Small Animal Medicine Flashcards Preview

Veterinary Technician > Small Animal Medicine > Flashcards

Flashcards in Small Animal Medicine Deck (309):
1

What is the main reason for a Pre-GA Exam?

Determine the ability of the CV and Respiratory system to maintain O2 delivery and waste removal

2

T/F Smaller dogs and youngsters should decrease fasting time due to decreased glycogen stores & higher metabolic rates.

true

3

What are the parts of a signalment?

1) Species
2) Breed
3) Weight
4) Age
5) Sex
6) Reproductive status

4

Normal temperature for dog and cat.

dog: 99.5-102.5
cat: 100-102.5

5

______ can cause abortions

glucocorticoids

6

6 divisions of anesthetic risks- ASA classification of Patient Risk:
1) Class I-
2) Class II-
3) Class III-
4) Class IV-
5) Class V-
6) Class VI-

1) minimal risk, healthy animal with no underlying dz
2) slight risk (neonate or geriatric) mild systemic disease
3) moderate risk, moderate systemic disease and mild clinical signs
4) high risk, pre-existing systemic dz of severe nature
5) extreme risk, patient not expected to survive
6) patient will not recover

7

Atropine and Glycopyrrolate are what type of preanesthetics?

anticholinergics

8

Name 2 tranquilizers/sedatives.

1) Phenothiazines
2) Benzodiazepines
3) Alpha-2 agonists
4) Opioids

9

How do anticholinergics work?

Block acetylcholine (vagus nerve) from parasympathetic on the muscarinic receptors

10

What's the difference between Benzodiazepines and Alpha-2 agonists?

Alpha-2 agonists can be reversed and give analgesia

11

What are 2 parts of the minimum database?

1) Patient history
2) Nature of procedure
3) Complete physical examination
4) Diagnostic tests
5) In consult with DVM, patient status and anesthetic risk

12

What are the three basic action of the anesthesia machine?

1) Deliver O2
2) Safe anesthesia concentration
3) Remove CO2

13

What are the basic components?

1) Compressed gas source
2) Anesthetic machine
3) Breathing circuit

14

What does the pressure gauge do?

Indicates the pressure of the gas remaining within the cylinder

15

What does the flow meter do?

1) Controls rate at which specific gas is delivered
2) Further reduces pressure to 15 psi

16

What is a Rotameter?

Ball or bobbin rising within graduated glass tube to height proportional to flow of gas in tube

17

The Oxygen Flush valve bypasses the _____ and is direct to common gas outlet or anesthetic circle

vaporizer

18

What does the O2 flush valve do?

Dilutes anesthetic gas in system

19

What does the vaporizer do?

Volatilizes liquids & inhaled anesthetics & delivers clinically useful concentrations of anesthetic vapor

20

If someone is color blind, how will they know where the oxygen tank and the nitrogen tank goes?

the Pin-index cylinders, for those connecting to the machine directly it has different positions for different gases

21

When should an O2 flush valve not be used?

1) should NEVER be used in closed breathing system without an open expiratory valve
2) should NEVER be used in a nonrebreather
3) should NEVER be used while the patient is connected

22

What's the difference between the rebreather vs the nonrebreather?

Rebreather: Eliminate CO2 by chemical removal and allows same gas to be rebreathed by patient
Nonrebreather: Eliminates CO2 by flushing of waste or exhaust system

23

What transfers gas from machine to patient

endotracheal tube

24

Used to increase visibility of larynx

laryngoscopes

25

Define Anesthesia.

State of controlled and reversible unconsciousness achieved through the use of injectable and/ or inhaled drugs and characterized by the absence of pain perception, memory, motor response to stimuli or reflex responses

26

What are the two routes of anesthesia?

injectable and inhalant

27

Advantages and disadvantages of inhalation anesthesia.

1) Advantages: Depth of anesthesia can be readily altered, Elimination occurs mainly through the lungs, Allows the constant delivery of 100% O2
2) Disadvantages: Requires an anesthetic machine, Induction is slow when used alone

28

What are the uses for an ET tube?

-Efficient delivery of gas
-Correct size improves efficiency by reducing anatomic dead space (portions of breathing passages containing air but no gas exchange)
-Prevents aspiration
-Inflated cuff decreases risk

29

ET placement Disadvantages:

-Increased vagal tone
-Difficulty
-Laryngeal damage
-Blind
-Using human tubes= can be too long which increases anatomic dead space
-Pressure necrosis

30

What stage of anesthesia is where the 4 planes occur?

stage 3

31

Describe the 4 planes of anesthesia.

1) too light for surgical procedures
2) surgical plane
3) significant depression of all systems
4) overdose

32

Never use the _______ in animal appearing to be alive.

Corneal reflex

33

What does the Pulse oximeter do?

Estimates the saturation of hgb

34

What does the Pulse oximeter require? When will it not read accurately?

-Requires non-pigment motionless tissue
-Will not read accurately with vasoconstriction and anemia (PCV < 15%)

35

What are some indicators of ventilation?

-Respiratory rate
-Tidal volume (Amount of air inhaled with each breath)
-Respiratory character (Effort required to breathe, the relative length of inhalation and exhalation)
-Apnea monitor (Sensor warns when patient has not taken a breath)

36

What does the Capnograph measure?

Measures the end tidal (ET) CO2

37

The Capnograph gives good assessments of depth of _______ and _______ but is not an adequate ventilation.

anesthesia, ventilation

38

Describe the right patient positioning.

-Support during induction
-D/C from circuit when moving or rolling
-Ensure proper tube placement prior to prep
-Support anesthetic hoses
-Position patient as normal as possible
-Table tilting
-Unilateral lung disease-good side up
-Artificial tears ointment q 90 min

39

The lower the ratio the _____ the induction

faster

40

______ used as a standard of comparison for the potency of anesthetics

MAC

41

What does MAC stand for?

Minimum Alveolar Concentration

42

Low MAC value indicates a ____ anesthetic

potent

43

What three factors decrease MAC

1) Severe hypotension
2) Hypothermia
3) Aging

44

What is the only type of anesthetic gas that uses a non-precision vaporizer?

Methoxyflurane

45

What does Doxapram do?

Inc. RR and depth reversing resp depression

46

If an anesthetic gas has low solubility what does that mean?

it has a fast induction

47

How can you ensure proper placement of an endotracheal tube?

-Watch reservoir bag movement
-Feel for air movement from tube connector
-Tube condensation
-Palpate the neck
-Vocalization
-Cough or forcefully exhale

48

Reflex closure of the glottis is called?

laryngospasm

49

Anticholinergic drugs such as atropine block the release of acteylcholine at the:

muscarinic receptors of the parasympathetic system

50

Doxapram is what class of drug?

Analeptic drug

51

What technique is not recommended for handling small dogs?

scruffing

52

Small dog breeds have a higher incidence of __________ that should give you pause when determining restraint methods.

Collapsing trachea

53

A neuroleptanalgestic is a combination of?

an opioid and a tranquilizer

54

T/F Most preanesthetics will not cross the placental barrier.

false

55

T/F It is recommended that atropine not be given to an animal that has tachycardia.

true

56

T/F High doses of opioids can cause bradycardia and respiratory depression.

true

57

What drug will precipitate out when mixed with other drugs or solutions?

Diazepam

58

An anesthetic agent that has a low blood-gas partition coefficient will result in ____ induction and recovery time.

fast

59

As a rough guideline, to safely maintain a surgical plane of anesthesia, the vaporizer should be set at about:
a) 0.5 X MAC
b) 1 X MAC
c) 1.5 X MAC
d) 2 X MAC

c) 1.5 X MAC

60

Propofol sometimes causes transient apnea. To avoid this, the anesthetist should:

Titrate this drug in several boluses

61

A reservoir bag that is not moving well may indicate:

1) the ET tube is not in the trachea
2) the animal has a decreased tidal volume
3) there is a leak around the ET tube

62

Adverse effects common with isoflurane include:

depression of respiration

63

When the O2 tank is half full, the tank pressure gauge will read approximately:

1100 psi

64

The amount of O2 an animal is receiving is indicated by the

flow meter

65

Flow meters that have a ball for reading the gauge should be read from the _____ of the ball

middle

66

The flutter valves on an anesthetic machine help:

control the direction of movement of gases

67

The pop-off valve is part of the anesthetic machine and helps:

prevent excess gas pressure from building up within the breathing circuit

68

In small animal anesthesia, when the patient is bagged, the pressure manometer reading should not exceed:

20 cm H20

69

T/F Rebreathing systems, when used with standard small animal corrugated breathing tubes, are best reserved for animals weighing more than 7kg

true

70

The negative pressure relief valve is particularly important when:

there is a failure of O2 flow through the system

71

The tidal volume of an anesthetized animal is considered to be _____ mL/kg of body weight

10

72

A scavenging system is generally attached to

the pop-off valve

73

The anesthetist will know when the granules in the carbon dioxide absorber have been depleted because the:

1) granules will be brittle
2) granules may change color
3) granules may be hard

74

T/F With most injectable and inhalant anesthetics, there is generally a progressive depression of cardiovascular and respiratory function as the depth of anesthesia increases.

true

75

The plane of anesthesia most suitable for surgical procedures is generally considered to be:

Stage III, plane 2

76

T/F Analgesic Adjunt Agents may enhance effects of other classes of CNS depressant drugs

true

77

Anatomic dead space is considered to be the:

air within the trachea, pharynx, larynx, bronchi, and nasal passages

78

The minimum acceptable heart rate for an anesthetized large breed dog is ____ bpm

60

79

T/F If the ECG is normal, the heart must be beating normally.

false

80

In general, a respiratory rate of less than _____ breaths/min in an anesthetized dog should be reported to the veterinarian.

6

81

Tachypnea is

an increase in respiratory rate

82

T/F An animal that is in a surgical plane of anesthesia should not respond in any way to any procedure that is being done to it (ex pulling on viscera should not change heart beat)

false

83

Pulse oximetery allows accurate estimation of:

percent saturation of hemoglobin with oxygen

84

Pale mucuous membranes commonly indicate:
a. blood loss
b. anemia
c. decreased perfusion
d. hypertension

a. blood loss
b. anemia
c. decreased perfusion

85

What is hypostatic pooling?

Pooling of blood in dependent lungs & tissues

86

When do you extubate?

coughing, swallowing, chewing on tube

87

Complications of Intubation:

-Vagal nerve stimulation (supresses cardiac)
-Difficulty, especially brachycephalics
-Cuff overinflation
-Obstruction
-Chewing of tube and inhalation into trachea
-Tracheal tares

88

Length of recovery depends on:

-age of animal
-breed
-body temperature
-type of drug used

89

What is the type of vaporizer found out of the circle?

precision vaporizer

90

T/F After a dental cleaning the cuff should be completely deflated prior to removal.

false

91

What is the first and last gas on?

oxygen

92

Drugs may predispose horses to colic which ones? Why?

anticholinergics because they slow down the GI system

93

What can horses get if their head is not supported?

-Neuropathy (from compressed nerves-Radial and facial)
-Myopathy (from compressed muscles-Tying up)

94

What drug class is not used in ruminants? Why?

Anticholinergics not used because it does not reduce salivation it makes it thicker and ropy

95

You hold horses' heads ____ and ruminants heads' are _____

up, down

96

Define analgesia

absence of pain SENSATION

97

What are some consequences of pain?

-Increased risk of infection
-Delayed wound healing
-Reduced food and water intake
-Immobilization

98

Any drug used to induce a loss of sensation with or without unconsciousness

anesthetic agent

99

What is an adjunct?

any drug used (but not a true anesthetic) which can produce other desired effects such as sedation, reversal, muscle relaxation, analgesia, neuromuscular blockade or parasympathetic blockade

100

What are the time periods when anesthetic agents are given?

1) Preanesthetics
2) Induction
3) Maintenance

101

What is an agonist?

bind to and stimulate target tissue receptors
(most anesthetics and adjuncts)

102

What is an antagonists?

bind but do not stimulate receptors
(Apha-2 adrenergics and opioids), Given after agonist to “wake” patient

103

What is a partial agonist?

bind to and partially stimulate receptors

104

What is an agonist-antagonist?

bind to more that one receptor type and simultaneously stimulate and block at least one receptor

105

When should analgesia be provided?

Analgesia must be provided before, during and after procedure

106

What is windup?

accumulation of pain upon waking from previous procedure

107

T/F Anticholinergics prevents ptyalism(drooling), but will cause thick mucus (1o cats)

true

108

Water soluble drugs can usually be combined in same syringe. One exception is?

diazepam (non-water soluble) and ketamine

109

Allows visualization, illumination and manipulation of tongue and epiglottis

laryngoscope (Cough or visually-vocalization is impossible if in place)

110

Inflate the cuff with small increments of air if you over inflate you will get ___ _____

back pressure

111

1) Check by placing __ cm of pressure and listening for air escape
2) Loud hiss needs ___ air
3) No hiss ____ slightly as may be adding too much pressure
4) Slight hiss cuff ___
5) Recheck ___ min as may need to add more due to muscle relaxation

1) 20
2) more
3) deflate
4) okay
5) 15-20

112

Optimal size for the reservoir bag should be __ full, if overfull can rupture alveoli

3/4

113

Preanesthetics are any drug administered within an ____ of general anesthesia

1 hour

114

What are the different types of preanesthetic classes?

1) Anticholinergics
2) Tranquilizers or sedatives
3) Opioids
10-30 minutes prior to sx
IM or SQ

115

What are some reasons to administer preanesthetics?

-Calm or sedate a patient
-To produce smoother anesthetic inductions and recoveries
-Decrease pain and discomfort associated with procedure
-Produce muscle relaxation

116

Do anticholinergics provide analgesia? Do they cause CV or resp depression at normal doses?

no, no

117

What's the difference between tranquilizers and sedatives?

Tranquilizer reduces anxiety but doesn't alter mentation and Sedative decreases mental ability & induces sleepiness

118

Sedatives and tranquilzers have 3 classes. What are they and which has analgesia?

-Phenothiazines
-Benzodiazepines
-Alpha-2-agonist (only class w/ analgesia)

119

What is an example of a Phenothiazine?

Acepromazine
Chlorpromazine

120

What is an example of a Benzodiazepine?

Diazepam

121

What is another route to inject Diazepam if an animal is having a seizure?

per rectum

122

T/F Diazepam should not be mixed with any other drug besides ketamine

true

123

What is an example of an Alpha-2-agonist?

Xylazine (Rompun)

124

Narcotics term reserved for agents with potential to cause physical dependence

opioids

125

Derived from opium, an extract of a species of ___ that bind both ___ and kappa receptors

poppy, mu

126

Which class of drug is best for pain?

opioids, mu receptors tell you pain

127

Why should Morphine not be used in bowel obstructions or diaphragmatic hernias?

due to stimulation of vomiting and defecation

128

T/F To use barbiturates on a continuous or repeated basis during the course of a surgical procedure is contraindicated.

true

129

Because of depressant effects on the CV & resp systems and variation in dose requirements among patients, barbiturates are given?

half the calculated dose as a bolus and then to effect

130

Why are barbiturates contraindicated in sight hounds?

Avoid in sight hounds-Related to low fat stores and lipid solubility in the brain

131

Thiopental is ALWAYS given ___ and is Anesthesia ____ analgesia

IV, without

132

T/F Propofol IV use ONLY and is the only turbid solution.

true

133

What do dissociatives do?

Inhibit NMDA receptors in CNS responsible for ‘windup’

134

T/F Dissociative anesthesia is characterized by: exaggerated reflexes (pharyngeal, laryngeal, palpebral)

true

135

Dissociative anesthesia is analgesia to integument but not to ____.

viscera

136

What are the 5 H's (common complications)

1) Hypoxemia
2) Hypoventilation
3) Hypotension
4) Hypovolemia
5) Hypothermia

137

Define pain

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

138

What is Nociception?

detection by the nervous system of the potential got or the actual occurrence of tissue injury

139

Pain occurring after tissue injury is?

pathological pain

140

Physiology:
1) Visceral pain arises from the _____
2) Somatic pain arises from the ______ system
3) Superficial?
4) Deep?

1) organs
2) musculoskeletal
3) skin
4)joints, muscles or bones

141

What are 5 signs of behavioral pain?

1) Hypertension
2) Tachycardia
3) Tachypnea
4) Panting
5) Mydriasis (dilation of pupils)

142

T/F No single physiologic parameter is specific for pain.

true

143

What are the 4 main steps for nociception?

1) Transformation of noxious stimuli into electrical stimuli called action potentials called transduction
2) Sensory impulses carried to spinal cord via transmission
3) Signals altered either amplified or suppressed in process called modulation
4) Final step is perception

144

Interference with the translation of tissue injury

Transduction

145

Block the generation and conduction of nerve impulses

Transmission

146

Alterations of mood and level of consciousness profoundly affect pain experience

Perception

147

State of general anesthesia sufficient for surgical intervention

balanced anesthesia

148

What are 4 examples of unbalanced anesthesia?

1) Any anesthetic protocol using one or two drugs to achieve state of unconsciousness
2) Mask induction and maintenance w/ iso
3) IV propofol alone
4) Bolus dose of thiopental to unpremedicated patient

149

What are the two causes of stress?

-Physical (Temperature extremes, disease, injury)
-Emotional (fear, conflict, frustration, anxiety)

150

Opioid analgesics:
1) Pure mu agonist-Occupy receptor and provide analgesia. The higher the dose the greater number of receptors occupied, the greater the _____
2) Partial mu agonist-Produces good analgesia at lower doses. ______: the higher doses do not give greater analgesia

1) analgesia
2) Ceiling effect (Butorphanol is an example)

151

What opioid is a pure agonist for mu and kappa receptors

Morphine

152

What is the only injectable opioid in VM not classified as controlled?

Nalbuphine

153

What is the objective of Analgesia by CRI (constant rate infusion)?

maintain steady state plasma or tissue concentration of the drug in the body

154

What is anesthesia? (2 words)

controlled poisoning

155

Name 1 anticholinergic drug and a reason for its use.

atropine, prevent bradycardia, reduce salivation

156

1 feature of alpha-2 agonists that sets is apart from the others?

1) not controlled
2) some analgesia

157

What class of drug has a dissociative effect?

ketaleptic/cycloheximide

158

A neuroleptanalgestic is a combination of?

opiod and tranquilizer

159

3 signs a patient needs analgesia?

1) tachycardia
2) tachypnea
3) restlessness

160

What is Preemptive Analgesia? Why give it?

analgesia given before pain starts or procedure, to prevent windup

161

Only injectable opioid in VM not classified as controlled is?

Nalbuphine

162

What's the objective of analgesia by CRI (constant rate infusion)?

maintain steady state plasma or tissue concentration of the drug in the body

163

Blocks sodium ion channels in neuronal cells & membrane stabilization, If administered at higher infusion rate by mistake- CNS stimulation, sign of toxicity would be excitement

Lidocane

164

Analgesic effect stems from antagonistic role on specific brain receptors which when stimulated cause-CNS sensitization, Does not provide analgesia alone must be used with an opioid

Ketamine

165

T/F Injections may be administered in same manner in a rat as mouse.

true

166

T/F Monitor RR and quality prior to removal from original carrier

true

167

Ferrets should be fasted ___ hours prior to surgery

4-6

168

Since Ferret's GI transit time is fast, and longer periods without food increase the risk of ______.

hypoglycemia

169

Ferrets with insulinoma should only be fasted ___ hours

2-4

170

Birds also have extremely fast GI transit, so fasting ____ hours is usually sufficient to allow the crop to empty

6-8

171

Reptiles should have food and water withheld for longer periods. How long for lizards and chelonians? Snakes?

1) 12-24 hours
2) 72 hours

172

What is the most common problem?

dehydration

173

T/F IV is not usable in small mammals, IO is used in severe cases.

true

174

Most preanesthetic drugs are given __, ___, ___ for small mammals.

SC, IP, IM

175

_____ only species may benefit from sedation prior to anesthesia

rabbits

176

Why should rabbits be premedicated especially when using a mask?

May breath hold causing bradycardia

177

Induction is safest using this method

inhalation anesthetics (nonrebreather)

178

Most reliable reflex for small mammals is ______ or _______. The _____ reflex is not reliable.

pedal withdrawal(lost at light to medium planes) or tail pinch(lost at light to medium planes), ocular

179

When monitoring small mammals what is critical?

thermoregulation

180

T/F Return to spontaneous respiration can be slow.

true

181

In mammals and birds the stimulus for respiration is increased blood ____ levels. In reptiles, however, the stimulus is low ____ levels. Therefore, providing pure O2 during recovery may actually delay spontaneous breathing in reptiles.

CO2, oxygen

182

For birds, recovery is complete when? For small mammals? For reptiles?

1) the patient is alert, ambulatory, and begins eating and grooming(takes between 30 minutes to 3 hours)
2) grooming and return to eating take place within 6-12 hours
3) a return to normal movement appetite and activity may take 24-48 hours

183

What 4 things are the foundation for supportive care in birds and exotics?

1) providing heat
2) fluids
3) nutrition
4) antimicrobials

184

What are some signs of pain in small mammals?

1) Unkempt coat
2) Buildup of secretions around nose and eyes
3) Remains motionless
4) Abnormal posture or gait when encouraged to move

185

What are examples of other analgesics besides opioids?

1) Tranquilizers
2) NSAID’s
3) Local anesthetics
4) Alpha-2 adrenergic agonists

186

List 2 of the 4 major classifications of anesthetic emergencies.

1) Hypoxia
2) Excessive airway/thoracic pressure and volume
3) Anesthetic over- and underdose
4) Hypoventilation

187

In general, the most common cause of anesthetic emergencies is ____________

human error

188

An anesthetized patient exhibiting an exaggerated breathing pattern would lead you to consider the problem to be respiratory obstruction caused by:
a) Twisted/kinked ET tube
b) Occlusion of ET lumen by faulty cuff
c) Bronchial intubation
d) Any/all of the above

d) Any/all of the above

189

What else will you see that tells you what the general problem is?

Lack of reservoir bag movement

190

If the pop-off valve is inadvertently left closed, it will:
a) Stop the oxygen flow from entering the circuit
b) Convert the circuit to low flow anesthesia
c) Cause a significant rise of pressure within the circuit and patient
d) Cause the flutter valves to malfunction

c) Cause a significant rise of pressure within the circuit and patient`

191

If the pop-off valve is left closed, this eventually will cause what to decrease in the patient?

Cardiac output (also BP drop & impeded venous return)

192

T/F With CO2 absorber exhaustion, the patient may exhibit bradyarrhythmias, dyspnea and pale to blue mucous membranes.

False-Hypercapnia causes tachypnea, tachycardia, other cardaic arrhythmias and brick red mucous membranes

193

What would be a cause of anesthetic gas underdose?
a) Problems with the vaporizer
b) Inappropriate/altered oxygen flow
c) Anesthetic leaks
d) Any/all of the above

d) Any/all of the above

194

How is hypoxia defined? The tissue most sensitive to the negative effects of hypoxia is?

A deficiency in O2 reaching the lungs or airway of the patient, brain

195

Why is it important to rapidly induce and intubate a brachycephalic patient?

Redundant soft tissue in pharyngeal area may obstruct trachea (sedation exacerbates by relaxing these tissues); may be obligate mouth breathers (stenotic nares common)

196

List 4 patient factors that increase anesthetic risk.

-Geriatric
-Pediatric
-Brachycephalic
-Obese animal
-Trauma

197

What is a bronchial spasm? First warning sign?

constriction of bronchioles, coughing

198

Most common anesthetic overdose? 2nd?

wrong agent in wrong vaporizer , both vaporizers turned on at the same time

199

Geriatrics are defines as reaching ___ of expected age for that species and breed.

75%

200

What are concerns for pediatrics under anesthesia?

-hypoglycemia
-bradycardia
-hypotension
-hypothermia

201

What are signs of fluid overload?

-crackles/wheezes in chest
-serous nasal discharge
-chemosis
-restlessness
-coughing

202

Anesthetic drugs cause ______ to the heart which is the most common problem.

bradycardia

203

What drugs affect renal perfusion?

ketamine, xylazine

204

Most common causes of respiratory distress?

1) inability to obtain O2 from machine
2) empty
3) flow meter off
4) flow blocked

205

What are signs of cardiac arrest?

1) no heartbeat auscultated
2) no palpable pulse
3) ECG tracing
4) MM gray or cyanotic
5) CRT >2

206

What is a factor to consider in the anesthetic protocol of a geriatric patient?

Hypothermia and reduced organ function

207

Which is a potential problem encountered during anesthesia of pregnant bitches for C-sections.
a) Decreased lung capacity
b) Seizures
c) Hypertension
d) Hypothermia

a) Decreased lung capacity

208

T/F Sighthounds are particulary sensitive to barbitutaes due to lack of body fat and reduced renal elimination of this drug.

false-inefficient hepatic metabolism

209

List one cause of post anesthetic dyspnea in the cat And dog.

cat-laryngospasm
dog-brachycephalic dogs, obstruction

210

Give one reason why nutritional intervention is crucial to patient recovery and survival.

-Support to counteract the immunosuppressive effects of disease, trauma & surgery
-Enhances healing - necessary for tissue synthesis
-Necessary for immune competence and drug metabolism

211

Baseline data includes:

-Weight
-Body condition score
-Hydration status
-Cardiopulmonary sounds
-Body temperature

212

What is the purpose for nutritional assistance?

Support to counteract the immunosuppressive effects of disease, trauma & surgery

213

What are some indications for nutritional support?

-Recent weight loss of more than 10%
-Absent or poor food intake for more than 2 days
-Acute illness or injury
-Acute muscle wasting
-Heavy GI or urinary system losses of protein or electrolytes

214

What are lab indications for nutritional support?

Albumin, total protein, blood urea nitrogen (BUN)

215

Defined as any disorder of nutrients with inadequate or unbalanced nutrition

malnutrition

216

What is the best way to investigate malnutrition?

medical history

217

T/F Undernourished patients are three times as likely as well-nourished patients to have surgical complications

true

218

What are some common surgical complications?

-Wound dehiscence
-Delayed tissue healing
-Decubital ulcers
-Sepsis
-Pulmonary infections

219

T/F There is no one clinical test to assess nutritional status.

true

220

____(enteral) is safest and most natural route for nutritional assistance.

Gut

221

What are some examples of enteral feeding?

1) Hand- feeding
2) Nasogastric/nasoesophageal
3) Pharyngostomy
4) Jejunostomy
5) Gastrotomy

222

Aspirate each feeding, but do not feed if air ______

aspirated

223

What is the primary tissue target for most anesthetics?

CNS

224

What are 2 examples of an antagonist?

alpha-2 agonists, opioids

225

What are 4 potential harmful effects of mu agonists?

1) respiratory depression
2) bradycardia
3) GI effects
4) dysphoria

226

What is something significant about use of sedatives in brachycephalic breeds?

relaxed pharygneal tissue so becomes harder to breathe

227

What can happen if incompatible anesthetic drugs are mixed together in the same syringe?

-change in chemistry
-loss of potency

228

Why are some of these mixtures incompatible? What exception is there regarding mixing drugs in the same syringe?

Both of the mixtures are not water-soluble, ketamine and diazepam

229

What are 2 preanesthetic drugs that do not provide analgesia?

-anticholinergics
-phenothiazines
-benzodiazpines

230

Which class has potential to cause physical dependence? What other class tranquilizer is known to in people?

-opioids
-benzodiazapines

231

What group is not used in sighthounds, why?

barbiturates because they are very lipid soluble and don't have a lot of fat

232

2 groups of drugs that provide muscle relaxation.

-benzodiazpines
-alpha-2 agonists

233

What is a major disadvantage to using propofol? What else is unusual about it?

poor storage characteristics, it is the only IV turbid solution

234

Which type of anesthesia is characterized by exaggerated pharyngeal, laryngeal, and palpabral reflexes?

dissociative anesthesia

235

What are the most common agents used to induce anesthesia?

injection: propofol
inhalant: isoflurane

236

2 side effects of hypothermia which can have an adverse reaction on patient recovery

-decrease in metabolism
-decrease in O2 consumption

237

How many steps are there in the realization of pain?

4

238

What type of drug is considered the best to use to control severe pain? What is an example?

pure mu agonists, morphine

239

Why do patients under inhalant anesthesia do not appear to react to pain?

unconscious not aware

240

2 non-specific behaviors that can be attributed to an early pain episoe

-reduced exercise tolerance
-decrease appetite

241

2 categories of factors that can cause stress to the animal

-emotional
-physical

242

2 conditions/syndromes that can be attributed to being cause by stress.

-feline idiopathic cystitis
-feline cycogenic alopecia

243

2 methods to deliver CRIs:

-syringe pump
-IV fluid bag

244

2 harmful side effects of NSAIDs

-GI ulcers
-renal toxicity

245

What is multimodal anesthesia and why is it used?

1 or 2 drugs, less adverse effects

246

Patient discomfort can be minimized, name 2 pain control.

hygiene, gentle reassurance

247

Where are intraperitoneal injections administered in small mammals? What is the reasons for using this area?

lower right quadrant, to avoid the cecum and bladder

248

What species of small mammal is the least amenable to pre-operative physical exams? Why?

hamsters because they bite hard and are difficult to restrain

249

Consequences from withholding food from small mammals?

hypoglycemia and it slows rabbit's GI

250

What anticholinergic is successful in rabbits?

atropinase

251

What is the method of choice for anesthesia in most small mammals? 2 reasons for this choice.

inhalant, safer, no veins for catheter placement

252

1 species intubate with blind technique

rabbits, chinchillas

253

Why can't eye position be monitored in animals?

may not be changed, or fixed

254

Which reflex is most reliable for small mammals?

pedal withdrawl

255

Why does providing pure oxygen during recovery in reptiles actually delay breathing?

low O2 not high CO2

256

What class is safe to use in reptiles and rabbits?

butorphanol

257

What are the difference levels of consciousness?

1) conscious
2) semi-conscious
3) unconscious
4) comatose or awake again

258

2 patient characteristics that affect anesthesia?

1) age
2) breed
3) species
4) disease

259

1 advantage and disadvantage of inhalant anesthesia.

-adv: allows the constant delivery of 100% O2
-dis: anesthetic waste increase

260

The reflex used when anticholinergics are used is

(dilates pupils) PLR pupillary light reflex

261

What parameters are you monitoring with respiration with a patient under anesthesia?

-respiratory rate
-effort
-depth

262

Class of tranquilizer that is an antiemetic and antihistamine

phenothiazine

263

2 causes of abnormal capnograph readings

-hyperventilation
-hypoventilation

264

2 areas on a patient where you can monitor respiration function.

-mm
-crt
-chest movement

265

4 vital signs to monitor under anesthesia

1) respiration
2) heart rate
3) temperature
4) pain

266

3 body systems to monitor a patient that is on fluids

1) cardio
2) respiratory
3) renal

267

How can you make sure the patient is ventilating properly?

capnograph, eye position, rebreather bag

268

Name an anesthetic gas with no analgesia.

isoflurane

269

What causes pale pink mm

hypotension, vasoconstriction

270

1 method to check to make sure the pulse oximeter is working

put it on your finger

271

Definition of a preanesthetic drug.

drug given before anesthesia for analgesia or to reduce amount of anesthesia

272

When does recovery begin and end?

when the iso is turned off and the animal is awake and walking

273

Anesthetic depth depends on what:

-drugs
-route of administration

274

When checking cuff inflation, what indicates more inflation is needed?

hiss when you bag them

275

Advantages of the ET containing a side hole

mucus inside still gives O2 and anesthesia

276

4 reasons that effect recovery

1) how long the procedure was
2) the amount of drugs used
3) the patient's temperature
4) type of procedure

277

How can you check the correct placement of the ET tube with the machine

look at the rebreather bag, condensation in the tube

278

What procedure ensures that alectasis does not occur?

bagging the patient

279

What is a cause of back pressure?

pop-off closed

280

Name 4 safety features on an anesthesia machine.

1) pin index
2) pop-off valve
3) pressure reducing valve
4) unidirectional valves

281

Name 4 reflexes to monitor during anesthetic prodecures

1) PLR
2) swallowing
3) jaw tone
4) pedal

282

What tissues need a continuous supply of glucose for energy?

-Brain
-Kidney
-Red blood cells

283

T/F Animal's nutritional requirements shift from an omnivore to an obligate carnivore requiring higher amounts of protein and fat.

true

284

Clinical signs of hypermetabolic state

1) Tachycardia
2) Tachypnea
3) Hyperglycemia

285

Define anorexia

= loss of desire for food before caloric needs have been satisfied

286

What are some causes of anorexia?

1) Disease or trauma
2) Fear or stress
3) Medications

287

The 1st energy source used is in an animal who is going through starvation is _____(depleted within the 1st 24-72 hours)

glycogen

288

What is the GOAL of nutritional support?

provide the patient with adequate nutrition such that protein catabolism and negative nitrogen balance are corrected and/or prevented

289

Before starting nutritional support what must be corrected?

correct dehydration & acid/base disturbances

290

What should you consider when choosing a route?

-Available route of delivery
-Anticipated duration of enteral support
-Signalment
-Disease
-Condition of GIT

291

Serious Complications of Tube Feedings.

-Pulmonary aspiration
-Diarrhea
-Tube occlusion
-Bacterial contamination

292

How do you monitor gastric mobility?

Monitor by checking contents of stomach by aspirating tube prior to feeding

293

If greater than ___ of previous feeding remains in the stomach, recommend subsequent feeding be skipped.

1/3

294

What is an advantage and disadvantage of a Pharyngostomy Tube?

-adv: larger bore tube for wider variety of diets
-dis: placement through LES, too close to larynx

295

Pharyngostomy tube complications.

-Vomiting
-Aspiration pneumonia
-Pharyngitis
-Esophageal perforation
-Gastritis

296

T/F PEG (Percutaneous endoscopic gastrostomy) tubes can be use right after they are placed.

false-must wait 24 hours

297

Proportions of fat, carbohydrates, and protein in food fed to hospitalized patients should be similar to that which the liver is estimated to be using from body stores. By the fifth day of food deprivation or longer, patients should receive the majority (greater than 50%) of their calculated _____ as fat.

resting energy requirement (RER)

298

Define resting energy requirement.

amount of energy animal requires for rest in a post-prandial state

299

Candidates for parenteral nutrition (delivery of nutrients IV) are unable to digest or absorb nutrients via the ____, or have uncontrolled ____.

GI tract, vomiting

300

T/F Parenteral nutrition does not supply all of patient’s nutrient needs.

true

301

T/F Parenteral nutrition goal is to provide short-term support for animals that are expected to recover soon.

true

302

Parenteral nutrition calculations are based on patient’s?

RER, disease history, protein levels, and hydration status.

303

Most common complication to parental nutrition is?

sepsis or bacterial contamination

304

Complications of Total Parenteral Nutrition (TPN)

-Catheter occlusion
-Hypoglycemia
-Hyperglycemia
-Hyperlipidemia

305

What vitamin do you never give IV?

vitamin K

306

What is refeeding syndrome?

Electrolyte disturbance in patients with depleted intracellular ions in patients that are malnourished or starved

307

T/F Refeeding syndrome causes shift in patient from catabolic state where protein is primary energy source to anabolic state where carbohydrates are preferred energy source.

true

308

Refreeding syndrome causes dramatic shift of electrolytes from extracellular to intracellular, which electrolytes?

Phosphorus, potassium, magnesium

309

Refreeding syndrome causes dramatic shift of electrolytes from ____ to ____

extracellular, intracellular