Test 2 Flashcards
(164 cards)
1
Q
How do we determine risk classification?
A
history, physical, testing
2
Q
If safety factor is not an issue what can you do?
A
choose lower cost
3
Q
Neonates are newborns up to how old?
A
8 weeks
4
Q
Pediatrics are how old?
A
8-12 weeks
5
Q
Neonates and Pediatrics are considered what kind of risk for Ax?
A
higher risk
6
Q
You are more dependent on heart rate for cardiac output in what patients?
A
neonates and pediatrics
7
Q
Which patients are more prone to airway obstructions?
A
neonates and pediatrics
8
Q
Neonates and pediatrics have a higher what?
A
resting heart rate and oxygen demand
9
Q
What function is not fully developed in neonates and pediatrics?
A
renal
10
Q
What is deficient in neonates and pediatrics?
A
hepatic microsomal enzymes
11
Q
Neonates and pediatrics are more susceptible to what?
A
hypothermia
12
Q
Neonates and pediatrics are always what class?
A
at least class 2
13
Q
With neonates and pediatrics you should always consider what route of Ax?
A
IH induction via mask
14
Q
In neonates and pediatrics you should use what kind of drugs when possible?
A
reversible
15
Q
Stress= what?
A
high risk anesthesia situation
16
Q
What are some indications of a stressed animal?
A
behavior, WBC on the high side, Glucose level increased
17
Q
How can you calm the patient?
A
handling techniques, sedatives or antianxiety medications
18
Q
What are some indications of dehydration?
A
skin tenting severe, elevated PCV, elevated TP
19
Q
How can you address dehydration?
A
rehydrate first before surgery or use fluids during surgery
20
Q
Dehydration greatly increases what?
A
Ax risk
21
Q
In patients with hypotension, what should be avoided?
A
acepromazine
22
Q
In patients with hypotension, what is important?
A
fluids
23
Q
In patients with hypotension, Ax levels should be what?
A
light
24
Q
In patients with hypotension, you should use what kind of Ax?
A
IH rather than injectable
25
Treat anemia with what?
Oxygen, fluids, blood transfusion
26
When should fluids be considered for a patient with anemia?
PCV less than 37%
27
When should a blood transfusion be considered for a patient with anemia?
PCV less than 20%
28
What is a normal PCV in dogs and cats?
37-54%
29
Which anesthetic is the best choice for patients with cardiac problems?
Isoflurane, stabilizes heart
30
How can you support a patient with cardiac problems?
oxygen and fluids
31
Which drugs should be avoided in cardiac patients?
Xylazine/Rompun, Barbiturates, Halothane, Propofol, Atropine
32
In patients with seizures what drugs should be avoided?
acepromazine and ketaset
33
Which drugs should you have on hand for patients with seizures?
valium
34
In patients with a low end of normalTP what should be done with barbiturates?
reduce dose and concentration
35
In patients with a TP <5 g/dl what should be done with barbiturates?
don't use
36
In patients with a TP < 3 g/dl what should be done?
administer plasma
37
In patients with liver and kidney disease, what induction agents should be used?
propofol, alfaxan, Val/Ket, IH mask or chamber
38
In patients with liver and kidney disease, what drugs should be used for maintenance?
isoflurane and sevoflurane
39
Which IH anesthetic is the first choice for patients with liver and kidney disease?
isoflurane
40
Which IH anesthetic has some concern with effect on kidneys?
sevoflurane
41
What agents should be avoided for patients with liver and kidney disease?
most injectable and older inhalation
42
How can you support a patient with liver and kidney disease?
fluids, oxygen, warmth
43
What affects ventilation?
obesity
44
What are some common problems in patients with obesity?
pancreatitis, diabetes, hepatic lipidosis, hypothyroidism, cardiac, orthopedic and intervertebral disk dx, arthritis
45
What should be done in patients with respiratory problems?
rapid inductions so can get on oxygen quickly
46
Patients with respiratory problems require what?
intubation
47
In patients with respiratory problems what route of induction should be used?
IV
48
In patients with respiratory problems what route of maintenance should be used?
IH
49
What should not be used in patients with respiratory problems?
mask or chamber inductions
50
What drugs should be used in patients with bradycardia?
atropine and glycopypropolate
51
What drug should be avoided in patients with tachycardia?
atropine
52
Rapid inductions are needed on what?
critically ill, respiratory patients, overweight animals, brachiocephalic patients
53
Why is rapid induction needed in certain cases?
so can get ET tube in and on oxygen quickly
54
When should oxygen and fluids be provided?
Ax periods lasting longer than 30 min and Class 3 or higher patients
55
What should be considered when choosing an Ax for a high risk (class 4-5) critical patient?
no depressant premeds, easy to detoxify, easy on heart, rapid induction
56
What Ax should be used in high risk critical patients?
IH rather than injectable
57
If you use injectables in high risk critical patients, which ones should be used?
alfaxan or propofol
58
How can you support high risk patients?
oxygen, intubation, IV fluids, inhalation Ax, low doses of Ax, warmth, close monitoring, short Ax time
59
What are the phases of anesthesia?
pre-anesthetic period, pre-anesthetic meds, induction, maintenance, recovery
60
What is included in the pre-anesthesia period?
patient evaluation, patient preparation, equipment and supplies
61
What tests should be done within 2 weeks of anesthesia?
full physical, complete CBC, urinalysis, history review
62
What tests should be done within 6 months of anesthesia?
Fecal, BUN, ALT, Creatine, Glucose, HWC
63
What should be done the morning of Ax?
TPR
64
How long should animals be off food before blood draw?
6-12 hours
65
Where should you collect blood on Ax patients?
jugular, medial saphenous/femoral on cats, saphenous on dogs
66
How full should you have blood collection tubes?
3/4 full for accurate test results
67
An ALT of 150 U/L is what?
high
68
A BUN of 36 mg/dl is what?
slightly high
69
A K of 2.9 mmol/L is what?
low
70
A T4 of 6.2 ug/dl is what?
high
71
What are some things that weight loss could be due to?
hyperthyroidism or early renal failure
72
Why should pre-anesthetic testing be offered to clients?
better medicine, reduce risks as much as possible, determine best Ax for patient
73
Patient evaluation and pre-anesthetic testing is a combination of what?
patient history, physical exam and clinical testing
74
Preanesthetic evaluation is essential to determine what?
health status of patient, what types of patient support will be needed, which Ax is safest, if surgery is worth risk
75
All agents used to provide sedation and anesthesia alter what?
cardiopulmonary function, thus contributing to patient risk
76
Patient evaluation includes consideration of what 4 categories?
patient characteristics, medical history, physical examination, patient testing- laboratory data
77
What are some patient characteristics that can call for special considerations?
species, breed, age, sex
78
What are some things that would be included in medical history?
injuries, diseases, illnesses, past Ax complications, concurrent or recent meds
79
What should be avoided in client communication?
yes or no questions, leading questions
80
Why is knowing your patients vaccination status important?
want to prevent spread of contagious disease between patients
81
Emphasis of the physical exam is on what systems?
cardiovascular, respiratory, hepatic, renal, central nervous
82
What should be included in a physical exam?
TPR, MM color, CRT, Weight and BCS, Ears, Teeth
83
What should be included in a physical exam in a male?
distention of testicles
84
What should be included in a physical exam in a female?
signs of being in heat
85
What can pale MM means?
preexisting anemia, hypothermia or pain
86
What does PCV and Hb indicate?
ability of hydration and ability of blood to deliver oxygen
87
Either a high or low PCV means what?
increased Ax risk
88
Patients with a high or low PCV need what?
extra support
89
Minimum PCV pre-op
27 to 30%
90
Minimum PCV during surgery
20%
91
Anemia with PCV below 20% what should be done?
fluids not enough, blood transfusion to ensure adequate blood and Hb to carry oxygen
92
What is an abnormally high result for dehydration in dogs?
above 54
93
What is an abnormally high result for dehydration in cats?
above 45
94
What is a normal TP range in dogs?
5.7-7.8
95
What is a normal TP range in cats?
6.3-8.3
96
Increased TP means what?
dehydration
97
Decreased TP means what?
hypoproteinemia
98
What can hypoproteneimia be from?
renal, hepatic, GI disease, or breed
99
A low TP is a special concern with what?
barbiturates
100
What should be done when you have an abnormal urinalysis?
further testing, run fluids, appropriate Ax, support with oxygen
101
What are the most common blood chemistries done for Ax screening?
ALT, Creatine, BUN, Blood Glucose
102
Why is it important to know liver and kidney function?
commonly used Ax agents are metabolized by the liver and kidney
103
What are the common Ax agents are metabolized by the liver and kidney?
domitor, ketaset, xylazine, telazol, ace
104
High WBC values mean what?
infection or stress
105
High WBC reduces what?
immunity and body's ability to eliminate Ax and recover from Sx
106
Infections become worse with what?
anesthetic
107
Infections spread with what?
Surgery
108
What should you do if you have a patient with a high WBC count?
postpone procedure, start antibiotics, select appropriate Ax, support with fluids and oxygen
109
Given the busy nature of a veterinary practice, it is probably best to assume that the same anesthetic protocol should be used on all patients, true or false?
false
110
Different species may have different physiologies in regard to the metabolism of drugs, true or false?
true
111
An obese dog will require more anesthetic than a normal weight dog of the same breed, true or false?
false
112
Blood tests such as ALT have minimal value for an anesthetist, true or false?
false
113
It is always best to withhold food and water from any patient scheduled to receive a general anesthetic for at least 12 hours before the scheduled procedure, true or false?
false
114
What is not crystalloid solution
Dextran
115
What is not a valid reason for administering a preanesthetic medication?
it increases patient safety by allowing the animal to stay under the general anesthetic for a longer time
116
Most preanesthetics will not cross the placental barrier, true or false?
false
117
It is recommended that atropine not be given to an animal that has tachycardia, true or false?
true
118
Anticholinergic drugs such as atropine block the release of acetylcholine at the what?
muscarinic receptors of the parasympathetic system
119
Phenothiazine tranquilizers such as acepromazine sedate the animal and give some analgesia, true or false?
false
120
In general, the opioids can have a significant effect on the cardiovascular and respiratory systems, causing bradycardia and respiratory depression, true or false?
true
121
A patient that is anemic or moderately dehydrated would be classified as what class?
Class III
122
When the oxygen tank is half full, the pressure gauge will read approximately how many psi?
1000
123
What will the pressure gauge of a nitrous oxide tank read when the tank is full?
750 psi
124
What will the pressure gauge read when the nitrous oxide tank is half full?
750 psi
125
Nitrous oxide is present in the tank as a what?
liquid and a gas
126
The amount of oxygen an animal is receiving is indicated by the what?
flowmeter
127
Flowmeters have a ball for reading the gauge should be read from the what?
Middle of the ball
128
The best flow rate to use with nitrous oxide and oxygen would be a combination of what?
33% oxygen and 67% nitrous oxide
129
What is the minimum size that a reservoir bag can be calculated by?
60ml/kg
130
The flutter valves on an anesthetic machine help do what?
control the direction of movement of gases
131
The pop-off valve us part of the anesthetic machine and helps what?
prevent excess gas pressure from building up within the breathing circuits
132
When the pressure manometer reading exceeds what cm of water pressure, it indicates there is a buildup of pressure within the circuit that could be dangerous
15
133
Rebreathing systems are best reserved for animals over 7kg, true or false?
true
134
Rebreathing is determined primarily by the what?
fresh gas flow
135
Nonrebreathing systems should have maintenance flow rates that are what?
very high (>130ml/kg/minute)
136
The negative pressure relief valve is particularly useful when?
there is insufficient oxygen flow through the system
137
The tidal volume of an animal is considered to be _____ml/kg of body weight?
5-10
138
A reservoir bad that is not moving may indicate what?
The ET tube is not in trachea, the animal has a decreased tidal volume, there is a leak around the ET tube
139
The anesthetist will know when the granules in the carbon dioxide absorber have been depleted because of what?
the granules will be brittle, change color, or be hard
140
An increase in the depth of Ax can be achieved quickly by what?
having high oxygen flow rates, having high vaporizer settings, or bagging the animal with the vaporizer on
141
The concentration of anesthetic delivered from a non precision vaporizer may depend on the what?
temp of the liquid Ax, flow of the carrier gas through the vaporizer, and back pressure
142
The advantages of a non precision vaporizer include what?
it is economical to buy and is easy to clean and service
143
Low flow Ax means what?
using flows that only meet the metabolic requirements of the animal on oxygen
144
The disadvantages of low-flow Ax include what?
it may allow carbon dioxide to accumulate in the circuit and it can't be used with nitrous oxide
145
Using special techniques, non precision vaporizers can be used for what?
low flow Ax and delivery of iso
146
As depth of Ax increased, there will be a continued depression of the vital centers of the body, true or false?
true
147
The surgical plane of Ax is generally considered to be what?
Stage III, plane 2
148
Breath holding, vocalization, and movement of the limbs are most likely an indication that the animal is in what stage/plane of Ax?
Stage II
149
Anatomic dead space is considered to be the what?
air within the mouth, nose, and all airways except the alveoli
150
The minimum acceptable HR for an anesthetized large breed dog is how many beats per minute?
60
151
A heartbeat that is audible through a stethoscope is a good indicator that there must also be a strong pulse, true or false?
false
152
In general, a respiratory rate less than how many bpm for an anesthetized patient should be reported to the veterinarian?
8
153
Tachypnea is what?
an increased respiratory rate
154
The term atelectasis refers to what?
collapsed alveoli
155
A patient that has been anesthetized usually will have a what?
mild respiratory acidosis
156
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, true or false?
false
157
After an anesthetic procedure, when is it best to extubatne a dog?
when the animal begins to swallow
158
Hypostatic congestion may be present at the end of the anesthetic protocol. This term refers to what?
pooling of blood in the lungs
159
Pulse oximetry allows accurate determination of what?
percent saturation of hemoglobin
160
Pale MM may be an indication of what?
blood loss, anemia, or decreased perfusion
161
An ET tube is used to do what?
decrease dead air space, allow for patent airway, protect patient from aspiration of vomitus, allow anesthetist to ventilate patient
162
Possible complications of ET intubation includes what?
pressure necrosis of the tracheal mucosa, intubation of a bronchus, obstruction of the ET tube, spread of infection disease
163
An animal under stage III, plane 2 Ax would exhibit what signs?
regular respiration and relaxed skeletal muscle tone
164
As you intubate an ET tube into an animal, what clinical signs will indicate to you that the ET tube is in the trachea?
animal may cough, feel tube in the neck region, and the reservoir bag will move as the patient breathes
