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Vett 115 wk 8&9
Anes/SX assisting Week 8&9 ch on sx nursing
| Question | Answer |
|---|---|
| 1141-1182 ch 34 in older edition (9th) 3273 | |
| Chapter 33 Quiz Study Guide | |
| What type of information should be gathered when obtaining a good patient history prior to a surgical procedure? | e/d; urination/defecation; |
| Why should most patients be fasted prior to anesthesia? | decrease the risk of aspiration of stomach contents |
| Why should antibiotics NOT be used indiscriminately in patients undergoing surgery? | side effects, increased cost of sx, contribs to development of resistant strains of bacteria, ie. hospital superbugs |
| Therapeutic drug levels must be present in the wound fluid (serum and interstitial tissues) at the time of surgical incision, or the antibiotics will be ineffective. They should be given at least how many minutes before the surgical incision is made? | abx should be administered at least 20 minutes prior; 3 hours before and/or 3-5 post are ineffective |
| What potential problems that could arise during anesthesia and surgery should a veterinary technician always be on the lookout for? | blood loss, hypothermia, pain, and cardiac and respiratory issues |
| It is not unusual for packed cell volume (PCV) and total plasma protein (TP) to drop what percentage as a result of anesthesia and surgery, even when no major blood loss has occurred? | It is not unusual for PCV and TP to drop up to 10% as a result of anesth. & sx even when no major blood loss has occurred |
| Animals with substantial blood loss will experience what clinical signs? | hypothermia, rapid heart rate with weak pulse, rapid RR, & pale/white mucous membranes, incisional swelling or oozing blood, abdominal enlargement if intra-abdominal hemorrhage, and dyspnea and decreased lung sounds if intrathoracic hemorrhage |
| If hemorrhage into the abdominal cavity is suspected and an abdominocentesis is performed, the PCV of the fluid when compared to the systemic PCV will be changed how? | Sampled fluid will have a PCV nearly equal to the systemic PCV |
| What measures should be taken to help offset hypothermia during the intraoperative and postoperative periods? | water blankets, wrapping paws and body in plastic wrap, warm water bottles or gloves w/ towel, warmed cages and sx tables, warm air blanket |
| At what point are warming devices turned off in the post operative patient? | In the rare instance that the patient's body temp rises above normal |
| On what kind of schedule should pain medications be given to surgical patients? | dosing intervals appropriate for the medication , not as needed |
| Why are ointments not applied to the incision? | it can cause irritation, and components of the ointment can delay wound healing |
| What causes surgical dehiscence? | MOST often error in suture technique, but incision complications & pt status play a role. Factors: inapp. suture material or technique, tension on the incision line, incision infection, seroma formation, DZ/drug therapy ->delayed healing, self mutilation |
| Swelling secondary to surgical trauma will usually resolve within how many days? | Swelling secondary to surgical trauma will usually resolve within 3 to 7 days after surgery |
| What is the accumulation of serum under a surgical incision that may last for weeks called? localized areas of fluctuant swellings that are not usually painful or warm to the touch | seroma - seromas can form if extensive sx dissection occurred beneath the incision, tissue planes could not be or were not adequately closed, or excessive motion occurs at incision site |
| Why are seromas not typically drained? | due to the increased chance for infection and decrease in self resolution. warm compresses, hydrotherapy, and bandaging may aid in resolution. if causing impairment, drainage is warranted if done aseptically and drain placed |
| What is the infection along tissue planes that can arise postoperatively called? | cellulitis |
| Complete dehiscence of a thoracic wound will result in what condition? | pneumothorax (air within the chest causing collapse of the lungs), a problem that may result in sudden death. |
| What is it called when wounds drain excessively, causing serum to seep through the bandage and extend to the external environment? | Strike-through - must be prevented to help prevent wound infection because bacteria have better access to a wound or incision when they can migrate through the moisture of a wet bandage. |
| Veterinary technicians should advise clients that animals undergoing routine sterilization or simple mass removal usually require how many days of restricted activity? | 10 to 14 days of restricted activity, whereas animals undergoing orthopedic surgery will likely require 6 to 8 weeks of confinement |
| When should tail docking and dewclaw removal in puppies be performed? | during the first week of life (3–5 days of age) |
| When should pain medication for an onychectomy be administered? | Preoperative analgesics should be administered. Pain medication should be administered to all cats in the postoperative period. It is appropriate to administer a pure opioid agonist for the first 24 hours after surgery |
| What kind of postoperative care is required for onychectomies? | Bandages for 24 hours then removed; paper litter x10 days; paws should be monitored for hemorrhage, swelling, drainage, and redness; e.collar; |
| Why should animals being prepared for an exploratory celiotomy always be clipped widely? | the incision may need to be extended, and an inappropriate preparation will hinder surgical exposure |
| During abdominal surgery, any excess hemorrhage on the viscera is blotted away with moistened sponges. Why should the surfaces of the viscera not be wiped with sponges? | surfaces should not be wiped with sponges because this causes tissue trauma and dislodges blood clots |
| The abdomen is usually sutured closed in how many layers? | at least three layers |
| Intraoperative intestinal and pancreatic manipulation can lead to what condition, which is the temporary loss of intestinal motility? | ileus |
| What is the term for the suturing together of portions of the gastrointestinal tract to allow confluent ingesta flow. | Anastomosis |
| What are the characteristics of intestinal devitalization? | • Lack of motility • Gray, green, or black discoloration • Severe thinning of the visceral wall • Lack of bleeding on cut section • Lack of fluorescein dye uptake • Lack of Doppler blood flow |
| Why should a veterinary technician have two surgical packs prepared, or at the least extra instruments ready, prior to gastrointestinal surgery? | Many surgeons will ask for a clean surgical pack, gloves, and drape to perform the celiotomy closure to prevent contamination of the celiotomy wound with ingesta from instruments used during the intestinal procedure. |
| What are the signs of peritonitis? | inappetence, vomiting, fever, painful abdomen, abdominal enlargement, incision drainage, and shock |
| Why is gastropexy surgically performed after a dog experiences GDV? | to substantially decrease the chance of stomach rotation, but it does not prevent bloating |
| Animals suffering from GDV usually are in what kind of shock? | hypovolemic shock - The enlarged stomach compresses the caudal vena cava and affects venous return to the heart, leading to hypovolemic shock |
| What organ, other than the stomach, often rotates as well during a GDV event and may require removal? | the spleen - Vascular compromise to the spleen can occur with dilatation and rotation of the stomach, or the spleen may rotate |
| Ovariohysterectomy, if performed during estrus or pregnancy in the dog, increases the potential surgical risk due to what factors? | increased vasculature may be encountered with the potential for increased hemorrhage |
| During a routine ovariohysterectomy the most painful manipulation will at what point? | severing or tearing the suspensory ligament that holds each ovary tight in the abdominal cavity, which must be done to exteriorize the ovaries |
| What are the possible complications of pyometra? | the risk for uterine rupture, septicemia and endotoxemia, and possibly death. |
| What are the common indications for canine castration? Feline castration? | dogs - roaming, aggressiveness, unwanted breeding, or a combination of these; prostate disorders, anal and perianal tumors, perineal hernias, and testicular tumors cats - prevent fighting, roaming, and urine spraying and to decrease urine odor |
| What are the possible postoperative complications for canine castration? Feline castration? | dogs - scrotal dermatitis w/ inflammation & swelling of scrotal and prescrotal skin, dehiscence; hemorrhage/scrotal hematoma w/trauma and skin sloughing cats - Scrotal swelling and bleeding, Severe hemorrhage intra-abdominally |
| For which species is the scrotum the site for the primary incision during castration? | cats |
| When preparing a patient for cesarean section, when is the abdomen clipped? | Clipping is performed before anesthesia. |
| In patients who have undergone cystotomy for removal of calculi, why is the entire urinary tract flushed after removal of the calculi? | calculi can lodge in the urethra |
| For how long postoperatively may a patient who has undergone a cystotomy be expected to have mild hematuria and frequent urination? | During the first week postoperatively, mild hematuria (bloody urine) with or without blood clots and frequent urination can be expected |
| The process of making an external opening in the urethra in the area of the perineum is known as what? | Perineal urethrostomy Urethrostomy is also performed in other locations and procedures are named by their location (scrotal urethrostomy, prescrotal urethrostomy, antepubic urethrostomy, etc.) |
| What is the concern for large umbilical hernias? | intestinal entrapment (incarceration) within the confines of the hernia with resultant strangulation (loss of intestinal blood supply with devitalization and possible intestinal perforation). |
| What kind of handling and supportive measures are needed for a patient with a diaphragmatic hernia to prevent or mitigate respiratory distress? | O2 & cage confinement to achieve mal oxygenation, minimal stress, and constant monitoring for respiratory insufficiency before surgery; nasal O2 insufflation, sternal recumbency; allow some abdominal contents to shift back into the abdomen; prop pt in suc |
| If a patient who has just undergone repair for a diaphragmatic hernia is not able to maintain adequate blood oxygen saturation and/or shows signs of dyspnea, what should be tried to remedy the situation? | the chest should be evacuated with a hypodermic needle, a three-way stopcock, and a large syringe, or evacuation can be done through the chest tube |
| What medication should be given preoperatively for patients who are about to undergo a mass removal of a suspected mast cell tumor? | Diphenhydramine injection is recommended before surgery or aspiration because of increased risk associated with degranulation of these tumors |
| What is the most frequently occurring neoplasm in female dogs? | Mammary neoplasia is cancer of the mammary gland |
| What are the potential post op complications of amputation? | pain management; Seroma and Hematoma formation which increases risk of infection; anemia/blood loss; tension on incision line, seroma, and infection lead to dehiscence; metastatic dz or tumor recurrence |
| Why is the urinary bladder expressed multiple times daily in postoperative patients with neurological conditions? | to keep the bladder empty and the pt clean; to prevent detrusor muscle atony (flaccid bladder) 2° to over distension and permanent bladder disfunction; might lower the incidence of infection from urine retention |
| How often should the neurological patient be turned and why? | every 4 hours |
| Why is padding important for the postoperative neurological patient? | to prevent the formation of sores |
| Should animals with cervical damage should be placed in a harness or in a collar? | harness |
| What kind of activity level is appropriate for a patient with neurological injuries? | cage rest and controlled activity |
| What should occur before repair of a long bone fracture is attempted? | 1. pt must be stabilized with respect to all other body systems (treated for shock, chest and abdominal injuries) 2. open wounds associated with the fracture should be managed 3. fracture must be immobilized by means of a bandage, cast, or sling |
| What kinds of duties may the veterinary technician be called on to perform during repair of a long bone fracture? | retraction, muscle fatigue, alignment and reduction, and suction of the field |
| For which orthopedic procedure should activity be strongly encouraged post operatively in order to build muscle mass and have optimal limb function? | femoral head and neck excision - for which rehabilitation, building of muscle mass, and encouragement of weight bearing are extremely important for optimal limb function |
| What kind of care needs to be taken when assisting in surgery of a joint in order to avoid damaging the cartilage? | avoid placing retractors in direct contact with the articular cartilage, and the cartilage should be kept moist to prevent permanent cartilage damage |
| Abdominocentesis | |
| Anastomosis | |
| Arthrodesis | |
| Capillary refill time | |
| Celiotomy | |
| Cellulitis | |
| Cystotomy | |
| Dehiscence | |
| Enterotomy | |
| Evisceration | |
| Gastrotomy | |
| Hydrometra | |
| Ileus | |
| Intussusception | |
| Mucometra | |
| Onychectomy | |
| Orchidectomy | |
| Ostectomy | |
| Osteochondrosis | |
| Ovariohysterectomy | |
| Pseudocyesis | |
| Pyometra | |
| Seroma | |
| Strangulation | |
| Urethrostomy |
Created by:
shawamber