General Anes. 4
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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
How do you tell muscle tone in dogs?
How can you tell muscle tone in cats?
jaw tone and tail tone
Can muscle relaxing drugs interfere with muscle tone?
yes, it interferes with muscle tone as anesthetic indicator
When do patients have central eye position?
When do patients have a rotated eye position?
in light and surgical planes of anesthesia
When do patients have miosis?
When do patient's have moderate mydriasis?
When do patient's have extreme mydriasis?
What is the pupillary light reflex?
ability of pupil to constrict in response to light
When does the pupillary light reflex descrease?
as patient gets deeper
What drugs interfere with pupillary light reflex?
What does it mean when a patients pupils are unresponsive and widely dilated?
What is direct pupillary reflex?
- shine light in right eye, right eye constricts
- shine light in left eye, left eye constricts
What is indirect pupillary reflex?
- shine light in right eye, left eye constricts
- shine light in left eye, right eye constricts
How do you know if a patient has a normal pupillary reflex?
shine light into one eye and both eyes will constrict
What happens to secretions as a patient gets deeper?
Because secretions decrease as a patient gets deeper, what do we need to do to protect the patient's eyes?
use ophthalmic ointment
What causes a patient's heart rate to increase during anesthesia?
- getting light
- decreased BP (shock)
- painful surgery stimulation
- drugs - atropine, ketamine
What causes a patient's heart rate to decrease during anesthesia?
- getting deeper
- vagal response (handling viscera or intubation)
- most anesthetic drugs
How does a patient respond to pain during anesthesia?
- increased HR and RR
- pupil dilation
- sweating paw pads
- voluntary movement of limbs and head
Individual medical records should be _____ & _____.
What should be included in the medical record?
What is the monitoring form?
- more elaborate than medical record
- records minute by minute
What information is included in the log book?
- client name
- status protocol
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
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
Should you rotate the endotracheal tube while the tube is in the patient? Why?
no because it can scrap the patients throat
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
How should the patient be positioned during surgery?
- as close to natural as possible
- avoid hyperflexion, hyperextension of neck and limbs
How should a patient be tied down during surgery and why?
double loops, not too tight
How should a patient be tied during surgery if you need to be able to untie them quickly?
Should a patient have extra weight on their chest?
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
The longer the anesthesia, the _____ the recovery.
What causes a patient's anesthesia to be prolonged?
- liver or kidney problems
Patients recover _____ from IV route than IM.
Patient's recover _____ from inhalants than injectables
What does hypothermia cause?
- prolonged recovery
- slower metabolic rate (not producing as much heat so the body isn't metabolizing drugs as fast)
What should you do differently for brachycephalics during recovery?
leave the trach tube in as long as possible
How long should a patient have an IV catheter in? Why?
- until patient is fully recovered
- incase of emergency
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
When do we move the tube?
when the patient starts to chew or swallow
How do we prepare for removal of the tube?
What do we do with the patient after the tube is removed?
- place patient in sternal recumbency
- extend neck
- keep airway open
Why and how do we stimulate the patient?
- helps speed up recovery
- talk to him, rub, move jaws or legs
When and why do we turn the patient over during recovery?
- every 10 - 15 minutes
- prevents hypostatic congestion
What is hypostatic congestion?
pooling of blood on the "down" side of the patient
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
What do we use to warm the patient during recovery?
heating pads (make sure not to burn the patient), heat lamps, hot air
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
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
What is a stormy recovery?
coming back up through stage ll excitement
What does the patient do during a stormy recovery?
- may injure himself or human attendants
What are some problems during recovery (there are 18).
- thermal injuries
- hypostatic congestion
- prolonged recovery
- tracheal mucosa necrosis
What is Murphy's Law?
what can go wrong will go wrong
How do we prevent Murphy's Law?
When is the patient considered to be free of the influences of anesthesia?
36 - 48 hours after its over
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