Test 4 Flashcards
(214 cards)
1
Q
Barbiturate drugs have a pH that is what?
A
strongly alkaline (>9.5)
2
Q
Drugs that are highly fat soluble are likely to be taken up by the brain more quickly than drugs that are not fat soluble, true or false?
A
true
3
Q
What is an example of a dissociative anesthetic?
A
ketamine hydrochloride
4
Q
One of the disadvantages of the drug methohexital is that animals that are anesthetized with it often may demonstrate excitement during recovery, true or false?
A
true
5
Q
Metabolism and elimination of ketamine hydrochloride are the same in the dog as they are in the cat, true or false?
A
false
6
Q
Compared with methoxyflurane, halothane is considered to have what?
A
a higher vapor pressure
7
Q
Halothane may sensitize the heart to catecholamines, true or false?
A
true
8
Q
Halothane is moderately soluble in rubber, which may result in release of this gas from anesthetic equipment , true or false?
A
true
9
Q
An anesthetic agent that has a low solubility coefficient will result in what?
A
fast induction and recovery time
10
Q
What is an example of a volatile anesthetic with a high solubility coefficient?
A
methoxyflurane
11
Q
As a rough guideline, to safely maintain a surgical plane of anesthesia, the vaporizer should be set at what?
A
1.5 X MAC
12
Q
Isoflurane is a more potent cardiac depressant than halothane, true or false?
A
false
13
Q
A patient known to have pulmonary dysfunction would be considered a ____ candidate to receive nitrous oxide?
A
poor
14
Q
To be considered effective, nitrous oxide should be used in concentration of what?
A
60%
15
Q
The depressant effects that barbiturates have on the vital centers of the body are less likely to occur if what?
A
only a dilute solution is used, injection of drug is not too rapid
16
Q
What are some effects that Halothane may have on the body?
A
vasodilation, sensitization of myocardium to catecholamines, depression of myocardial cells, respiratory depression
17
Q
What are some effects that barbiturates may have on the body?
A
reduction of respiratory rate, cardiac arrhythmias, decreased blood pressure
18
Q
The concentration of barbiturate entering the brain is affected by a variety of factors such as what?
A
perfusion of the brain, lipid solubility of the drug, plasma protein levels, blood pH of the animal
19
Q
What are some effects that are commonly seen after administration of a cyclohexamuine drug?
A
increased blood pressure, HR, CSF pressure, and ocular pressure
20
Q
What are some effects that Isoflurane may have on the body?
A
depression of respiration
21
Q
MAC will vary with what?
A
temp of patient, age of patient, species, Ax agent
22
Q
What are some factors that may affect the speed of the induction process with a volatile gaseous anesthetic?
A
solubility coefficient of the agent and concentration of the agent
23
Q
Nitrous oxide may be included as part of an anesthetic protocol because why?
A
has good analgesic properties, will reduce amount of volatile anesthetic needed, has minimal depressant effects on the respiratory or cardiovascular centers
24
Q
When pentobarbital sodium is used as an anesthetic, what may be noted?
A
relatively slow onset of action, respiratory depression, poor analgesia, slow recovery
25
What drugs may be safely given IM or IV in a cat?
telazol and ketamine hydrochloride
26
As the depth of anesthesia increase, there will be a continued depression of the vital centers of the body, true or false?
true
27
The surgical plane of anesthesia is generally considered to be what?
stage III, plane 2
28
Breath holding, vocalization, and movement of the limbs are most likely an indication that the animal is in what stage/plane of anesthesia?
Stage II
29
Anatomic dead space is what?
air within the mouth, nose, and all airways except the alveoli
30
The minimum acceptable heart rate for an anesthetized large breed dog is what?
60 beats per minute
31
A heart beat that is audible through a stethoscope is a good indicator that there must also be a strong pulse, true or false?
false
32
In general, a respiratory rate of less than what breaths per minute for an anesthetized should be reported to the veterinarian?
8
33
What is tachypnea?
an increase in respiratory rate
34
What does the term atelectasis refers to what?
collapsed alveoli
35
A patient that has been anesthetized usually will have a what?
mild respiratory acidosis
36
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
37
After an anesthetic procedure, when is it best to extubatne a dog?
when the animal begins to swallow
38
What is hypostatic congestion?
pooling of blood in the lungs
39
Pulse oximetry allows accurate determination of what?
percent saturation of Hb
40
Pale mucous membranes may be an indication of what?
blood loss, anemia, decreased perfusion
41
An ET tube is used to do what?
decreased dead space, allow for patent airway, protect the patient from aspiration of vomitus, allow the anesthetist to ventilate the patient
42
Possible complication of ET intubation includes what?
pressure necrosis of the tracheal mucosa, IT of the bronchus, obstruction of the ET tube, spread of infectious disease
43
An animal under stage III, plane 2 anesthesia would exhibit which of the following signs?
regular respiration and relaxed skeletal muscle tone
44
As you intubate an ET tube into an animal, what clinical signs will indicate to you that the endotracheal tube is in the trachea?
the animal may cough as you insert the tube down the trachea, you can feel only one tube in the neck region, the reservoir bad of the anesthetic machine moves as the patient breathes
45
Diazepam is a safe agent for Ax premedication and induction, true or false?
true
46
Diazepam effectively does what?
relaxes muscles and controls convulsions
47
What does Diazepam stimulate?
appetite
48
What does diazepam relieve?
anxiety
49
Unlike major tranquilizers, diazepam does not significantly do what?
sedate or tranquilize most animals
50
Diazepam can produce significant sedation in what kind of patients?
geriatric or debilitated animals
51
Is Diazepam considered to be a sage pre-Ax agent for geriatric or debilitated patients?
yes
52
Does Diazepam adversely effect the heart or blood pressure?
no
53
Diazepam is also used as a premed in what patients?
animals with seizure disorders
54
Since Diazepam decreases the possibility of seizures during pre-Ax and recovery periods, it is often used as a preanesthetic in what?
animals that are schedules to undergo a diagnostic or surgical procedure of the spinal cord or brain
55
What combination with diazepam has become widely accepted as an inexpensive, safe, and effective alternative to barbiturate induction in small animals?
ketamine
56
What agents are known to stimulate appetite in cats?
diazepam and the similar flurazepam and oxazepam
57
The anti anxiety effect of diazepam has led to its use for what in dogs, cats, and horses?
behavioral disorders
58
What behaviors are believed to arise in part from internal conflict and anxieties with the use of diazepam?
urine spraying in neutered animals, noise phobias, aggressive or destructive behaviors and excessive grooming
59
Treatment with what is often helpful in resolving undesirable behavior, particularly in cats?
oral diazepam for 2-8 weeks
60
Diazepam has also been used clinically to treat what in inexperienced stallions before breeding?
nervousness
61
Diazepam should be used with care in what?
neonates and animals with liver disease
62
Why should Diazepam be used with care in neonates and animals with liver disease?
because the drug is poorly metabolized in such patients
63
Animals given oral diazepam on a long-term basis should be closely monitored for what?
liver dysfunction
64
What may be evident after diazepam administration?
sedation, ataxia, and paradoxic excitement and/or aggression
65
What is the major sign of overdose with diazepam?
excessive sedation, with minimal effects on respiration, pulse, or blood pressure, unless overdose is extreme
66
Why should Diazepam not be mixed in a single syringe with atropine, ace, maleate, barbiturates, or opioids?
precipitate may result
67
Where should Diazepam be kept?
in secured and locked cabinet
68
Valium has minimal adverse effects on which systems?
cardiovascular or respiratory
69
Does valium have a wide margin of safety?
yes
70
Does diazepam work well in aggressive patients?
no
71
Why does Diazepam not work well in aggressive patients?
normal inhibitions and training are removed and animal may become worse to handle
72
Propylene-glycol based product may cause what?
dysrhythmias
73
Why can Valium not be used for C-sections?
crosses blood barrier
74
Valium used in animals with liver dysfunction results in what?
it being poorly metabolized
75
What is the dose for diazepam as a pre-ax?
.5 mg/kg
76
What is the pre-ax dose for animals suffering from seizure disorders?
.2 - .6 mg/kg tid
77
What is the dose for diazepam when used for appetite stimulation?
.2mg/kg
78
What is the dose for diazepam in cats with behavioral problems?
1-2mg/kg bid
79
What is the dose for IM injection of Diazepam in dogs and cats?
.1 - .5 mg/kg
80
What are the 4 periods of general anesthesia?
pre-ax, induction, maintenance, recovery
81
What is induction anesthesia?
anesthetic that patients are given that causes unconsciousness
82
When are pre-meds administered?
may or may not be given first
83
What are 5 characteristics of the ideal induction anesthetic?
1. A smooth and calm transition from consciousness to unconsciousness
2. Abolishes swallowing reflex
3. Brief duration of effect
4. Produces minimal toxicity
5. Requires minimal metabolism for recovery
84
What are the sequence of events during induction?
uncoordinated or excitement, analgesia, muscle relaxation, cessation of movement, unconsciousness, loss of reflexes such as ability to swallow, cough, blink
85
What will occur if excessive induction anesthetic is given?
respiratory and cardiac arrest
86
What are the 4 possible routes of administration for the induction anesthetic?
IV, IH, IM, Oral
87
Which route of administration is most commonly used for induction?
IV
88
Which route of administration will provide the fastest unconsciousness?
IV
89
What are 4 possible IV induction agents?
Barbiturate, Diazepam/Ketaset, Ace/Atropine/Ketaset, Propofol
90
What are 2 common methods of IH induction?
nose cone and chamber
91
Waste anesthetic gases are a potential hazard to personnel, but problems that arise are really only short-term nature, true or false?
false
92
Long-term toxicity of inhalation anesthetics is thought to be caused but the release of toxic metabolites during the breakdown of these drugs, true or false?
true
93
What anesthetic is thought to be the least toxic to hospital personnel?
isoflurane
94
In the United States, the National Institute for Occupational Safety and Health recommends that the levels of waste anesthetic gases for anesthetic such as isoflurane, halothane, or methoxyflurane should not exceed what?
2 ppm
95
The odor of halothane may be detected by a person when levels reach a minimum of what?
33 ppm
96
Rooms in which animals are recovering from anesthesia may be highly contaminated with waste gas, true or false?
true
97
It is recommended that for a passive scavenger system, the hose be no longer than how many feet if it discharged into the room ventilation exhaust?
10 feet
98
How often should a test for low-pressure leaks be conducted?
each time machine is used
99
The safest way to transport a high-pressure tank, such as an oxygen tank, is by what?
a handcart
100
Room in which waste anesthetic gases are at risk of being released should have a minimum of how many air changes per hour?
15
101
Long-term hazards that may occur from exposure to high levels of anesthetic waste gases include what?
Reproductive disorders, liver damage, kidney damage, nervous system dysfunction
102
A technician may reduce of wastes gases by?
using cuffed endotracheal tubes, ensuring the anesthetic machine has been tested for leaks, using an induction technique other than mask or chamber
103
To conduct a low-pressure test on an anesthetic machine you must do what?
close the pop-off valve and occlude the end of the circuit, compress the reservoir bag, pressurize the circuit with a volume of gas
104
What is a big source of heat loss during anesthesia?
the lungs because oxygen is cold and dry
105
Where do humid vents attach?
between ET tube and breathing hoses
106
What do humid vents do?
warms air, traps moisture, humidifies the air, keeps capnograph dry
107
Can humid vents be disinfected?
no
108
What is the cost of a humid vent?
$4.00 - $200.00 each
109
What are some ways a patient under Ax can display signs of pain?
increased HR, increased RR, decreased CO2 levels during expiration, increased BP, pupil dilation, sweating, salivation, patient movement
110
The stages of Ax are based on what?
patient behavior, body movements, ocular signs, reflexes, and vital signs
111
Goal of Ax is to pass through which stages quickly
1 and 2
112
Stage 1 of Ax begins when?
when induction anesthetic is started
113
What is the patients behavior like in stage 1 of Ax?
gradually loses consciousness, disoriented but conscious
114
What are respirations for a patient under stage 1 of Ax?
normal, breath holding, panting
115
What is the HR like for a patient under stage 1 Ax?
unchanged
116
What is the depth of a stage 1 Ax?
not anesthetized
117
What is the eyeball location for stage 1 Ax?
central
118
What is the pupil size for stage 1 Ax?
normal
119
What is the pupil response to light for stage 1 Ax?
present
120
What is the muscle tone for stage 1 Ax?
good
121
Reflexes for stage 1 Ax?
all present
122
What is stage 2 called?
excitatory
123
What does stage 2 begin with?
unconscious, patient loses voluntary control but reflexes are present
124
What is the behavior for stage 2?
fearful, excitement, struggling, vocalization, paddling, involuntary movement, may urinate and defecate
125
What are respirations for stage 2?
irregular, may hold breath or hyperventilate
126
What are HR for stage 2?
usually increases
127
What is the depth for stage 2?
not anesthetized
128
What are the MM color for stage 2?
pink
129
Eyeball location for stage 2?
central and/or nystagmus
130
Pupil size for stage 2?
often dilated
131
Pupil response to light for stage 2?
yes
132
Muscle tone for stage 2?
present- good
133
Palpebral-wink reflex for stage 2?
lateral and medial present
134
Reflexes for stage 2?
present- may be exaggerated
135
Stage 3 is divided into how many planes?
4
136
What is the first plane of Ax?
very light
137
What is the second plane of Ax?
surgical plane
138
What is the third plane of Ax?
deep Ax
139
What is the fourth plane of Ax?
heading for overdose and death
140
What is stage 3 called?
surgical anesthesia
141
In stage 3 the patient is what?
unconscious and progresses gradually from light to deep surgical Ax
142
Muscle relaxation in stage 3?
progressive muscle relaxation
143
HR and RR in stage 3?
decreasing
144
Reflexes in stage 3?
gradually disappear
145
Pupils in stage 3?
gradually dilate, tear production decreases
146
Pupillary reflex to light in stage 3?
gone
147
What is stage 3 plane 1 called?
light Ax
148
Behavior in stage 3 plane 1?`
unconscious
149
Respirations in stage 3 plane 1?
12 to 24 bpm- regular in rhythm
150
Cardiovascular in stage 3 plane 1?
heart beat is regular and strong- >90bpm
151
Depth in stage 3 plane 1?
light Ax
152
MM in stage 3 plane 1?
capillary refill time good, pink to a little cyanotic
153
Eyeball location in stage 3 plane 1?
central or rotated
154
Pupil size in stage 3 plane 1?
normal
155
Pupil response to light in stage 3 plane 1?
yes
156
Muscle tone in stage 3 plane 1?
present
157
Reflexes in stage 3 plane 1?
gagging and swallowing depressed, may still respond to pain, movement, respirations increase, HR increase, BP increase
158
Pedal reflex in stage 3 plane 1?
Present but diminished
159
Palpebral reflex in stage 3 plane 1?
present but diminished
160
What is stage 3 plane 2 called?
medium, surgical Ax, moderate
161
Behavior in stage 3 plane 2?
unconscious, anesthetized
162
Respirations in stage 3 plane 2?
regular, may be shallow
163
Cardiovascular in stage 3 plane 2?
HR above 80-90 bpm
164
Depth in stage 3 plane 2?
moderate
165
Response to surgery in stage 3 plane 2?
HR and resp may increase
166
MM in stage 3 plane 2?
pink
167
Eyeball location in stage 3 plane 2?
often rotates ventrally
168
Pupil size in stage 3 plane 2?
slightly dilated
169
Muscle tone in stage 3 plane 2?
relaxed
170
Stage 3 plane 3 is called what?
deep surgical Ax
171
Behavior in stage 3 plane 3?
unconscious, anesthetized
172
Respirations in stage 3 plane 3?
regular, shallow and slow, abdominal breathing, paralysis of intercostal muscles
173
Cardiovascular in stage 3 plane 3?
60-90 bpm, BP drops, pulse weakens
174
Depth in stage 3 plane 3?
deep
175
Response to surgery in stage 3 plane 3?
none
176
MM in stage 3 plane 3?
start to blanch or pale
177
Eyeball location in stage 3 plane 3?
usually central, may rotate ventrally, 3rd eyelid prolapsed, cornea dry
178
Pupil size in stage 3 plane 3?
moderately dilated
179
Pupil response to light in stage 3 plane 3?
very sluggish or absent
180
Muscle tone in stage 3 plane 3?
greatly reduced
181
Ear flick and pedal reflex in stage 3 plane 3?
absent
182
Palpebral in stage 3 plane 3?
lateral and medial gone
183
Jaw tone in stage 3 plane 3?
very little to none
184
Behavior in stage 3 plane 4?
in danger of imminent respiratory and cardiac arrest
185
Respirations in stage 3 plane 4?
very slow or non existent
186
Cardiovascular in stage 3 plane 4?
CV system collapses, pulse slows <60 bpm, BP decreases
187
Depth in stage 3 plane 4?
overdose
188
Response to surgery in stage 3 plane 4?
none
189
MM in stage 3 plane 4?
prolonged CRT, MM pale, cyanotic
190
Eyeball location in stage 3 plane 4?
centrally fixed
191
Pupil size in stage 3 plane 4?
widely dilated
192
Pupil response in stage 3 plane 4?
unresponsive
193
Ear flick, pedal, and palpebral reflex in stage 3 plane 4?
none
194
What is stage 4?
overdose
195
What happens to the nervous, cardiovascular, and respiratory systems during stage 4?
extremely depressed
196
Cardiovascular in stage 4?
dysrhythmia, fibrillation or systole
197
MM in stage 4?
white, cyanotic, pink
198
Eyeball position in stage 4?
central
199
Pupil size in stage 4?
widely dilated
200
Pupil response to light in stage 4?
none
201
Patients reach stage 3 plane 2 more rapidly with which induction route?
IV
202
What induction route takes longer for the patient to reach stage 3 plane 2
IH
203
Patients under Iso have what kind of recovery?
rapid
204
What kind of safety does Iso have?
unsurpassed
205
Iso allows a reduced what?
pre-op and post-op time
206
Iso allows the ability to perform what on high risk patients?
safer anesthesia
207
Iso allows the ability to keep patient safely under Ax for how long?
long periods
208
What is the induction rate for Iso in dogs?
2-4%
209
What is the induction rate for Iso in cats?
2-3%
210
What is the induction rate for Iso in birds?
1.5-2%
211
What is the oxygen flow rate for Iso during intubation?
3000 cc
212
What is the oxygen flow rate for Iso for a chamber induction?
1 liter per gallon chamber
213
What is the oxygen flow rate for Iso mask induction for an animal that weighs less than 5 pounds?
3000cc/min
214
What is the oxygen flow rate for Iso mask induction for an animal that weighs more than 5 pounds?
5000cc/min
