Ch 32 Small Animal surgical nursing - lecture

Question 1

What are the preoperative patient assessment criteria?

Answer 1

• surgical candidate
• primary problems
• elective and emergency demands not the same
• 12 hour fasting
• ASA - American Society of Anesthesiologists

Question 2

What are the 5 levels that the ASA has a set standard for on whether or not a patient is ready for surgery?

Answer 2

P1 minimal
P2 Low
P3 moderate
P4 high
P5 extreme

Question 3

What does P1 minimal mean?

Answer 3

normal healthy patient (OHE, Declaw, castration, etc)

Question 4

What does P2 Low mean?

Answer 4

patient with mild systemic disease (neonatal, geriatric or obese)

Question 5

What does P3 mean?

Answer 5

patient with severe systemic disease (anemia, moderate dehydration)

Question 6

What does P4 mean?

Answer 6

patient with systemic disease, constant threat to life

Question 7

What does P5 mean?

Answer 7

Moribund, not expected to survive without procedure

Question 8

What diagnostic bloodwork is needed before surgery?

Answer 8

PCV
TP
BUN
CBC

Question 9

What does PCV stand for?

Answer 9

packed cell volume

Question 10

What does TP stand for?

Answer 10

Total Plasma Protein

Question 11

What does BUN stand for?

Answer 11

Concentration Blood, Urea, Blood Glucose

Question 12

What does CBC stand for?

Answer 12

complete blood count

Question 13

What does perioperative antibiotics do?

Answer 13

• decrease the risk for infection
• clean or unclean contaminated surgeries
• help to controll an active infection

Question 14

What type of monitoring is needed before and after surgery?

Answer 14

• surgical plane of anesthesia is crucial
• watch for fatal complications
  such as blood loss, pain, hypothermia, cardiac and respiratory problems

Question 15

What are things should be visually and palpably inspected daily when evaluating an incision?

Answer 15

• check hospital environment
• absorb seepage on incision
• do not use ointment and creams on incision - can cause irritation and delay the wound from healing

Question 16

Early on during postoperative time what should you look for on incision?

Answer 16

redness, swelling, drainage, dehiscence, seromas

Question 17

What can be done for swelling on an incision?

Answer 17

ice packs

Question 18

What can be done for drainage on an incision?

Answer 18

do we know if wound is suppose to drain - find out

Question 19

What is dehiscence with a incision?

Answer 19

tissues start separating (wound breakdown)

Question 20

What are seromas?

Answer 20

serum accumulation under the incison

Question 21

Sutures are usually removed after how many days?

Answer 21

7 - 14 days

Question 22

Why do we remove sutures at 7 - 14 days?

Answer 22

because this is the approx. time that the wound is beginning to strengthen

Question 23

What should we check before removing sutures?

Answer 23

inspect for adequate healing

Question 24

A adequate healed incision looks like?

Answer 24

• no drainage
• not severely reddened
• not severely swollen

Question 25

If complications happen with a suture, what can happen?

Answer 25

some reddening, swelling and excessive scarring

Question 26

How do you remove sutures?

Answer 26

- grasp with thumb forceps or fingers - gentle traction - manually pull out of skin - staple removal - follow manufacturer instructions

Question 27

What should monitor carefully once a bandage has been placed on a limb?

Answer 27

- 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

Question 28

Why are drains placed?

Answer 28

- collect fluid | - when large amount of drainage is expected

Question 29

If a drain is placed what must you do to the drain exit?

Answer 29

cover drain exit with a bandage

Question 30

Why is a e-collar needed with a drain?

Answer 30

so animal will leave drain alone

Question 31

What are the two kinds of drains?

Answer 31

active drains -sealed to environment | passive drain - provide an exit port

Question 32

Why is the passive drain difficult to maintain?

Answer 32

because of the constant drainage of fluid through the drain exit site - makes it a risk for a bacterial infection

Question 33

Why is animal restraint important?

Answer 33

- for appropriate surgical technique - patient safety - patient comfort - The animal should be well controlled after surgery to minimize complications

Question 34

Why must a vet. tech. have a working knowledge of common surgical procedures?

Answer 34

- 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

Question 35

What is meant by an elective surgical procedure?

Answer 35

surgery performed at the vet's and owners convenience, usually in healthy animals (OHE, declaw, castration)

Question 36

What is meant by an nonelective surgical procudure?

Answer 36

surgical procedures that must be done urgently (stifle stablization, correction of patellar luxation, cancer resection