anesthesia Flashcards
what is the ideal flow rate for a patient in an anesthetic chamber?
5-10L/min
what lungs would you expect to hear post-op in a healthy patient?
light whooshing sound
what will happen if there is an accumulation of fluid and secretions in the small airways post anesthesia?
rales (crackling)
t/f - all of the following patients are at risk for atelectasis
a) sternally positioned anesthetized patient
b) orthopneic feline patient with asthma
c) laterally recumbent brachycephalic patient
true
your patient is apneic and you must provide ventilation - what is your strategy?
provide ventilation at a rate of 1 breath every 10 seconds
a patient’s heart rate has consistently decreased during anesthesia - what drug would address this?
anticholinergic (ex. atropine)
there is no sign of regurgitation in your bulldog patient - how do you remove the ET tube?
allow patient to maintain the ET tube until they are chewing at it - specific to bulldogs!
when would you remove the ET tube from your feline patient?
at the first sign of arousal (i.e. ear twitch)
2% lidocaine is what concentration?
2g/100ml (remember- % equals g/100dL)
350 mcg is equal to how many milligrams?
0.35mg (divide by 1000 to get mg)
a 10% w/v solution is equal to what concentration?
100mg/ml
the maximum dose of 10mg/ml acepromazine in cats is 1mg - what is the maximum dose in ml?
0.1ml
what is the legal maximum waste anesthetic gas level of halogenated gases?
2ppm
propofol was used to induce your patient - what is an expected side effect?
no movement of flutter valves - patient becomes apneic with admin of propofol and will hold its breath - HAVE TO GIVE THEM A FEW BREATHS
what assessment would not be reliable for intubation in an 8 week old puppy?
jaw tone
ventromedial eye positioning is found in which of the following anesthetic stages?
stage IIIb
doppler blood pressure monitors assess which blood pressure value?
systolic
t/f - propofol, ketamine, isoflurane, glycopyrrolate and acepromazine all cause hypotension
false - only propofol, ketamine and isoflurane cause hypotension
what is a possible side effect of isoflurane administration?
decreased temp
if a patient wakes up very quickly, is the blood:gas coefficient for the inhalant low or high?
low
t/f - pigmented tongues can affect pulse oximeter readings
true
what does the R-R interval on an ECG represent?
seconds between ventricular depolarizations
if your anesthetized patient is apneic what will the capnograph read?
0 mmHg
your patient is hyperventilating - what is the capnograph reading?
<40 mmHg
which patient is at greatest risk for anesthetic hyperthermia?
a) 3yr old obese bulldog
b) 12wk old jack russell terrier
c) 16yr old bichon frise
a) the 3yr old obese bulldog
prolonged anesthetic recovery is most likely to happen at which temperature? 33.3C or 38.5C
33.3C
you want to administer warm IV fluids to your patient - what temperature should they be?
37.5C
what is the appropriate ambient temperature for an anesthetized patient?
24C
what type of measurement is required for successful ventilation of your patient?
qualitative
you cannot hear any breath sounds during anesthesia - is this normal for the patient?
yes - normal finding d/t decreased tidal volume
which of the following patients would benefit most from ventilation?
a) hypoventilation
b) hyperventilation
atelectasis
they could all benefit from ventilation
concerns for hypoxia requiring immediate therapy occurs at what pulse oximeter reading?
SpO2 of 85-89%
the DVM is incising into the abdomen for a spay surgery - what is the ideal eye position for the patient?
ventromedial
what respiratory change would you expect if your patient anesthetic depth is too LIGHT?
tachypnea
what cardiovascular change is consistent with a patient at stage IIIc?
hypotension
what blood pressure parameter best represents tissue perfusion?
mean arterial pressure (MAP)
t/f - it is normal for a patient’s tidal volume to decrease by 50% during anesthesia
false - it should only decrease by 25%
which of the following drugs would affect jaw tone assessment?
a) diazepam
b) glyco
c) ketamine
d) propofol
diazepam
your patient is at stage IIIb - what should happen when you tap gently on the medial canthus?
no movement to the eyelids
t/f - the anesthetic protocol should be included in the minimum patient database
false - signalment, history and physical exam only
is temperament included in the patient signalment?
no
t/f - vomiting is the passive process of expelling gastric contents
false - vomiting is active not passive
what risk is associated with regurgitation under anesthesia?
aspiration
the initial O2 flow rate on a non-rebreathing circuit should be ____ to the maintenance flow rate
equal to
a dam should be pre-oxygenated for a minimum of how long prior to c-section?
5 minutes
C-section using hydromorphone, propofol and isoflurane - puppy is in respiratory arrest - what drug do you give?
naloxone
what is the greatest concern for the c-section patient clipped and prepped in dorsal recumbency?
venous return
you have a neonate who is breathing poorly immediately after birth - what do you do first?
suction nose, mouth and throat
the newly born neonate is bradycardic - how do you administer atropine?
sublingually
a very small kitten is unable to self regulate body temp post-anesthesia - what is the prognosis?
good
during your pediatric patient’s surgery the O2 tank becomes empty - what is your first step?
disconnect ET tube
a bulldog with 12 pups requires a c-section - her PCV is 22% - what do you do?
monitor for hypoxia and perform c-section
the patient is on oxygen post-op for 3-5 minutes but isn’t swallowing yet - pulse ox is 98% - what do you do?
disconnect ET tube from oxygen
50lb dog - dosing at 5mg/kg with 15% w/v sol’n - what is the concentration of solution in mg/ml?
150mg/ml
HAG recipe - 4ml 10mg/ml H - 1ml 10mg/ml A - 5ml 0.2mg/ml G what is the final concentration of A?
1mg/ml
3kg yorkie - circle system - propofol IV - isoflurane
what is the major flaw with this description?
re-breathing circuit - patient is TOO SMALL
what is a component of brachycephalic syndrome?
narrow trachea
why would an anesthetist cut the ET tube for a pediatric patient?
decreased dead space
the anesthetist calculated emergency atropine dose for the pediatric patient - why?
cardiac output is heart rate dependent
asthmatic cat - preoxygenated for 10min with nasal catheter - pulseox of 90% - what next?
continue to preoxygenate
blocked cat - dull, large, painful bladder - HR 120 - RR 60 - tacky, pale MM - what is next?
prepare calcium gluconate immediately for administration
CN exam abnormal post trauma - hydro ace premed - ketval induction - iso maintenance - error?
avoid dissociative anesthetics
obese patient - ETco2 elevates - positive palpebral reflex under anesthesia - what do you do?
perform PPV
