General Anes. 4

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kris10leejmu
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135900
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General Anes. 4
Updated:
2012-02-16 22:49:49
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Clinical Practice
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Clinical Practice
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  1. What are ways to indicate the depth of anesthesia?
    • muscle tone
    • eye position
    • pupil size
    • pupillary light reflex
    • salivary and lacrimal secretions
    • heart and respiratory rates
    • response to surgical stimulation
  2. How do you tell muscle tone in dogs?
    jaw tone
  3. How can you tell muscle tone in cats?
    jaw tone and tail tone
  4. Can muscle relaxing drugs interfere with muscle tone?
    yes, it interferes with muscle tone as anesthetic indicator
  5. When do patients have central eye position?
    • awake
    • too light
    • too deep
  6. When do patients have a rotated eye position?
    in light and surgical planes of anesthesia
  7. When do patients have miosis?
    light anesthesia
  8. When do patient's have moderate mydriasis?
    surgical anesthesia
  9. When do patient's have extreme mydriasis?
    too deep
  10. What is the pupillary light reflex?
    ability of pupil to constrict in response to light
  11. When does the pupillary light reflex descrease?
    as patient gets deeper
  12. What drugs interfere with pupillary light reflex?
    • ketamine
    • atropine
  13. What does it mean when a patients pupils are unresponsive and widely dilated?
    • too deep
    • dead
  14. What is direct pupillary reflex?
    • shine light in right eye, right eye constricts
    • shine light in left eye, left eye constricts
  15. What is indirect pupillary reflex?
    • shine light in right eye, left eye constricts
    • shine light in left eye, right eye constricts
  16. How do you know if a patient has a normal pupillary reflex?
    shine light into one eye and both eyes will constrict
  17. What happens to secretions as a patient gets deeper?
    decreases
  18. Because secretions decrease as a patient gets deeper, what do we need to do to protect the patient's eyes?
    use ophthalmic ointment
  19. What causes a patient's heart rate to increase during anesthesia?
    • getting light
    • decreased BP (shock)
    • painful surgery stimulation
    • drugs - atropine, ketamine
  20. What causes a patient's heart rate to decrease during anesthesia?
    • getting deeper
    • vagal response (handling viscera or intubation)
    • most anesthetic drugs
  21. How does a patient respond to pain during anesthesia?
    • increased HR and RR
    • pupil dilation
    • salivation
    • sweating paw pads
    • voluntary movement of limbs and head
  22. Individual medical records should be _____ & _____.
    accurate, complete
  23. What should be included in the medical record?
    • drugs
    • dose
    • procedure
    • results
  24. What is the monitoring form?
    • more elaborate than medical record
    • records minute by minute
  25. What information is included in the log book?
    • date
    • patient
    • client name
    • procedure
    • status protocol
    • outcome
  26. What are the purpose of the logbook?
    • may be legal or AAHA requirement for the hospital
    • can use to evaluate protocols
    • can use for research
  27. How do you prevent injuries of the animal?
    do not leave the animal alone on the table or in a cage with the door open
  28. Should you rotate the endotracheal tube while the tube is in the patient? Why?
    no because it can scrap the patients throat
  29. How should you move/rotate a patient when they have in an endotracheal tube?
    • unhook tube from anesthesia machine when moving
    • do not let machine pull on trach tube
  30. How should the patient be positioned during surgery?
    • as close to natural as possible
    • avoid hyperflexion, hyperextension of neck and limbs
  31. How should a patient be tied down during surgery and why?
    double loops, not too tight
  32. How should a patient be tied during surgery if you need to be able to untie them quickly?
    flagpole tie
  33. Should a patient have extra weight on their chest?
    no
  34. What is the definition of the recovery period?
    from time drug administration is discontinued to the time the patient is able to maintain sternal recumbency
  35. The longer the anesthesia, the _____ the recovery.
    longer
  36. What causes a patient's anesthesia to be prolonged?
    • illness
    • debilitation
    • liver or kidney problems
  37. Patients recover _____ from IV route than IM.
    faster
  38. Patient's recover _____ from inhalants than injectables
    faster
  39. What does hypothermia cause?
    • prolonged recovery
    • slower metabolic rate (not producing as much heat so the body isn't metabolizing drugs as fast)
  40. What should you do differently for brachycephalics during recovery?
    leave the trach tube in as long as possible
  41. How long should a patient have an IV catheter in? Why?
    • until patient is fully recovered
    • incase of emergency
  42. How do you administer O2? Why?
    • give 100% O2 for 5 minutes after turning off inhalant anesthesic
    • prevents patient from exhaling waste gas into room air and speeds up recovery and improves healing
  43. When do we move the tube?
    when the patient starts to chew or swallow
  44. How do we prepare for removal of the tube?
    • deflate cuff
    • untie gauze
  45. What do we do with the patient after the tube is removed?
    • place patient in sternal recumbency
    • extend neck
    • keep airway open
  46. Why and how do we stimulate the patient?
    • helps speed up recovery
    • talk to him, rub, move jaws or legs
  47. When and why do we turn the patient over during recovery?
    • every 10 - 15 minutes
    • prevents hypostatic congestion
  48. What is hypostatic congestion?
    pooling of blood on the "down" side of the patient
  49. How do we reassure the patient during recovery?
    • be quiet and calm
    • put in normal position
    • finish other procedures before recovery starts
    • give pain medication before patient starts to show signs of pain
  50. What do we use to warm the patient during recovery?
    heating pads (make sure not to burn the patient), heat lamps, hot air
  51. What kind of bedding do we use for the patient during recovery?
    • nice towels
    • blankets (make sure theres no strings so they don't wrap around the limbs and cut off circulation)
    • rack - keeps patient up off stainless steel and if they pee then it will fall to the bottom of the cage under the rack
  52. How do we ensure the safety of the patient during recovery?
    • do not leave patient where he can fall
    • if patient vomits while not fully recovered then place head lower than lung
    • do not leave food or water bowls with patient
  53. What is a stormy recovery?
    coming back up through stage ll excitement
  54. What does the patient do during a stormy recovery?
    • cry
    • howl
    • thrash
    • may injure himself or human attendants
  55. What are some problems during recovery (there are 18).
    • pain
    • hemorrhage
    • shock
    • dyspnea
    • laryngospasm
    • vomiting
    • aspiration
    • thermal injuries
    • hypostatic congestion
    • pneumonia
    • falling
    • seizures
    • hypothermia
    • prolonged recovery
    • hypoglycemia
    • tracheal mucosa necrosis
    • death
  56. What is Murphy's Law?
    what can go wrong will go wrong
  57. How do we prevent Murphy's Law?
    careful monitoring
  58. When is the patient considered to be free of the influences of anesthesia?
    36 - 48 hours after its over

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