Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesiology > Monitoring the Anesthetized Patient > Flashcards

Monitoring the Anesthetized Patient Flashcards

1
Q

What is analgesia?

A

The absence of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hypnosis?

A

Artificially induced sleep or a trance resembling sleep from which an animal can be aroused by a stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are oxygenation and ventilation assessed subjectively?

A 
Reflex activity
Eye position
Muscle relaxation
Heart rate, pulse quality and strength
Respiratory rate, volume, character
Mucous membrane color and refill time
Response to noxious stimulus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are oxygenation and ventilation assessed objectively?

A 
ECG
Blood pressure
Hemoglobin saturation
CO2 production/elimination
Inhaled anesthetic concentration
Neuromuscular responses
EEG
Temporally processed data
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What types of equipment is used to measure oxygenation and ventilation objectively?

A

Doppler (indirect), oscillometric (indirect), or arterial catheter (direct) for blood pressure
Pulse oximeter for Hgb saturation
Capnograph for CO2 production/elimination
Train-of-four, tetanic fade for neuromuscular responses
Bispectral index from EEG, heart rate variability from ECG for temporally processed data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What types of equipment is used to measure oxygenation and ventilation subjectively?

A

Does not require specialized monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the normal parameters for heart rate?

A 
Dog: 60-160
Cat: 120-220
Horse: 25-45
Cow, sheep, goat: 60-80
Pig: 60-110
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the normal parameters for respiratory rate?

A 
Dog: 20-40
Cat: 20-40
Horse: 8-10
Cow: 10-30
Pig: 12-20
Sheep, goat: 15-30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the normal parameter for systolic pressure?

A

100-160 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the normal parameter for diastolic pressure?

A

60-90 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the normal parameter for mean arterial pressure?

A

60-80 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is it possible to be well oxygenated but poorly ventilated?

A

Yes, due to poor perfusion, delivery of oxygen to tissues is dependent on CO2 and arterial CO2 content. Ventilation is defined by the level of CO2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are causes of pulse oximeter artifact?

A

Vasoconstriction
Probe motion
Hypotension
Large number of false alarms (probe slips out of position)
Limited placement locations
Misleading results in the face of severe anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the ECG represent?

A

ECG produces a continuous waveform representing the summation of electrical ativity of the heart for a given axis or plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is ECG a good stand-alone monitor?

A

No, it does not provide assessment of perfusion, information on cardiac pumping activity, and it is limited to its assessment of the conduction speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the differences between direct and indirect methods to measure blood pressure?

A

Indirect is non-invasive and direct is invasive

17
Q

What are the 2 methods to indirectly measure blood pressure?

A

Doppler and oscillometric

18
Q

How are doppler and oscillometric similar?

A

The both proved systolic BP and HR, they do not measure flow or perfusion

19
Q

How are doppler and oscillometric different?

A

Oscillometric also gives diastolic and mean arterial pressures, doppler does not

20
Q

What is the accuracy of any indirect blood pressure method directly related to?

A

Cuff fit

21
Q

What are the differentials for absence of a CO2 waveform following endotracheal intubation?

A

Improper ET tube placement and patency: depressed or absent capnogram may be due to a dislodged ET tube
Misplaced ET tube (place it in esophagus)
Obstructed ET tube or airway, a leak around ET tube cuff, or disconnection of the ET tube from the anesthetic machine

22
Q

What objective parameter solely defines the adequacy of ventilation?

A

Capnography

23
Q

What is the most useful subjective sign for assessing the depth of anesthesia?

A

Respiratory rate, volume, and character (gives the best indicator of ventilation)

24
Q

What are the 4 guidelines for monitoring veterinary patients advocated by the ACVA?

A

Assessment of circulation
Assessment of ventilation
Maintenance of an anesthetic record of events
Assignment of a responsible person to be aware of the patient’s status and prepared to intervene, if necessary

25
Q

What are Guedel’s 4 stages of anesthesia?

A

Stage 1: Stage of voluntary movement
Stage 2: stage of delirium or involuntary excitement
Stage 3: Stage of surgical anesthesia
Stage 4: stage of medullary depression

26
Q

Describe stage 1 of anesthesia

A

Patient is awake or asleep but arousable

This stage lasts until ataxia and the loss of righting reflex

27
Q

Describe stage 2 of anesthesia

A

Lasts from the loss of unconsciousness to the onset of regular breathing
CNS is depressed
Patient shows signs of exaggerated reflex activity, vocalization, swallowing, urination/defecation, dilated pupils, breath holding and/or hyperpnea, tachypnea, palpebral reflexes will be prominent, and vomiting
These patients are not conscious and are not aware of what they are doing

28
Q

Describe stage 3 of anesthesia

A

Light, medium, and deep

Medium is where we want patients for surgery

29
Q

Describe light stage 3 of anesthesia

A

Spontaneous eyeball movement, may respond to toe pinch, brisk palpebral reflex present, strong jaw tone, eye rotated ventrally in ruminants

30
Q

Describe medium stage 3 of anesthesia

A

Stable respiration and pulse, abolished laryngeal reflexes, response to toe pinch, sluggish palpebral reflex, strong corneal reflex, adequate muscle relaxation, pupil is central but not dilated in ruminants, no purposeful response to noxious stimuli

31
Q

Describe deep stage 3 of anesthesia

A

Decreased intercostal muscle function, reduced tidal volume, increased respiratory rate, diaphragmatic breathing, profound muscle relaxation, weak corneal reflex, ventrally rotate pupil in ruminants, pupil sluggish or non-responsive to light

32
Q

Describe stage 4 of anesthesia

A

Do not want patients here
CNS is extremely depressed and spontaneous respiration ceases
The heart continues to beat for only a short time
Blood pressure is low, CRT is delayed, pupils are widely dilated and nonresponsive to light, sphincter tone is lost

33
Q

What is a differential list for a tachycardic anesthetized patient?

A 
Sympathetic stimulation
Hypotension
Hypovolemia
Hypoxemia (early) or anemia
Hypercarbia
Hyperthermia
Acute anaphylactoid response
Drugs
Electrolyte disturbances
34
Q

What is a differential list for a bradycardic anesthetized patient?

A 
Excessive sympathetic depression
Increased vagal tone
Hypothermia
Hyperkalemia
Elevated intracranial pressure
Hypoxemia (late)
Drugs
35
Q

What is a differential list for a tachypneic anesthetized patient?

A 
Sympathetic stimulation or pain
Hypoxemia
Hypercarbia
Hyperthermia
CSF acidosis
Drug effects
36
Q

What is a differential list for a bradypneic/apneic anesthetized patient?

A

Excessive respiratory depression
Recent hyperventilation
Hypothermia
Musculoskeletal weakness or paralysis

37
Q

Do anesthetized animals feel pain? Justify your answer based on your knowledge of neurophysiology and anesthetic action.

A

No, pain is a conscious experience and the anesthetized animal is unconscious. However, adequate analgesia will reduce physiologic and autonomic response (non-purposeful movement) to noxious stimuli (movement occurring at the level of the spinal cord not brain) which anesthesia does not have control over

Anesthesiology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions