Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia and Sugery > Anesthetic Complications: 7 > Flashcards

Anesthetic Complications: 7 Flashcards

1
Q

Predictable complications

A

hypoventilation
hypoxemia
hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypoventilation

A

insufficient elimination of CO2 from body relative to CO2 production
reduction in alveolar minute ventilation/VA

respiratory acidosis can occur

monitored by PCO2 during ventilation
35-45 mmHG
(blood gas or ETCO2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypercapnia

A

PaCO2 greater than 45 mmHg

hypoventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypoventilation causes

A

dead space

increase RR/TV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

factors that decrease TV

A

abdominal distention
obesity
thoracic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

factors increase dead space

A 
malfunction/missing one way valve
improper CO2 absorbent
cracked inner tube coaxial circuit
too many adapters between ET tube and hose
Not using a septum in Y piece
ET tube extending past the incisors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rebreathing CO2

A

can lead to hypercapnia

exhausted CO2 absorbant
malfunctioning scavenging system
inadequate O2 flow rates (non rebreather)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

elevated CO2

A

hyperventilation or rebreathing of CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypoventilation

A

monitor Co2
most common complication of anesthetized patients

giving a breath 1-2 times a minute will likely prevent hypoventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If PaCo2 approaching 60 mmHg

(hypoventilation)

A

intermittent positive pressure ventilation should be started a controlled RR and TV

assess depth not excessive

ensure one way valves function/no cracks/fresh CO2 absorbent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Keep dead space to a minimum

hypoventilation

A

using appropriate length ET tube
not use more than one adapter
if patient less than 3KG use pediatric size

make surgeon is not leaning/resting instruments on thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypoxemia

A

reduced O2 concentration in blood

insufficient amount of O2 in arterial blood to meet body’s metabolic demands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypoxemia monitoring

A

predicted Pa02 is approx. 4-5 times the inspired O2 concentration

100% O2
Pa02 400-500mmHG
Pa02 less than 60mmHg is severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

less than ideal oxygen

A

02 100% and Pa02 80-400mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ventilation to perfusion inequality

V/Q mismatch

A

ventilation and blood flow are mismatched at the level of the alveoli
inefficient gas exchange between lungs and pulmonary blood
most common cause of reduced 02 in an anesthetized patient

positioning patient in dorsal recumbency or in head down position for longer periods of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

V/Q ratio less than 1

A

perfusion is occurring but ventilation is not

atelectasis and bronchial intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

V/Q ratio greater than 1

A

dead space ventilation

ventilation is present but perfusion is not
“Wasted ventilation”

thromboembolism
severe hypovolemia
hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diffusion impairment

A

hypoxemia cause
prevents the normal uptake of 02 from alveoli and pulmonary capillary blood

pulmonary edema
interstitial pneumonia
pulmonary fibrosis

rarely primary cause of hypoxemia in animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Anatomical shunts

A

congenital heart abnormalities-blood shunted from right side of heart to left without passing through lungs (not oxygenated)

tetralogy of Fallout
reversed patent ductus arteriosus
ventricular septal defects

are not responsive to 02 therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Severe hypoventilation

A

can lead to elevated c02 level
significant dilution of partial pressure of 02 in alveoli and lead to hypoxemia

post operative period when breathing room air -concern

respond to 02 therapy easily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Low inspired 02

A

human error:
running out 02 during procedure
using too low 02 flow rate
using nitrous oxide too high concentration combined with 02

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypoxemia prevention

A

pre-oxygenated 3-5 minutes prior to induction
100% 02 regardless of inhalant agent
minimize anesthesia and surgery time
check 02 source
calculate 02 flow rate for type of anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hypoxemia with 100% 02

A

increased peak airway pressure
hold positive pressure in lungs 3-5 seconds (can decrease cardiac output)
Positive end expiratory pressure
use bronchodilator (albuterol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypotension

A

below normal arterial blood pressure

MAP less than 60 mmHg or SAP less than 80 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hypotension monitoring

A

oscilometric or doppler techniques

systolic only with Doppleer
mean only with arterial catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hypotension causes

A

inhalants-depress cardiovascular system
reduced blood hypovolemia/hemorrhage
inadequate volume administration or replacement
dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

vascular tone reduction

A

shock
sepsis
histamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

hypotension prevention

A 
balanced anesthesia approach
keep inhalant concentration to a minimum
provide IV crystalloid fluid 
ensure adequate fluid volume
adequate heat source
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hypotension treatment

A 
turn down vaporizer if too deep
5-20 ml/kg bolus crystalloid fluid
hypertonic saline 4-6ml/kg dogs, 2-3ml/kg cats
inotropes: dopamine and dobutamine
norepinephrine, ephedrine, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Absolute Hypovolemia

A

loss of intravascular volume

results when intravascular fluid losses exceed gains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Relative Hypovolemia

A

increase in intravascular space due to loss of vasomotor tone (vasodilation)

normal intravascular volume but larger space to occupy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hypovolemia monitoring

A 
monitor circulating blood volume and tissue perfusion:
pale mucous membranes
prolonged CRT
thready pulse quality
cool/cold temp
tachycardia
hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

scarcely perceptible pulse

A

commonly rapid

feels like a fine mobile thread/cord under palpating finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hypovolemia

monitoring

A

PCV-low/anemia
TP-low/hypoproteinemia
Lactate-greater than 2mmol/L/poor tissue perfusion
Urine Output-less than 0.5mL/Kg/hr poor perfusion/hypovolemia
Central venous pressure-low <0cmH20 or decreased CVP hypovolemia

35
Q

absoute

(Hypovolemia) causes

A

acute hemorrhage trauma
water or electrolyte loss
plasma loss

36
Q

relative
(Hypovolemia)
causes

A

adverse drug reactions
sepsis
anaphylaxis

caution Acepromazine

37
Q

Hypovolemia prevention

A

crystalloid fluids
5 ps
multiple peripheral IV catheters and central line

38
Q

Hypovolemia

treatment

A

normal blood loss 10-20%, greater than 20% needs immediate treatment

replacement crystalloid fluids
shock 90-90ml/kg dogs
40-60ml/kg cats
3:1 ratio of blood loss
1/4 total volume as bolus
39
Q

Colloid therapy

A

restore oncotic pressure

if TP is <3.5 g/dL

40
Q

Hypertonic saline

A

rapid, low volume resuscitation uncontrolled hemorrhage
short lived effects
4-6ml/kg dogs, 2-3 ml/kg cats
contraindications: severe dehydration, cardiac disease, hypernatremic

41
Q

PCV<20% or TP <3.5 g/dL

A

whole blood: 25% circulating blood lost

packed RBC: PCV<20% but TP adequate

42
Q

PCV adequate but TP <3.5 g/dl

A

fresh frozen plasma<1 year: coagulation

fresh frozen plasma>1 year: hypoproteinemia, coagulation, restore plasma proteins

hemaglobin based oxygen carrier

43
Q

Hypothermia

A

below normal body temp
101-102.5F

a decrease of just 2 degrees can have adverse effects

44
Q

Hypothermia classification

A

mild: 90-99 F
moderate: 96-98 F
severe: 92-96 F
critical <92F

45
Q

Hypothermia

monitoring

A

every 15-20 minutes

46
Q

Hypothermia causes

A 
heat loss
(vasodilation in anesthetic agents)
large surgical incisions (fur clipping)
prolonged anesthesia/surgery
cold surgical scrub (water or alcohol)
cool/cold saline abdominal avage
cold operating table
cool ambient environment
47
Q

Hypothermia

prevention

A

warm room
blankets/bair hugger
IV fluid warmer
wrap extremities

48
Q

Hypothermia

No-Nos

A

use electric heating pads=thermal burns

use fluid bags/bottles with a towel

49
Q

Hypoglycemia

A

below normal glucose levels

50
Q

normal glucose levels

A

70-120 mg/dL

below 60 mg/dL=immediate treatment

51
Q

hypoglycemia

caution

A

watch for in pediatric, diabetic, hepatic, portal systemic shunt, insulinoma, septicemia, endotoxemia

52
Q

Hypoglycemia

consequences

A

coma
hypotension
prolonged recovery from anesthesia with depression, weakness, or seizures

53
Q

at risk patients monitored

A

prior to induction
every 30 minutes intraoperative
postoperative

54
Q

Hypoglycemia treatment

A

dextrose added to their IV fluid therapy 2.5%-5$

55
Q

Hyperthermia

A

above normal body temperature

56
Q

Hyperthermia causes

A 
excessive heat source
fever bactrial infection
contamination of IV fluids/drugs
malignant hyperthermia syndrome triggered by stress
loss of CNS temperature regulation
Thyrotoxicosis
Pheochromocytoma
cats given pure mu opioid
disassociate agents (ketamine, etc)
57
Q

Hyperthermia

prevention

A

treatment not instigated until 105.8 F

turn off heat sources
use cooler fluids
apply alcohol to inguinal and axillary and paws
use fan
provide 02

do not use ice packs or submerge in water can cuase vasoconstriction

58
Q

Hyperventilation

A

excessive elimination of c02 from body

leads to hypocapnia

59
Q

Hyperventilation monitoring

A

Pac02 less than 35mmHg

less than 25 mmHg severe cerebral vasoconstriction and brain ischemia

60
Q

Hyperventilation causes

A

inadequate anesthetic depth or response to pain
overzealous ventilation
significant hypoxemia leading to hypoxic drive
hyperthermia
low inspired oxygen concentrations
increased c02 production

61
Q

Hyperventilation

prevention/treatment

A

administer analgesic drugs
decrease TV/RR
supplemental 02

62
Q

Hypertension

A

above normal arterial blood pressure

63
Q

Awake patients hypertension

A

MAP 120mmHg
SAP>160mmHg
DAP>95mmHg

64
Q

general anesthesia

hypertension

A

MAP>100mmHg

65
Q

Severe and Chronic

hypertension

A

SAP>180mmHg
DAP>120mmHg
cause damage to eyes, kidneys, heart, brain, and peripheral vessels

66
Q

monitoring equipment

A

hypotension and hypertension the same

67
Q

causes hypertension

A 
pain
inadequate depth
hypercapnia
anesthetic drugs (ketamine, telazol, Xylazin, Dexmetatomadine) can cause a transitory increase in blood pressure
renal disease, hyperadrenocoricism, hyperthyroidism, diabetes mellitus, heart failure, pneochomocytoma
anemia
fever
metabolic acidosis
cushings/intracanial pressure
68
Q

treatment: hypertension

A

administer additional analgesics
assess anesthetic depth (too light?)
keep C02 normal range
Esmolol (beta adrenergic antagonists)-if already taking then Phenoxybenzamine

69
Q

Apnea

A

temporary cessation of breathing

70
Q

causes: apnea

A

rapid admin of induction (propofol, ketamine/diazepam, thiopental)
overdose of anesthetics
cardiopulminary arrest
equipment (pop off valve, ventilator malfunction)

71
Q

treatment: apnea

A 
place ET tube
ventilate
provide 02
assess depth-too light?
inspect machine and ventilator
begin CPR
72
Q

Barotrauma

A

excessive peak airway pressure during positive pressure ventilation that results in lung injury

73
Q

causes: barotrauma

A

closed pop off valve
improper ventilator settings
manometer above 20cm h20
using flush valve when non rebreathing circuit attached

74
Q

treatment: barotrauma

A

thoracocentesis to correct pneumothorax
provide 02
check pulse and begin CPR

75
Q

postoperative myopathy

A

damage done to skeletal muscles likely due to hypoperfusion and ischemia after a period of recumbency

76
Q

causes: postoperative myopathy

A

common large dogs incorrectly positioned on surgical table

77
Q

treatment: myopathy

A

provide support/padding for limbs

IV fluid therapy, analgesic drugs, sedatives, physical therapy

78
Q

prolonged recovery causes

A 
hypoventilation
hypercapnia
hypoxemia
metabolic acidosis
hypoglycemia
hypotension
hypothermia
hepatic and renal disease
overdose of anesthetic drugs
79
Q

prolonged recovery treatment

A

balanced anesthesia
correct underlying condition
provide supplemental 02
provide fluid therapy

80
Q

reversible agents: opiods

A

opioid overdose=use butorphanol

81
Q

reversible agents: Alpha 2

A

Dexmedatomine, xylaxine, Romifidine=use yohimbe, antisedan, tolozine

82
Q

reversible agents: Benzodiazepines

A

Diazepam, Midazolam, Zolazepam=use Flumazenil

83
Q

reversible agents:

Phenothiazines

A

Acepromazine, Promazine=no reversal agent

Anesthesia and Sugery (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions