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Post-Anesthesia Care Flashcards

(42 cards)

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1
Q

4 signs of airway obstruction after extubation

A
  • increased inspiratory effort
  • stridor
  • thorax doesn’t expand

you cannot feel air passing through the nose

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2
Q

Which patients are more to catastrophic injury during recovery?

A
  • horses
  • large animals
  • wild animals
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3
Q

(hypoxemia/hypoxia) leads to organ damage

A

hypoxia

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4
Q

Dysphoric patients can be treated with ___________ and __________/_______

A
  • opiod antagonists
    • careful, you will reverse analgesia too!
  • sedatives/tranquilizers
    • Acepromazine
    • Dexmedetomidine
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5
Q

Problems with brachycephalics that make them prone to airway issues

A
  • stenotic nostrils
  • elongated soft palate
  • everted saccules and tonsils
  • hypoplastic trachea
  • laryngeal collapse

(plus edema and irritation)

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6
Q

Risk factors for airway obstruction (4)

A
  • obligate nasal breathers
    • horses
    • camelids
    • rabbits
  • brachycephalics
  • pre-existing respiratory conditions
    • tracheal collapse
    • bronchial disease
  • tight bandage around the neck
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7
Q

Predicting airway obstruction prior to extubation (5)

A
  • increased respiratory effort
  • thorax does not expand
  • high PIP alarm on ventilator
  • capnography
  • try to ventilate (feels like trying to ventilate a brick)
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8
Q

causes of hypoxemia (4)

A
  • low FiO2
  • hypoventilation
  • ventilation to perfusion mismatch
  • AV shunt (anatomical)
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9
Q

4 things that can cause prolonged recovery

A
  • residual drug effect
  • acid base/electrolyte abnormalities
  • hypoxemia, hypercapnea
  • hypothermia
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10
Q

Airway obstructions are usually due to _________ or __________

A
  • tube kinking
  • mucus plug obstructing the lumen of the ET tube
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11
Q

3 causes of atelectasis

A
  • absorption (high FiO2)
  • compression
    • mm relaxation
    • external compression
  • decreased surfactant
    • more relevant for long term ventilation
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12
Q

in ______ the alveolus is ventilated but not perfused (caused by _______)

A
  • High V/Q
  • hypotension
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13
Q

_______ and/or ____ are the only way to rule it out hypoxia

A
  • Pulse-oxymetry
  • ABG
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14
Q

3 signs of a painful patient (vs. dysphoric)

A
  • responds to palpation of surgical site
  • seems to be aware
  • responds to administration of an opiod
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15
Q

_____________: profound state of unease or dissatisfaction accompanied by anxiety or agitation

A

dysphoria

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16
Q

__________ during anesthesia can result i a pneumothorax hours after anesthesia is over

A

closed APL (pop-off valve)

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17
Q

What to do when an animal is taking too long to recover

Study These Flashcards
A
  • check the temperature
    • treat hypothermia
  • evaluate the ventilation status
    • capnography (if still intubated)
    • venous or arterial blood gas
  • evaluate oxygenation
    • pulse-ox
    • arterial blood gas
  • evaluate acid base/electrolyte status
  • all normal? can any of the anesthetic drugs be reversed?
18
Q

___________ is the drug given to treat malignant hyperthermia

19
Q

3 causes of myopathy/neuropathy

Study These Flashcards
A
  • malpositioning during anesthesia
  • compression of nerves
  • hypoperfusion of muscles
21
Q

cyanosis becomes visible when the concentration of deoxyHb rises above ____ g/dL

22
Q

in ______ the alveolus is perfused but not ventilated (commonly caused by _______)

Study These Flashcards
A
  • low V/Q
  • atelectasis
23
Q

Cautions for airway obstruction in alpacas (often silent) (5)

Study These Flashcards
A
  • watch for movements of the thorax
  • use IN phenylephrine prior to recovery
  • nasopharyngeal tubes can be used
  • extubate only when they are reactive and don’t tolerate the tube
  • have drugs for induction and airway equipment available
24
Q

3 signs of dysphoria

Study These Flashcards
A
  • whining
  • screaming
  • uncoordinated movements
25
Aspiration/regurgitation risk factors (7)
- GI surgery (FB, GDV) - septic abdomen - hx of vomiting - megaesophagus - laryngeal paralysis - airway surgery requiring unprotected airway - ruminants
26
3 signs of a dysphoric patient (vs painful)
- does not respond to anything in particular - seems to be "out of it" - is often caused by opiod administration
27
Can you be hypoxic without being hypoxemic?
yes
28
Why does regurgitation/aspiration occur under anesthesia?
- many anesthetic drugs cause nausea, vomiting, and delayed gastric emptying - most anesthetic drugs also impair swallowing reflexes
29
Treatment/prevention for aspiration/regurgitation (3)
- administration of gastro protectants/ antiacids - suction - late extubation of patients at risk
30
About 50% of the anesthesia related mortality happen in the _______ period
post anesthetic
31
Risk factors of hypoxemia (9)
- obese patients - intra-thoracic surgery - abdominal surgeries - dorsal recumbency - pre-existing respiratory disease - long anesthetic procedures - patients requiring higher doses of opiods/sedatives - painful animals - dysphoric animals
32
Why is it easy to become hypoxemic during the recovery period?
most of the drugs used during anesthesia or as analgesics/sedatives cause hypoventilation - untreated pain may also cause hypoventilation
33
What can we do to promote a smooth recovery in a horse? (5)
* sedation * alpha 2 adrenergic agonist * acepromazine * good analgesia * they should lie down for at least 30-40 min after discontinuation of haogenate * quiet recovery box * limit noises * low lighting/cover eyes * assist recovery * ropes/pool * risk for personnel
34
\_\_\_\_\_\_\_\_ is the cause of hypoxia
insufficient oxygen delivery
35
\_\_\_\_\_\_\_: deflated alveoli
atelectasis
36
\_\_\_\_\_\_\_\_\_\_= Reduction below normal levels of oxygen in blood = low PaO2
hypoxemia
37
How to treat hyperthermia (6)
- turn off all heating devices - increase fresh gas flow - check CO2 adsorbent canister (is it hot) - is it a cat or ferret that has been given opiods? - initiate cooling process - do you suspect malignant hyperplasia?
38
Horses can generate such a substantial negative pressure when trying to breath against an obstructed airway that they can develop \_\_\_\_\_\_\_\_
fulminating pulmonary edema
39
Common post-operative complications
- Respiratory complications - poor recovery - prolonged recovery - hyperthermia - CV complications - myopathy/neuropathy - worsening pre-existing conditions
40
\_\_\_\_\_\_\_: reduction below normal levels of oxygen in the tissues
hypoxia
41
T/F Dysphoria is not a reason to withold the administration of analgesics
T
42
Causes of peri-anesthetic hyperthermia (5)
- iatrogenic (heating pads) - opiod-related - capture related - exhausted CO2 adsorbent - malignant hyperthermia

Anesthesiology (13 decks)

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