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A&S - Week 1
Intro
| Question | Answer |
|---|---|
| Define Anaesthesia | Lack of sensation (touch and pain) |
| Define General Anaesthesia | Elimination of sensation by controlled, reversible depression of the CNS. |
| Define Local Anaesthesia | Elimination of sensation by controlled, reversible depression of peripheral sensory and motor nerves. |
| Define Analgesia | Lack of pain |
| Define Ataractic | Form of tranquilliser |
| Define Anti-tussive | Reduces coughing |
| Define Hypnosis | Drug-induced sleep |
| Define Narcosis | A state of stupor or insensibility (no response to stimuli) |
| Define Neuroleptic | Form of tranquilliser |
| Define Neuroleptanalgesia | A combination of opioid pain relief and a tranquilliser which together gives a more profound effect than either drug alone. |
| Define Sedation | Relaxation of muscles, reduced excitability and mental activity |
| Define Tranquilliser | Reduces excitability and anxiousness with less muscle relaxation |
| Define Sterility | Absence of microbes on an inanimate object |
| Define Asepsis | Absence of micro-organisms that cause disease |
| What is a Clean Procedure? | No break in asepsis, surgery does not enter contaminated area (orthopaedics). |
| What is a Clean-Contaminated Procedure? | Minor break in asepsis (glove puncture, gastronomy, enterectomy, neutering), surgery enters contaminated area with no infection or spillages of contents. |
| What is a Contaminated Procedure? | Break in asepsis with spillage of contents into a cavity or area. Surgery may enter an area with high bacteria load and/or inflammation, but there is no infection present. Wounds over 4 hours old enter this category. |
| What is a Dirty Procedure? | Surgery with pus and infection present, foreign bodies and/or necrosis may be present (ruptured pyo, old wounds). |
| When Do We Use Anaesthesia? | -Surgery -Restraint (for clinical examination, radiography) -Pain relief -Control status epilepticus -Euthanasia |
| What Is The Triad Of (General) Anaesthesia? | -Hypnosis -Analgesia -Muscle relaxation |
| What Major Body Systems Are Effected By Anaesthesia? | -Cardiovascular -Respiratory -Gastro-Intestinal -Endocrine -Hepatic -Renal |
| What Are The Main Groups Of Anaesthetic Drugs? | -Tranquillisers -Sedatives -Opioid-Analgesics -NSAIDS -Intravenous Anaesthetic Agents -Inhaled (Volatile) Anaesthetic Agents -Local Anaesthetics -Nero-Muscular Blocking Agents |
| How Can Informed Consent Be Achieved During The Admit Process For A Surgery? | -Discuss all associated risks (surgical and relating to anaesthetic) -Information to be given verbally and written (info sheet) -Procedure discussed in full, keep language simple -Consent form signing (legal document) -Price estimate |
| What Are The Main Components Of A Pre-Op Assessment? | -Signalment (age, breed, weight, sex) -History (on-going conditions) -Physical examination -Pre-anaesthetic blood test -Any further diagnostic tests needed |
| What Are The 5 Anaesthetic Risk Classes? | 1 - Minimal risk, healthy animal 2 - Slight risk, mild systemic disturbance, no clinical signs 3 - Moderate risk, mild clinical signs 4 - High risk, pre-existing disease 5 - Grave risk, life-threatening |
| What Must Be Checked During A Pre-Op Physical Examination? | -General body condition -TPR -Hydration status -Mentation/behaviour -Abdominal palpation |
| What Is Commonly Checked On A Pre-Anaesthetic Blood Test? | RBC Count = Oxygen carrying capacity ALT/ALP = Liver markers Urea/Creatinine = Kidney markers Glucose = Diabetes/stress Albumin/TP = Protein levels |
| What Factors In A Patient Increase Anaesthetic Risk? | -Conditions effecting oxygen uptake/transport -Inability to metabolise/excrete anaesthetic drugs -Toxins pre-disposing to shock and cardiac arrhythmias -Hypothermia |
| Why Might Geriatrics Have An Increased Anaesthetic Risk? | -Poor organ function -Osteoarthritis/pre-existing conditions |
| Why Might Neonates Have An Increased Anaesthetic Risk? | -Easy to develop hypothermia/over-hydration -Liver may not metabolise anaesthetic drugs efficiently -Difficult at times to intubate/place IV catheters |
| Why Might Obese Animals Have An Increased Anaesthetic Risk? | -At risk of overdose with drugs (as much of bodyweight is fat with a very poor blood supply and should not be included in dose calculations) -Fat within chest impairs respiratory function *Doses should be calculated using an estimated lean bodyweight* |
| Why Might Brachycephalic Animals Have An Increased Anaesthetic Risk? | -Upper airway obstruction -Abnormally high vagal tone (i.e. tendency for parasympathetic effects to predominate over sympathetic effects - slow heart rate, low blood pressure, slow respiratory rate) -High chance of gastro-oesophageal reflux |
| Why Might Animals With Cardiac Disease Have An Increased Anaesthetic Risk? | -Potential for arrhythmias is greater under anaesthetic -Decompensated heart disease (where fluid is accumulating in lungs) provides a real challenge as it may be very difficult to get enough oxygen in via the damaged lungs and circulation. |
| Why Might Animals With Respiratory Disease Have An Increased Anaesthetic Risk? | -Reduced ease of intubation -If sedated, risk of obstruction may be greater as they are unable to lift their head or change position -Lower respiratory disease will affect ability to exchange oxygen |
| Why Might Animals With Hepatic Disease Have An Increased Anaesthetic Risk? | -Most of the anaesthetic drugs require metabolism by the liver before excretion, so if function is impaired excretion of the drugs may be slow -Clotting times may be increased |
| Why Might Animals With Renal Disease Have An Increased Anaesthetic Risk? | -Excretion of many anaesthetic drugs requires a functional kidney -Dehydration may be present -In cases of urinary obstruction excretion of drugs via kidneys is impossible until the obstruction is relieved -Hyperkalaemia will cause bradycardia |
| Why Do Animals Undergoing Caesarean Have A High Anaesthetic Risk? | -Pressure on chest from abdominal contents - significant risk of blood loss -Anaesthetic agents may cross placenta to offspring and depress respiration and cardiovascular function |
| Why Do Animals Undergoing Pyometra Surgery Have A High Anaesthetic Risk? | -Often toxins and bacteria cross the uterine wall and enter the blood stream = shock -Kidneys are affected by both toxins and the low blood pressure -Metabolic acidosis is common -Arrhythmias may develop due to toxins effect on heart |
| Why Do Animals Undergoing Limb Fracture Surgery Have A High Anaesthetic Risk? | -Wherever trauma severe enough to cause a limb fracture is present, there is a high risk of pulmonary contusions (bleeding and bruising) which may impair respiratory function |
| Why Do Animals Undergoing GDV Surgery Have A High Anaesthetic Risk? | -The enlarged stomach will compromise respiration and impair venous return to the heart from the abdomen -Circulation is quickly affected = shock -Toxins released from injured stomach wall tissues can cause arrhythmia in the heart and renal failure |
| Why Do Horses And Exotics Have A High Anaesthetic Risk? | Horses = obligate nasal breathers, size Exotics = IV access difficult, intubation may not be possible, different reactions to drugs |
| What Are The Main Points Of Surgical Nursing? | -Manage nutrition -Manage pain -Manage infection control -Manage wounds and wound care -Manage stress -Manage fluid and electrolyte balance -Monitoring |
| Why Are Surgical Safety Checklists Important? | -Brings all parties involved in the patients care together to confirm that critical safety measures are performed before, during and after an operation -Completed when patient is draped but prior to first incision |
| Why Should Patients Be Starved Prior To Surgery? | -Reduces risk of regurgitation and reflux, which can cause damage to the oesophagus and aspiration -Aids visualisation of abdominal structures |
| How Long Should A Patient Generally Be Starved For Prior To Surgery? | 6-8 hours |
| How Long Should A Neonate/Paediatric/Young Animal Be Starved For Prior To Surgery? | Under 8 weeks/2kg = 1-2 hours for food, 0 hours for water Suckling = do not starve *risk of hypoglycaemia* |
| How Long Should A Diabetic Animal Be Starved For Prior To Surgery? | 2-4 hours -During this period a 1/2 meal can be given as well as a 1/2 dose of insulin |
| How Long Should A Brachycephalic Animal Be Starved For Prior To Surgery? | 6-12 hours -Can give 10-25% normal diet 4-6 hours prior to induction |
| How Long Should A Small Mammal Be Starved For Prior To Surgery? | 0 hours! -Can take away pellet food after pre-med to prevent food in airway when sedated |
| What Are The 5 Aspects To Pre-Operative Nursing? | -Gaining IV access -Final assessment -Pre-medication -Pre-warming -Pre-oxygenation |
| Why Might A Urinary Catheter Be Placed In An Animal During Surgery? | -Monitor urine output -Minimizes the risk of contamination esp. male dog -Facilitate access to abdominal organs -Prevents risk of bladder perforation/rupture -Identify the urethra |
| Why Is Eye Lubrication Used During Surgeries? | To prevent drying of the cornea and ulcer formation. |
| What Positioning Aids Are Available In The Operating Theatre? | -Ties -Cradles -Sandbags -Foam wedges -Vacuum bags -Tilting operating tables |
| What Are The Roles Of The Circulating Nurse? | -Complete surgical safety checklist -Prepare the theatre -Position patient on the operating table -Prepare the surgical site -Assist the surgical team with gowning -Assist with the draping of the patient -Monitoring |
| What Are The Roles Of The Scrubbed Nurse? | -Preparation of the instrument trolley -Keep instruments clean and orderly and wipe over when necessary -Keep the operating field neat and free of unnecessary instruments -Pass instruments as required -Holding instruments or retracting tissue |
| How Is The Instrument Trolley Cleaned Between Surgeries? | With an alcohol based solution |
| What Is The Standard Surgical Fluid Infusion Rate For Dogs And Cats? | Cats = 3ml/kg/hour Dogs =5ml/kg/hour |
| What Are The Signs Of Haemorrhage During Surgery? | -Shed of blood at the surgical site -Tachycardia -Pallor |
| What Can Happen If There Is Excessive Haemorrhaging In Patients Undergoing Surgery? | -Hypotension -Hypovolaemic shock |
| How Can Haemorrhaging Be Estimated By The Nurse During Surgery? | -Weigh swabs (1ml of blood = 1g in weight, weight of soaked swab - weight of dry swab) -Measure weight of blood in suction machine (may also include flush!) -Estimate loses, blood on floor etc |
| How Can % Blood Loss Be Calculated? | Total blood lost / normal blood volume x 100 |
| What Is The Normal Blood Volume For A Cat? | 60-70ml/kg |
| What Is The Normal Blood Volume For A Dog? | 80-90ml/kg |
| What Fluids Should be Be Given If A Surgical Patient Has Under 10% Total Blood Loss? | Crystalloids (hartmann's) |
| What Fluids Should be Be Given If A Surgical Patient Has Over 10% Total Blood Loss? | Colloids |
| What Fluids Should be Be Given If A Surgical Patient Has Over 20% Total Blood Loss? | Whole blood |
| How Can Exposed Mucosae Be Kept Moist During Surgery? | Flush! |
| What Are Some Considerations For Immediate Post-Op Care Of A Patient? | -TPR -Access to emergency equipment -Warm and quiet environment |
Created by:
aimee_knows_nothing
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