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Surgery & Anesthesia

QuestionAnswer
Long term toxicity of inhalant anesthetics is thought to be caused by release of toxic metabolites during liver metabolism
The anesthetic most clearly associated with neurologic and adverse reproductive effects is Nitrous Oxide
Which of the following can be used to effectively monitor waste anesthetic gas levels? passive dosimeter badge
to conduct a low pressure test for an anesthetic machine you must Close the pop-off valve, turn on the flow meter, and occlude the end of the circuit. (all)
How often should a test for low pressure leaks be conducted? Each day that the machine is used
The safest way to transport a large high-pressure tank, such as an oxygen tank, is by using a handcart
A technician may reduce the amount of waste gas by using cuffed endotracheal tubes, ensuring that the anesthetic machine has been tested for leaks, and using an injectable agent rather than a mask or chamber (all)
In what units are waste anesthetic gas levels measured? Parts per million (ppm)
which of the following is a source of waste anesthetic gas? Exhaled by the patient during recovery
which of the following is true regarding short term exposure to waste anesthetic gas? resolve spontaneously when the area of exposure is left
Which is not a potential long term side effect of waste gas exposure? Thyroid cancer
What strategy is most effective at reducing waste gas exposure? Utilizing a scavenging system
which of the following inhalant gases is least likely to cause long term side effects Isoflurane
which of the following hospital areas contain the largest concentration of waste gas? recovery room, surgical suite, and surgical prep room
If the pop-off valve is inadvertently left shut, it will cause a significant rise of pressure within the circuit
A geriatric patient is considered to be one that has reached 75% of its life expectancy
How do you check if an ET tube is blocked? Bag he patient and see if their chest rises
How do you decrease the anesthetic risk for a geriatric pt.? Decrease the IV fluid rate
Which is true regarding anesthetizing pediatric pt. Tend to develop hypoglycemia, anesthetic drugs should be calculated at lower doses, and dextrose can be added to IV fluids to decrease risk (all)
Why should brachycephalics be oxygenated prior to anesthesia It provides a reserve of pure oxygen for them to draw on during induction
Obese pts are at increased risk during ax because it is difficult for them to fully expand their lungs, difficult to accurately dose anesthetic drugs, and anesthetics poorly distribute (all)
Who has the highest risk of vomiting or regurgitating while anesthetized? Pregnant dams
How long after impact are HBCs at risk for fatal cardiac arrhythmias? 72 hours
Which of the following is a sign of fluid overload? Increased respiratory rate
what condition makes pt most susceptible to fluid overload? Cardiac dz
What is an indication for an enterotomy? intestinal foreign body
what fracture fixation technique has the highest risk of infection? External skeletal fixator
Drug induced calm, pt is reluctant to move, aware of but unconcerned with surroundings tranquilization
Balanced anesthesia administration of multiple drugs at smaller doses than would be necessary if given alone
anesthetic agents have narrow therapeutic indices
anesthetic accidents may result in permanent dz or dysfunction, death, legal action against staff (all)
O2 tank half full, pressure gauge will read 1100 psi
O2 tank should be replaced at 500 psi
part of anesthetic machine that controls the amount of O2 going to the pt flow meter
anesthetic machines deliver inhalation and remove respiratory waste products
What part of ax machine enables a quick infusion of O2 into the breathing circuit? Oxygen flush valve
non rebreathing pt under 2.5 kg
2200 psi indicates the tank is full
flow meters with a ball gauge should be read from the middle of the ball
unidirectional valves on ax machine help control the direction of movement of gases
the pop-off valve helps prevent gas pressure from building up within the breathing circuit
spinal cord neurons become hypersensitive and interpret non-painful stimuli as painful wind-up
pop-off valve should only be closed when giving the patient a breath
continuous suture patterns are not as secure as interrupted patterns, are quicker to place and use less suture, and if one part of the suture line breaks the entire line fails (all)
small animal ax, when the pt is bagged the pressure manometer reading should not exceed 20 cm H2O
granule in the CO2 absorber have been depleted when granules are brittle, hard, and change color (all)
Pt. weighing 26.5 lb uses rebreathing
scavenger system attaches to the pop-off valve
first ground drape is placed on the side closest to the person draping
inadequate tissue perfusion during sx is most likely to damage kidneys
reservoir bag not moving well may indicate ET tube not in trachea, decreased tidal volume, or there is a leak around the ET tube (all)
pt attached to machine, pop-off valve should always be open
important to perform instrument/sponge count at beginning and end of sx to avoid leaving instruments or sponges inside the body
during surgical gowning the hands must remain inside the gown cuffs until the gloves are on
to aid in hemostasis apply firm pressure to site of hemorrhage, pass the appropriate hemostat, and blot, don't wipe, the blood (all)
presoaking instruments prevents blood and other surgical debris from drying on the instruments
eyes in ventral position indicate stage 3/plane 2 of anesthesia
exposed tissues are kept moist by dripping sterile solution onto them
the part of ring handled surgical instruments that lock the jaw closed is the ratchet
gentle tissue handling is important to avoid causing trauma to healthy tissue, avoid complications such as hemorrhage, dehiscence, etc, and avoid further compromising unhealthy tissue (all)
what contributes to hypothermia in a healthy pt anesthetic induced muscle relaxation, water and alcohol used in surgical prep, and administering room temperature IV fluids (all)
hypotension can be caused by cardiac insufficiency
when passing ring handled instruments the instrument should be gently laid in the surgeon's waiting hand
minimum pt database for young healthy cat having elective surgery should include PCV/TP, BUN, ALT, blood glucose
reflex that significantly diminishes or is absent in surgical plane of ax palpebral
monitoring device that measures O2 saturation pulse oximeter
how should you pass a scalpel handle? handle facing surgeon, blade facing away from you
untreated pulse deficits lead to shock
blood pressure cuff should be what percentage of limb width to ensure accuracy? 40%
eye position when too deep under anesthesia central
what breeds need to be watched closely under ax to ensure patent airway brachiocephalic
how to monitor respirations watch the reservoir bag, watch the tube fogging, chest auscultation (all)
unconscious pt responds to sx with movement is in what stage of ax? stage 3/plane 1
instruments on instrument table should be laid out with the ring handles facing you
if the patient is apneic turn inhalant gas down
normal SaO2 for anesthetized pt >95%
tachycardia may indicate pt is too light
ALWAYS an emergency dyspnea
pt is too deep hypotension
towel clamps that penetrate through the drape into the skin Bakhaus
good jaw tone (snapping back) pt is too light
losing consciousness, vocalizing and struggling stage 2
measure the length of the ET tube to the thoracic inlet
ET tube for brachiocephalic pt select 1-2 sizes smaller than measured
ET tube is too far pt will breath with abdominal press
dog with bcs of 8/9 will require more anesthetic per unit body weight false
overinflation of ET tube cuff results in tracheal necrosis
surgical assistant cannot wear sandals, nail polish, jewelry (all)
jerky abdominal respirations, loose jaw tone, bradycardic, prolonged CRT stage 3/plane 4
large O2 tanks should be stored chained to the wall
part of the anesthetic machine that does not need to be checked prior to use oxygen flush valve
pt breathing rapidly under anesthesia turn up inhalant gas
what retractor requires more than one person for proper use? Senn
what is the first thing you should do if the SaO2 reading is low? check your equipment
what should you NOT do if pt is bradycardic? turn up the inhalant gas
conscious, struggling, fearful stage 1
what part of scrubbed in gown are part of the sterile field front from chest to table
how should thumb forceps be held? like a pencil
appropriate breakfast on surgery day? whole wheat toast with PB
nail care practices for surgery day? clip shorter than fingertips and remove polish
surgical mask should cover nose and mouth
if you need to sneeze in surgery while wearing a mask step back from the table and don't turn your head
minimum time for pre-surgical scrubbing? 5 minutes
absence of what equals asepsis? all pathogenic microorganinsms that cause infection
scalpel blade used for declaw? 12
Unscrubbed assistant should not step between 2 scrubbed people in the surgical field, should not step between pt and equipment table, always face the surgical field (all)
when opening a pack and checking it for sterility check the sterile indicator on the package
surgical instrument "box locks" absorb the greatest stress during use
liquid seeping through the sterile drape is strike-through
if mucous membranes are blue, first check for obstruction of the ET tube
scalpel blade used for most dog/cat surgical procedures 10
sleeplike, non-responsive to verbal stimulus, aroused by painful stimulus stuporus
why are needle holders the only surgical instruments that should be used to hold metal? it is unsafe to use other instruments, it will wear the jaws of other instruments, it will place too much stress on the box lock of other instruments (all)
how long should small animals be fasted prior to surgery? 12 hours
atraumatic surgical instruments cause little damage to tissue
very young/small pt should be fasted ____as other animals not as long
healthy 6 month old puppy according to ASA physical status classification system P1
HBC w/internal bleeding (ASA) P5
signalment age, breed, gender
premature suture loss and surgical site opening dehiscence
debridement of infected scratch on dog's hind limb should be done in the prep room
needle holders with built in scissors Olson-Hegar
vessels in the skin halstead mosquito hemostat
what room should the autoclave go in? Scrub room
nonmovable equipment of surgery room overhead lights
moveable equipment of surgery room suction unit
after turning off the anesthetic vaporizer leave pt on oxygen for 5 minutes
pt is most likely to die during induction and recovery
postanesthetic pt is recovered when physiologic parameters have returned to normal
hemostats with serrations extending half way up the tip Kelly hemostats
recover period: thrashing, crying out, paddling limbs emergence delirium
Pt to be given reduced concentrations of anesthetic agents neonates, sighthounds, pt with liver or kidney dz (all)
terminal cleaning cleaning surgery and prep rooms and equipment at the end of a surgery day
never use to clean surgery room dry dusting
scissors to use to cut gastrocnemius muscle Mayo scissors
deactivate the effects of chlorine-based disinfectant fecal matter
significant finding in calm canine pt with regard to anesthetic risk increased respiratory effort
Surgical scissors with long, thin blades used to cut delicate tissue Metzenbaum scissors
hemorrhage from surgical incision apply direct pressure 5-10 minutes
seroma at surgical site due to overactivity
treatment for seroma warm compresses
operating scissors used to cut inanimate objects
treatment for emergence delirium hold pt, talk quietly to pt, ask vet to administer tranquilizer (all)
pt experiencing pain after surgery can be given both an opioid and an NSAID
instrument milk is for lubrication
can only be mixed with ketamine diazepam
system targeted by anesthetic agents brain
most general anesthetics provide analgesia false
why administer pre-meds sedation, calm excited animals, analgesia, muscle relaxation, make induction and recovery smoother (all)
not an appropriate route of preanesthetic agents PO
primary effect of anticholinergics (atropine, glycopyrrolate) increased heart rate
drug that provides analgesia dexmeditomidine
preanesthetic drug, causes hypotension, reduces seizure threshold Acepromazine
safe for high risk, geriatric animals diazepam
antibiotics should not be needed if sterile and aseptic technique were followed
side effect of propofol apnea
induction agents that cause sensitivity to light, sound, and touch dissociatives
best anesthetic gas for mask inductions sevoflurane
stage that smooth induction should bypass stage 2
what can kill a cat during anesthesia laryngospasm from improper intubation, leaving pop-off valve closed, incorrect calculation of pre-anesthetic drugs (all)
ring handled instrument rings should be held with thumb and ring fingers
pulse oximetry allows accurate estimation of SaO2 or percent saturation of hemoglobin with oxygen
bradycardic turn vaporizer down
hypotensive turn vaporizer down
fully dilated pupils, no PLRS turn vaporizer down
tachypnic turn vaporizer up
palpebral reflex turn vaporizer up
amount of oxygen animal is receiving is indicated by the flow meter
device that measures CO2 levels capnometer
surgical plane of anesthesia, pt eyes are ventral
Jaw with no tone "flapping in the breeze" indicates Pt is too deep
Cats and dogs should be fasted how long prior to surgery 12 hours
ASA classification- mildly anemic or moderately dehydrated P3
Most common reason veterinary staff are sued? lack of communication
common adverse affect of induction agents apnea
safe technique to prevent hypothermia in SA surgical pt circulating hot water blanket
two most important practices to prevent surgical infection aseptic and sterile technique
strike through renders drapes contaminated
only scrubbed in, sterile personnel should reach over the surgical field
regarding the surgical field excessive talking and movement among personnel is unacceptable
unscrubbed personnel should never face the surgical field false
surgical assistant is responsible for monitoring the patient, maintaining sterility, and maintain hemostasis (all)
unscrubbed personnel enter or touch the sterile field it is no longer considered sterile
the space above and around an open sterile pack is considered part of the surgical field
scrubs can be worn for surgery more than one day as long as no blood is on them false
fingernail polish protects against microbial growth false
consent forms for surgery/anesthesia are legally required
caps and masks are put on before scrubbing, gowning, and gloving
pt who is underweight will appear ___ dehydrated than they are more
necklaces can be worn when scrubbing in for surgery false
postoperative recovery period begins on discontinuation of anesthesia
what contributes to prolonged recovery from anesthesia? hypoglycemia, liver dz, kidney dz (all)
what can hasten recovery? physical stimulation, oxygen supplementation, warming measures (all)
when moveable equipment is removed from the surgery room it should be thoroughly cleaned and disinfected before being returned
if there are no instructions how do you clean stethoscopes, BP cuffs, and other non-critical items for the surgery room? clean then disinfect with alcohol
how often should surgery room floor be cleaned? daily
difference between antiseptics and disinfectants? antiseptics used on living tissue, disinfectants use on inanimate objects
contact time time required for disinfectant to be in contact with the microorganism to achieve intended effect
correct order to disinfect surgical instruments clean, sanitize, sterilize
neuroleptanalgesic combination of opioid and tranquilizer
opioid reversed with naloxone
to avoid transient apnea with propofol titrate in several boluses
problem associated with recovery from teletamine-zolzepam in dogs excitement
severe bradycardia caused by dexmedetomidine is treated with atipamezole
surgical instruments should only be used for their designated purpose to avoid damaging them, to protect their useful life, high quality instruments are expensive and should be handled with care (all)
part of anesthesia machine that converts liquid anesthetic to gas anesthetic vaporizer
what do you use to place scalpel blade in scalpel handle? needle holders
idiopathic pain is defined as pain of unknown cause
pathologic pain is pain caused by tissue injury
spay has what components of pain? both somatic and visceral
in multimodal analgesic therapy the dose of each drug is decreased when multiple drugs are used
how does treating pain affect wound healing? treating pain improves wound healing
an animal enduring pain is suffering
how do we prevent windup? adding analgesic to premeds prior to surgery
behavioral responses to pain vary depending on species, breed, age, and temperament, presence or absence of humans, and cats tend to hide, dogs seek owner attention (all)
when in perioperative period is analgesia needed? preanesthetic period, surgical period, postoperative period (all)
which analgesics also provide anti-inflammatory action, can cause GI unlers, and can be sent home with owners NSAIDs
which analgesics cannot be used with NSAIDs? corticosteroids
good nursing care includes keeping cages clean and dry, making sure pt surroundings are quiet, supplying a toy or blanket from home (all)
skipping patient prep may result in life-threatening complications
after administering pre-meds by IM injection place pt in quiet, dark cage where you can constantly observe them
most dangerous type of induction chamber induction
what type of induction allows anesthetist to control both increases and decreases in depth? inhalant induction
tracheal rupture caused by overzealous intubation
pt is significantly too deep turn off vaporizer
before repositioning pt disconnect ET tube from anesthetic machine
during recovery from anesthesia physiologic parameters should be monitored every 5 minutes until they return to normal
Created by: Molmae