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2025 Anesthesia > Exam 1: Lecture 2: Patient Evaluation > Flashcards

Exam 1: Lecture 2: Patient Evaluation Flashcards

1
Q

Who should perform the pre-anesthetic evaluation on the patient

A

ultimatley the responsibility of the veternarian in charge of the patient

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2
Q

What do you always start with during the pre-anesthetic evaluation?

A

Signalment

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3
Q

What are the part to giving a doctor or another team member signalment

A

Species, breed, age, sex, and reproductive status

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4
Q

What should be done or checked during a pre-anesthetic evaluation?

A
  • Signalment
  • History (including anesthesia events or if the patient is currently ill)
  • Physical exam (Body weight and body condition score)
  • Blood and urine sample
  • Temperment / mentation and level of pain
  • Advances diagnositics if done
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5
Q

What patients should receive a routine ECG screening?

A
  • Patients with evidence of CV disease
  • Geriatic patients
  • underlying diseases that may lead to arrythmais
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6
Q

What are some underlying diseases that may lead to arrhythmias

A

hyperkalemia
GDV
splenomegaly
traumatic myocarditis

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7
Q

What should you look for/ give during a physical exam findings

A
  • Temperature
  • Pulse
  • Respiration
  • MM / CRT
  • Body weight
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8
Q

What percent dehydration describes the following?

  • Not detectable
A

Less than 5

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9
Q

What percent dehydration describes the following?

  • Not detectable
A

Less than 5

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10
Q

What percent dehydration describes the following?

  • Subtle loss of skin elasticity
A

5-6

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11
Q

What percent dehydration describes the following?

  • Definite delay in return to skin to normal position
A

6-8

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12
Q

What percent dehydration describes the following?

  • Slight prolongation of CRT
  • Possible dry MM
A

6-8

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13
Q

What percent dehydration describes the following?

  • Eyes possible sunken in orbits
A

6-8

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14
Q

What percent dehydration describes the following?

  • tented skin stays in place
  • eyes sunken in orbit
A

10-12

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15
Q

What percent dehydration describes the following?

  • Definite prolongation of CRT
  • Possible signs of shock
  • Dry MM
A

10-12

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16
Q

What percent dehydration describes the following?

  • Definite signs of shock
    (Tachycardia, cool extremities, rapid and weak pulse)
A

12-15

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17
Q

What percent dehydration describes the following?

  • Death Imminent
A

12-15

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18
Q

What systems are important when preforming a physical exam?

A
  • integument (skin)
  • Lymph nodes
  • GI tract / abdominal palpation / gut sounds
  • Genitourinary tract
  • Central nervous system
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19
Q

What lab work should be preformed on an animal that is less than 5 years old (young) having an elective procedure with no abnormal history?

A

PCV
Glucose
BUN

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20
Q

What lab work should be preformed on an animal that is older having an elective or non-electice procedure
- any history of recent illness
- Screening for suspected infectious disease in endemic regions
- All patients included in a research study

A

CBC
Chemistry Profile
UA

+/- the following:
- ECG
- blood pressure
- thoracic rads
- echocardiogram
- blood gas analysis
- coag profile
- liver function testing
- 4Dx

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21
Q

Where is the pre-anesthetic evaluation performed?

A

Typically in the clinic, but also done during farm calls

Find a quite place so you can better auscultate the heart and lungs

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22
Q

What happens if you cannot approach the animal because it is fractious or is a zoo or wild animal patient?

A

Be cautious and use drugs if needed

23
Q

When should you perform the pre-anesthetic evaluation on a normal procedure?

A
  • usually the day before or up to 1 week before the planned procedure
  • make sure to do another short exam on the day of anesthesia
24
Q

When should you perform the pre-anesthetic evaluation on an emergency case?

A

Done immediately before the procedure

25
Q

What questions should be asked of the owner when doing the pre-anesthetic exam for an emergency?

A

drugs given, diet, home life, etc.

26
Q

Why should pre-anesthetic evaluation be done on all patients?

A
  • safety
  • organ function and risk
  • To see if the client is willing to take the risk
    (this conversation should take place and be documented prior to sedating or anesthetizing any patient)
27
Q

What category does the following fall under?

  • Normal healthy patient
A

I

28
Q

What category does the following fall under?

  • OVH
  • casteration
  • ear/tail docking
  • declaw
A

I

29
Q

What category does the following fall under?

  • patients with mild systemic disease
A

II

30
Q

What category does the following fall under?

  • skin tumor
  • fracture
  • local infection
  • compensated cardiac disease
A

II

31
Q

What category does the following fall under?

  • well controlled diabeties
  • uncomplicated hernia
  • pregnancy
  • obesity
A

II

32
Q

What category does the following fall under?

  • patient with severe systemic disease
A

III

33
Q

What category does the following fall under?

  • fever
  • dehydration
  • anemia
  • cachexia
A

III

34
Q

What category does the following fall under?

  • uncontrolled DM
  • COPD
  • renal failure
A

III

35
Q

What category does the following fall under?

  • Patient with severe systemic disease that is a constant threat to life
A

IV

36
Q

What category does the following fall under?

  • Uremia
  • toxemia
  • sepsis
  • shock
  • severe dehydration
A

IV

37
Q

What category does the following fall under?

  • cardiac decompensation or failure
  • emaciation
  • high fever
A

IV

38
Q

What category does the following fall under?

  • moribund patients not expected to survive without operation
A

V

39
Q

What category does the following fall under?

  • extreme shock and dehydration
  • terminal malignancy or infection
  • severe trauma
A

V

40
Q

When should the ASA PS be assigned?

A
  • after the PE is complete and the lab work or diagnostic tests have been interrupted
41
Q

Case Example:

A 3-year-old intact beagle presents to your clinic in an emergency for a laceration over the right flank region after getting tangled in barbed wire. The laceration is about 4 inches long and will require cleaning the wound, placing a Penrose drain, and surgical closure of the remainder of the wound. The remainder of the PE is WNL. The owner says the dog is UTD on vaccines, flea/tick prevention, and HW medication. What ASA level is this?

A

ASA level 2
- no severe signs, but tear in integument

42
Q

Case Study:

Molly a 12 year old QH mare referred to the University teaching hospital for colic of 12 hour duration. Trainer gave a dose of banamine
- she is 9 months pregnant
- pawing and rolling intermittently

PE
- tachycardia
- tachypnea and increased effort
- distended abdomen - no gut sounds
- MM are dark pink

what is the ASA level?

A

ASA level 4 or 5

43
Q

Why is ASA’s physical status important?

A
  • Used to assess anesthetic risk of a case
  • physical status effects the PK and PD and aids in the selection of drugs and or techniques for a patient
  • Important criteria used in selection of patients in research studies
  • Can also be used from a legal standpoint (retrospectively)
44
Q

Give examples of considerations that are important for dosing drugs?

A
  • Age
  • disease
  • obesity
  • SA vs LA
  • size
  • pregnancy
45
Q

Give some examples of patient preparation which are important

A
  • Fasting recommendations
  • Hygiene and patient comfort
  • correct dehydration and electrolyte imbalance
  • Preoperative antibiotics
46
Q

What species of animals do not require fasting before surgery

A

rodents and rabbits
birds less than 200 grams
neonates

47
Q

What species of animals do not require water deprivation before surgery

A

Canine
feline
equine

48
Q

Do you know why a patient is fasted prior to general anesthesia?

A
  • decreased food and fluid in the stomach
  • decrease risk of aspiration
  • distended stomach or rumen impairs ventilation and could lead to hypoxemia and hypercapnia
49
Q

What consequence could happen in horses if their stomach is full

A

Rupture at induction

50
Q

Why is it not necessary for neonates, small birds, and some mammals to fast before surgery

A
  • prone to hypoglycemia within a few hours of starvation
  • increased metabolic rate in birds and small mammals
51
Q

What about depriving water from patients with increased fluid requirements

A
  • renal insufficiency
  • febrile
  • diabetes
  • hot environment
52
Q

What are the 4 H’s of General anesthetic concern

A

hypotension
hypoventilation
hypothermia
hypoxemia

53
Q

What are other concerns are species, age, disease or procedure specific for general anesthetic concerns

A

hemorrhage
pain
delayed recovery
regurgitation
laryngeal spasms
difficult intubation
dysphoria
arrythmisa
myopathy

54
Q

What do you always want to do and never forget

A

ALWAYS get a signed consent form by the owner

  • can get a verbal consent over the phone, but best to have a 2nd person to confirm the owners decision

2025 Anesthesia (9 decks)

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