRT
Normal MAP and systolic BP
Normal SPO2
Normal ETCO2

Answer 11

Dogs HR: 60 -150 RR: 8-20 and up to 40 bpm in cats. (lower end for larger dogs, higher end for cats, small dogs, and pediatrics)
Cats HR: 120 - 180 RR: 8-40
Horses HR: 28-40 RR: 6-12
cattle HR: 50 - 80 RR: 6-12
normal mm color: pink
normal MAP: 60 - 90 normal systolic BP: 110-160
Normal SP02: 95 - 100%
Normal ETCO2 - 35-45mmHg (up to 55mmHg)
25 - 35 mmHg (neuro patients)

Question 12

Know at least 2 reasons each for the following:
LOW HR
HIGH HR
LOW SPO2
LOW ETCO2
HIGH ETCO2
LOW BP
HIGH BP

Answer 12

low HR:
Dexmedotomidine, anesthetic depth, hypothermia, vagal stimulation

high HR: Ketamine, anticholingergics, shock, hypercapnia

Low SPO2 - inadequate oxygen intake (O2 is to low, flowmeter off, O2 tank disconnected) , inadequate ventilation or lung disease

Low ETCO2 - impending cardiac arrest, sampling error due to machine malfunction

High ETCO2 - hypoventilation, increased dead space

Low BP - arrythmias, too deep, propofol
High BP - pain / to light , overhydration

Question 13

Ventricular fibrillation

Question 14

Ventricular tachycardia

Question 15

2nd degree AV block (also known as 2nd degree heart block)

Question 16

Asystole

Question 17

⦁ Identify the P wave, QRS wave, and T wave on an ECG printout

Question 18

what is happening mechanically in the heart during
P wave:

Answer 18

atrial depolarization and contraction

Question 19

⦁ what is happening mechanically in the heart during QRS wave:

Answer 19

ventricular depolarization and contraction. Atrial repolarization is also taking place at this time but is “covered up” by the large QRS complex

Question 20

⦁what is happening mechanically in the heart during T wave

Answer 20

heart ventricles are repolarizing.

Answer 21

⦁ Hypoventilation

Answer 22

⦁ Hyperventilation

Answer 23

⦁ Rebreathing CO2

Answer 24

⦁ Airway obstruction (“shark fin” appearance—sloppy upward stroke)

Question 25

What are some causes for causes for sudden cessation of an ETCO2 waveform on a capnograph

Answer 25

Tube has been dislodged/come out of the trachea or ETCO2 sensor has come off Impending cardiac arrest

Question 26

What are the key differences between a sidestream and mainstream capnograph

Answer 26

sidestream - sampling port and the tube attached to the breathing circuit mainstream - CO2 is measured directly in a breathing system with an optional chamber between the ET tube and breathing circuit.

Question 27

where to place the following ECG leads according to the US color coding system: ⦁ Red ⦁ Black ⦁ Green ⦁ White

Answer 27

White on right smoke over fire green on rr

Question 28

what information does a pulse oximeter give you

Answer 28

how much the available hemoglobin is saturated with oxygen. can also give you CO2 and heart rate, respiratory rate

Question 29

common places to place a pulse oximeter probe

Answer 29

tounge, ear, pinna, prepuce, vulva, lip, toe webbing, achilles tendon, rectum

Question 30

Identify the manual indicators of perfusion

Answer 30

the mucus membrane color should be pink crt 1 -2 sec

Question 31

Identify the manual indicators of oxygenation

Answer 31

the mucus membrane color should be pink the color of the tounge breathing rate and effort crt

Question 32

⦁ Identify common areas where a blood pressure cuff can be placed

Answer 32

base of the tail, above the hock, above the carpus

Question 33

⦁ Describe how to measure a blood pressure cuff

Answer 33

place the cuff on the limb, the cuff width should be 40% of the limb circumference, the length should be appropriate so as to fall into the securing range indicated on the cuff

Question 34

Describe the following: Systolic blood pressure:

Answer 34

the pressure in the arteries when the heart is contracting (top number)

Question 35

⦁Describe the following: Diastolic blood pressure

Answer 35

the pressure in the arteries when the heart is at rest between contractions (bottom number

Question 36

Describe the following: Mean arterial pressure:

Answer 36

the average pressure throughout the cardiac cycle (a calculated value) and the best indicator of blood perfusion to the internal organs

Question 36

What are the main factors that make up blood pressure and identify each

Answer 36

Heart rate (generally the lower the heart rate, the lower the blood pressure. Very high heart rates will also lower blood pressure because the heart does not have enough time to fill with blood before the next heartbeat.) Stroke volume (Stroke volume is the amount of blood leaving the heart with each beat) Vascular resistance (this is the diameter of the blood vessels—vasoconstriction will cause a higher blood pressure while vasodilation will cause a lower blood pressure since there is more “room” in the vessels for the same volume of blood, thus showing a lower blood pressure reading). Arterial elasticity (how elastic, or easily stretched) the artery also plays a role in determining blood pressure. Blood volume (more blood volume=higher blood pressure and less blood volume either via blood loss or dehydration will lower blood pressure) Any changes in any of the above 4 can alter the blood pressure of the patient. The body will try to compensate: as one goes up, another may adjust and go down to “balance out” and try to keep the blood pressure in normal range.

Question 37

⦁ Calculate a drug dose in mLs given the dosage in mg/kg, the patient weight in pounds, and the drug concentration.

Answer 37

EX: drug @ 10mg/kg weight: 40 lbs (18kg) drug concentration: 100mg/ml 10mg/kg * 40 kg = 2,000mg 2,000 mg / 10 mg/ml = 8 ml

Question 38

⦁ Calculate the hourly fluid rate in MLS/hr given the patient's weight in pounds and the fluid rate in MLS/kg/hr.

Answer 38

weight: 18.48 lbs -----> 8.4 kb fluid rate: 2ml/kg/hr 8.4kg X 2ml/kg/hr = 16.8 or 17ml/hr