Ch 32 - Preoperative , surgery occurrences book notes Flashcards
What is included in a complete preoperative assessment?
- know the primary problem
- eating, drinking, urination, and defecation habits of animal
- ask if client ate or drank anything before anesthesia and surgery
- what medications the animal is taking or has taken
- history of previous medical problems and surgical procedures - let surgeon know
- vaccine status
- TPR, quality and character, CRT, muscous membrane, color, weight, and demeanor
The animal should not have food for a least ___ hours before antsthesia?
12 hours
Why is it important to know what medications the animal has taken the day of the surgery?
could affect what medications are administered before and after surgery
A young puppy or kitten is best vaccinated at least ___ weeks before surgery rather than on the day of sugery, Why?
2 weeks
- because the immune system can be suppressed by anesthesia and surgery, making the patient less responsive to immunization.
Diagnostics might include?
- blood work such as packed cell volume (PCV)
- total plasma protein (TP) concentration
- blood urea nitrogen (BUN)
- blood glucose concentration
- complete blood count (CBC)
- complete biochemical analysis, and the heart worm test
- blood gas analysis
- electrocardiogram (ECG)
- radographs
- ultrasound and fine-needle mass aspiration
- fecal analysis; and/or urinalysis
It is the vet tech’s responsibility to inquire about the ____ procedure to be performed and what ____will be required.
surgical
instrumentation
A ___ ___ water blanket should be placed on the operatng table, turned on, and covered with a towel so it is warm when needed.
heated circulating
Clean surgical hair ____ and skin ____ solutions should be made available for use.
clippers
cleansing
The _____ cage should be made ready wit warming equipment turned on.
postoperative
Warm- ____ blankets should be nearby to cover the patient if needed.
air
Inadequate animal preparation for surgery can?
hinder surgical technique, increase the risk for surgical infection, result in wasted time spent correcting deficiencies, and result in prolonged anesthesia
_____ antibiotics are used to decrease the risk for infection in clean or clean-contaminated surgeries.
prophylactic
Antibiotics should never be given _____ to animals undergoing surgery.
indiscriminately
What are some indications for prophylactic antibiotics?
- operative is longer than 90 min.
- the patient may be immunosuppressed
- a hollow viscus is to be entered (i.e., GI tract)
- the incision is to involve an area that is difficult to aseptically prepare (toe, or ear)
- orthopedic implants are placed
- joint procedures that are long and aggressive and require multiple entrances into the joint
- if the consequences of infection cold be devastating to the surgical outcome (hip replacement)
Prophylactic antibiotics are not recommended for?
short, clean surgical procedures, such as simple mass removal, OHE, castration etc.
What would cause the antibiotics to not be effective during surgery?
therapeutic drug levels are not present in the wound fluid (serum and interstitial tissues)
How much time is needed to make sure that the antibiotics are at a therapeutic level?
20 mins. before surgical incision is made
Antibiotics given 3 or more hours before the procedure?
select for resistant bacteria
Prophylactic antibiotics given more than 3 to 5 hours after the surgical incision has been made will?
likely not be effective in preventing infection
No advantage is associated with continuing antibiotics after surgery unless?
it is necessary to treat an active infection, or a break in sterile technique occurred during surgery.
Anesthesia and surgery can result in several potential problems?
- blood loss
- hypothermia
- pain
- cardiac and respiratory problems
What is normothermic?
normal body temperature
The postoperative phase is a critical transition period from?
general anesthesia to consciousness
After surgery, continual monitoring should be provided until the animal is?
safely extubated, normothermic, and in sternal recumbency
As long as the animal is hospitalized, what should be monitored?
vial signs, behavior, appetite, and the surgical incision should be evaluated
A ____ abnormal vital sign does not necessarily identify a significant ___.
single
problem
All indicators ___, ___ respiration, mucous membranes should be evaluated serially to detect a trend in an animals condition.
TPR, pulse
It is a trend that will determine the ____ of the postoperative problem and will dictate appropriate ____.
severity
treatment
___ and ___ should always be assess before surgery to obtain a baseline value and postoperative if substantial blood was lost during surgery (a few hours after).
PCV and TP
Packed cell volume
Total plasma protein
It is not unusual for PCV and TP to drop up to ___ % as a result of anesthesia and surgery, even when no major blood was lost.
10
What are the vital signs that should be checked/examined periodically during and after surgery?
temperature, heart rate, pulse quality, respiration, and character of mucous membranes
Animals with substantial blood loss could experience?
continued hypothermia or a drop in body temperature, rapid heart rate, and pale or white mucous membranes