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Post-op care

311.5 Vet nursing Basic post-operative care and planning for discharge

Why are pre-meds used before inducing anaesthesia in a patient? To reduce stress, amount of induction agent needed and amount of gas used
When are the 2 most dangerous times for a patient undergoing GA? Induction and recovery from anaesthesia
What is emergence delirium? Side effects of the patient coming around from anaesthesia. Can include limb rigidity, thrashing in the kennel, uncontrolled movements, vocalisation and limb paddling.
When should the vet be informed about a patient with emergence delerium? If it lasts longer than 5 mins
How long after extubation should you be concerned if a patient doesnt lift its head? Longer than 5-10 mins
7 reasons why a patient might take longer to come round from GA? Deep or long anaesthesia, Breed predispositions, Hypotension or shock, Liver or kidney disease, Intercranial disease, Hypoglycaemia, Hypothermia
When should an endotracheal tube be removed from a cat? Before first swallow, blinking and ear twitch
When should an endotracheal tube be removed from a dog? Once they start to swallow
When should an endotracheal tube be removed from a brachycephalic dog? Once they start to lift their head
How often should the patients respiratory rate, effort and character be monitored after GA? Every 5 mins for the first half hour and then 10 mins after for the next half hour and the patient is fully recovered
How often should the patients temperature be taken after GA? Normothermic: Every 30 mins. Hypothermic: every 15 mins until normothermic
What temp is termed as mild hypothermia? Around 36oC
What temp is termed as severe hypothermia? Around 34oC
8 patients who are at a higher risk of hypothermia Long anaesthesia, Abdominal surgery, Neonates, Thin animals, Geriatrics, Numerous procedures, Recieved drugs that can cause hypothermia (ACP, Iso), Given un-warmed IVFT
How often should heart, pulse rate, MM and CRT be monitored after GA? Every 10 mins for the first hour followed by every half hour for the first few hours then hourly thereafter
What can a low heart rate indicate in a patient recovering from surgery? Blood loss, Hypothermia, Drug reaction, Hypotension
What can a high heart rate indicate in a patient recovering from surgery? Pain, Hyperthermia, Drug reaction, Blood loss (in dogs)
When should wound dressings be put in place after surgery? Before the patient wakes up
How often should the surgical site be checked? Every 15 mins for the first hour and then hourly until discharge
What might be the signs of internal bleeding? Tachycardia, Pale MM, Increased CRT, Cold extremities, Bruising under skin, Leaking wound, Pain, Swelling, Collapse.
7 factors which could increase the chance of internal bleeding Coagulation disorders, Dislodge ligature around major vessel, Increase BP after surgery start small arteries bleeding, Liver disease, Platelet disorders, Removal of highly haematopoetic organ (spleen), Removal of complex tumours with good blood supplies
What is a seroma? A collection of fluid under the skin
How do seromas form? Usually when the patient is too active after surgery. Sutures in the subcut layers of skin rub and cause irritation to the underlying tissues
What is wound dehiscence? Wound breakdown leading to reopening of the surgical site. Can have serious and fatal consequences
10 factors which may cause wound dehiscence Infection, Interference by patient or other animals, Reaction to sutures, Exercise, Topical treatments, Sutures too tight/loose, Stress, Steroids, Unhealthy wound edges, Cushings/ hyperadrenocorticism
How often should pain scoring be carried out after surgery? Every 2 hours
When should food and fluid be offered to a patient after GA? As soon as they are fully awake unless undergone GI or dental surgery
Provision of food after surgery is especially important for which patients? Neonates, Elderly animals, Diabetics, Hypoglycaemic animals, Exotics and horses
When should a patient be taken outside after GA? As soon as they are fully awake and mobile
How long should they be given outside each time? At least 15 mins
How often should a patient on IVFT be taken outside? Every hour
Created by: 18000305