Ch 32 Small Animal surgical nursing - lecture Flashcards
What are the preoperative patient assessment criteria?
- surgical candidate
- primary problems
- elective and emergency demands not the same
- 12 hour fasting
- ASA - American Society of Anesthesiologists
What are the 5 levels that the ASA has a set standard for on whether or not a patient is ready for surgery?
P1 minimal P2 Low P3 moderate P4 high P5 extreme
What does P1 minimal mean?
normal healthy patient (OHE, Declaw, castration, etc)
What does P2 Low mean?
patient with mild systemic disease (neonatal, geriatric or obese)
What does P3 mean?
patient with severe systemic disease (anemia, moderate dehydration)
What does P4 mean?
patient with systemic disease, constant threat to life
What does P5 mean?
Moribund, not expected to survive without procedure
What diagnostic bloodwork is needed before surgery?
PCV
TP
BUN
CBC
What does PCV stand for?
packed cell volume
What does TP stand for?
Total Plasma Protein
What does BUN stand for?
Concentration Blood, Urea, Blood Glucose
What does CBC stand for?
complete blood count
What does perioperative antibiotics do?
- decrease the risk for infection
- clean or unclean contaminated surgeries
- help to controll an active infection
What type of monitoring is needed before and after surgery?
- surgical plane of anesthesia is crucial
- watch for fatal complications
such as blood loss, pain, hypothermia, cardiac and respiratory problems
What are things should be visually and palpably inspected daily when evaluating an incision?
- check hospital environment
- absorb seepage on incision
- do not use ointment and creams on incision - can cause irritation and delay the wound from healing
Early on during postoperative time what should you look for on incision?
redness, swelling, drainage, dehiscence, seromas
What can be done for swelling on an incision?
ice packs
What can be done for drainage on an incision?
do we know if wound is suppose to drain - find out
What is dehiscence with a incision?
tissues start separating (wound breakdown)
What are seromas?
serum accumulation under the incison
Sutures are usually removed after how many days?
7 - 14 days
Why do we remove sutures at 7 - 14 days?
because this is the approx. time that the wound is beginning to strengthen
What should we check before removing sutures?
inspect for adequate healing
A adequate healed incision looks like?
- no drainage
- not severely reddened
- not severely swollen
If complications happen with a suture, what can happen?
some reddening, swelling and excessive scarring
How do you remove sutures?
- grasp with thumb forceps or fingers
- gentle traction
- manually pull out of skin
- staple removal - follow manufacturer instructions
What should monitor carefully once a bandage has been placed on a limb?
- bandage (clean and dry?)
- make sure there is a plastic bag or water-resistant covering placed over bandage when animal is walked outside - removing it when coming back in
- check toes twice a day (swelling or coldness)
- change a wet, dirty, or smelling bandage
- avoid strike-through - bacteria can migrate through moisture of a wet bandage
Why are drains placed?
- collect fluid
- when large amount of drainage is expected
If a drain is placed what must you do to the drain exit?
cover drain exit with a bandage
Why is a e-collar needed with a drain?
so animal will leave drain alone
What are the two kinds of drains?
active drains -sealed to environment
passive drain - provide an exit port
Why is the passive drain difficult to maintain?
because of the constant drainage of fluid through the drain exit site - makes it a risk for a bacterial infection
Why is animal restraint important?
- for appropriate surgical technique
- patient safety
- patient comfort
- The animal should be well controlled after surgery to minimize complications
Why must a vet. tech. have a working knowledge of common surgical procedures?
- to properly prepare an animal preoperatively
- act as a surgical efficient assistant
- manage immediate and long-term postoperative care
- be able to clearly converse with owner
What is meant by an elective surgical procedure?
surgery performed at the vet’s and owners convenience, usually in healthy animals (OHE, declaw, castration)
What is meant by an nonelective surgical procudure?
surgical procedures that must be done urgently (stifle stablization, correction of patellar luxation, cancer resection
