monitoring Flashcards
stage 1 premed
decreases need for induction agents and anesthetics, place IV during this stage, we monitor HR, RR, perfusion, pulse, drooling/ vomit, sedation, reactions
stage 2 induction
injectable anesthetic to yield unconscious state, can be masked with inhalant anesthetic, intubate prior to this, we monitor HR, RR, MM, CRT, pulse, CNS reflex
stage 3 maintenance
pain free, iso or sevo for inhalant, IV fluids, and pain management, we monitor HR, RR, perfusion, MM, CRT, CO2 and O2, BP, CNS reflexes, temp
stage 4 recovery
inhalant turned off to extubation, vitals monitored until fully awake, quiet warm area, highest morbidity, we monitor HR, RR, CRT, MM, pulses, temp, CNS signs, BP
no equipment can replace…
human observation
eye position
start central then move rostroventral and then back to center as they get deeper
eye position is ineffective if P receives…
dissociative drug (ketamine)
four planes of anesthesia are
induction, excitement, operative, and danger
induction stage
pupils react to light, pulse is irregular but bp is normal
excitement stage
pupil has more reaction to light, pulse is irregular and fast, BP is high
operative stage
pupil has no reaction to light, pulse is steady and slow, BP is normal
danger stage
pupils are extremely large, no reaction to light, pulse is weak and thready, BP is low
suitable depth of anesthesia for surgery
Stage III plane II; regular shallow resp., BP and Hr mildly decreased, relaxed muscle tone, pedal and swallowing absent, ventromedial eye rotation, moderate pupil size
plane I (light)
not suitable for surgery, involuntary limb movement, eyes rotate ventrally, pupils constrict, reflexes present but decreased response
Stage III plane III (deep)
deep anesthesia, excessive for most procedures, low HR and RR, reduced pulse, increased CRT, poor light reflex, dilated pupils, reflexes absent
Stage III plane 4
early anesthesia overdose, abdominal breathing, fully dilated pupils, dry eyes, all reflexes absent, depression of CVS, pale MM, flaccid muscle tone
stage 5
overdose, cessation of RR, circulatory collapse, death, resuscitate immediately
sinus arrhythmias
HR coordination with respiratory, decrease during expiration, increase during inspiration, abnormal in cats
sinus bradycardia
abnormally slow heart rate, common during anesthesia, reverse with anticholinergics
sinus tachycardia
abnormally fast heart rate, inadequate anesthesia, drug reaction, Sx stim, treat according to cause
atrial fibrillation
fine, undulating baseline, absence of P wave, tachycardia, irregular QRS intervals
ventricular fibrillation
undulating baseline, absence of QRS (very squiggly curvy lines)
pulseless electrical activity
cessation of heart contractions or pulse with normal EKG, associated with cardiac arrest
mean arterial pressure (MAP)
average pressure through cardiac cycle, indicator of perfusion to organs (> 60 mmHg)
