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2025 Anesthesia > Exam 1: Lecture 7: Thermoregulation and Postoperative Care > Flashcards

Exam 1: Lecture 7: Thermoregulation and Postoperative Care Flashcards

1
Q

What is thermoregulation?

A

Ability of an oragnism to maintain body temperature within a certain range (+- 0.2C), even when surrounding temperatures vary

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2
Q

What range do we thermoregulate dogs and cats?

A

100 to 102.5

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3
Q

Homeothermic or Poikilothermic?

Most domestic animals

A

Homeothermic

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4
Q

Homeothermic or Poikilothermic?

reptiles, amphibians and some fish

A

Poikilothermic

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5
Q

Core body temperatures are often how much higher than skin temperatures?

A

2-4 C

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6
Q

Abnormal body temperatures in awake animals can be caused by?

A

metabolic dysfunction

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7
Q

Abnormal body temperature in anesthestized animals can be caused by?

A

fluid or drug related

enviornmental

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8
Q

In the brain, where is temperature regulation controlled

A

Hypothalamus

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9
Q

What type of fibers are caused by Noxious mechanical stimulus

A

Alpha delta fibers

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10
Q

What type of fibers are caused by noxious head and chemical stimuli

A

C fibers

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11
Q

Where do spinothalamic (along the spine) tract transmit temperature signals?

A

CNS: central nervous system

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12
Q

Where do efferent pathways end
- blood vessel tones
- shivering or sweating

A

Alpha motor neurons

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13
Q

What are the 4 heat loss mechanisms?

A
  • Radiation
  • Convection
  • Conduction
  • Evaporation
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14
Q

What are the two main mechanisms of heat loss?

A

Radiation and convection

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15
Q

Define Radiation

A

loss of heat via electromagnetic waves
- standin outside in the sun = warming up

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16
Q

Define Convection

A

Process of losing heat through the movement of air or water molecules across the skin
- moving through the pool

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17
Q

Define conduction

A

Loss of heat to objects directly in contact with the body

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18
Q

Define evaporation

A

Loss of heat through conversion of water to gas (moisture from skin and lungs)

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19
Q

What type of heat loss is illistrated by number 1

A

Convection

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20
Q

What type of heat loss is illistrated by number 2

A

Radiation

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21
Q

What type of heat loss is illistrated by number 3

A

Evaporation

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22
Q

What type of heat loss is illistrated by number 4

A

Conduction

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23
Q

What type of heat loss is descibed as:

  • Body warmed by absorbing rays of subshine and the body loses heat by thermal radiation
A

Radiation

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24
Q

What type of heat loss is descibed as:

  • Wood stove warming a room
A

Radiation

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25
Q

What type of heat loss is descibed as:

  • Microwave uses electromagnetic radiation to transfer heat to food
A

Radiation

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26
Q

What type of heat loss is descibed as:

  • Heat exchange between the body and ambient air or water in which it moves
A

Convection

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27
Q

What type of heat loss is descibed as:

  • Fan blowing on you
A

Convection

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28
Q

What type of heat loss is descibed as:

  • Wind-chill factor
A

Convection

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29
Q

What type of heat loss is descibed as:

  • Swimming in a cold pool or moving body of water
A

Convection

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30
Q

What type of heat loss is descibed as:

  • A seat staying warm after you have sat on it
A

Conduction

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31
Q

What type of heat loss is descibed as:

  • Cold surgery table cooling a patient down
A

Conduction

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32
Q

What type of heat loss is descibed as:

  • Holding water bottle to your head
A

Conduction

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33
Q

What type of heat loss is descibed as:

  • Passively through respiration (air breathed out has moisture)
A

Evaporation

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34
Q

What type of heat loss is descibed as:

  • Active through sweating (body creates a layer of water on the skin to cool down)
A

Evaporation

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35
Q

What type of heat loss is descibed as:

  • transfer of heat via electromagnetic waves through airspace

usually occurs when ambient temperature is below 68 degrees F

A

Radiation

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36
Q

In radiation heat loss this occurs when ambient temperature is blow ______ degrees F

A

68

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37
Q

Most of the electromagnetic radiation that comes to the earth from the sun is ________

A

Invisible

  • only a small portion is visible light
  • light is made from waves of different frequencies
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38
Q

What are the main 4’s to remeber in regards to anestheisa?

A

Hypothermia

Hypotension

Hypoventilation

Hypoxia

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39
Q

What extent of hypothermia has the following conditions:

Temperature: 89.6 to 98.6 F

A

Mild

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40
Q

What extent of hypothermia has the following conditions:

Temperature: 82.4 to 89.6 F

A

Moderate

41
Q

What extent of hypothermia has the following conditions:

Temperature: less than 82.4 F

A

Severe

42
Q

What extent of hypothermia has the following conditions:

Phsyiological changes
- Increased basal MR and O2 consumption
- vasoconstriction
- SNS activation

A

Mild

43
Q

What extent of hypothermia has the following conditions:

Phsyiological changes
- Slowing of HR and Breathing
- Low BP

A

Moderate

44
Q

What extent of hypothermia has the following conditions:

Phsyiological changes
- Further slowing of HR
- development of arrythmias prior to stopping
- No PLP

A

Severe

45
Q

What extent of hypothermia has the following conditions:

Clinical Changes
- Heat seeking behavior
- Shivering
- Tachycardia
- Tachypnea
- Diuresis

A

Mild

46
Q

What extent of hypothermia has the following conditions:

Clinical Changes
- Decreasing conscious state
- No longer shivering

A

Moderate

47
Q

What extent of hypothermia has the following conditions:

Clinical Changes
- No longer conscious
- Rigid Muscles
- Pulses and respiration difficult to detect

A

Severe

48
Q

What are passive rewarming strategies to warm anesthetized patients?

A
  • Blankets
  • towels
  • wrap extremities
49
Q

What are active rewarming stratigies to warm anesthetized patients?

A
  • Forced air blankets
  • circulating warm water blankets
  • Resistive polymer eletric heating
  • Humidifiers
  • IVF warmers
  • Warm fluids to lavage in abdominal cavity
50
Q

T/F: The use of eletric heating pads/blankets are safe and effective for use in anesthetized of recovery patients

A

False! they are NOT safe

51
Q

When does organ damage occur during hyperthermia?

A

around 106 to 107 F

52
Q

Define pyrexia

A

Fever
- a cause for the problem

53
Q

What is defined as a regulation probelm in animals

A

hyperthermia

54
Q

What is defined as causes (Ex: pyrogens) included infection, inflammation, neoplasia, trama, necrosis, and immune mediated

A

Pyrexia

55
Q

What is defined as elevation in core body temperature due to thermoregulation failure

A

hyperthermia

56
Q

Give some causes of hyperthermia

A
  • Heat stroke
  • respiratory obstruction
  • Exercise induced
  • Histamine release
  • Iatrogenic (doctor causes the problem)
  • Prolonged seizure activity
  • Malignant hypethermia
57
Q

From a clinical standpoint, how is fever treated / managed?

A

Cooling a patient may be counter productive since the body wall will expend energy to get back to the temperature it was at to fight bacteria, virus, etc.

dont fan a fever

Avoid antibiotics until origin of known and/or samples collected. Sepsis is the exception

Avoid NSAIDS and steroids if possible (use opiods or gabapentin if painful)

use acetaminophen in dogs

58
Q

T/F: Acetaminophen can ONLY be given to cats

A

BIG FLASE!!!!!!!

ONLY given to dogs
- if you give to cats = DeAtH

59
Q

From a clinical standpoint, how is hyperthemia treated / managed?

A

Requires active cooling and potential sedation
- no ice packs because it causes vasoconstriction and inhibits dissipation of heat from core body
- Alochol on foot pads not considered helpful

Dont over cool patient

60
Q

When a patient reached a temp of ______ stop cooling the patient to avoid rebound hypothermia

A

104F

61
Q

If you do not use caution with agressive methods of cooling what may happen to the patient?

  • think blood flow
A

Vasoconstriction may cause hypothermia

62
Q

What is the 1st line strategy to cool a patient

A
  • O2
  • room temperature
  • IVF
  • Fan
  • tepid water applied to skin
  • Shaving fur on the belly
63
Q

What is the 2nd line strategy for cooling a patient

A
  • Peritoneal dialysis
  • Cool IVF
64
Q

What strategy do you want to avoid when cooling a patient

A

cold water enema (cool water may be considered, but could damage the GI tract) and gastric lavage due to potential aspiration

65
Q

What drug in cats is hyperthermia commonly assoicated with

A

Hydromophone

  • other drugs may also cause hyperthermia
66
Q

During recovery of anesthesia in cats when do signs of hyperthermia occur

A

first 5 hours

67
Q

What body system may cause hypothermia in the following clinical signs
- Decreased function (chemotaxis, phagocytosis, antibody production, etc.)
- Delayed wound healing

A

Immune

68
Q

What body system may cause hypothermia in the following clinical signs
- Hemoconcentration and increased viscosity
- Left shift of Oxy-Hb curve
- Decreased RBC deformability
- Coagulation
- Abnormalitlies
- DIC

A

Hematopoietic

69
Q

What body system may cause hypothermia in the following clinical signs
- Reduced CO
- decreased contracility
- arrythmias
- vasoconstriction
- cardiac drugs less effective

A

CV

70
Q

What body system may cause hypothermia in the following clinical signs
- Falsely increased PaO2
- decreased RR

A

Respiratory

71
Q

What body system may cause hypothermia in the following clinical signs
- Decreased renal tubular function

A

Renal

72
Q

What body system may cause hypothermia in the following clinical signs
- Elevated serum amylase

A

GI

73
Q

What body system may cause hypothermia in the following clinical signs
- reduced hepatic function (altered enzyme activity( can prolong duration and effects of drugs

A

Hepatic

74
Q

What body system may cause hypothermia in the following clinical signs
- Falsely decreased pH
- Decreased adrenal activity
- Hyperkalemia
- delayed wound healing

A

Metabolic

75
Q

What body system may cause hypothermia in the following clinical signs
- Stupor progressing to coma
- absent motor and reflex function

A

Neurological

76
Q

What body system may cause hyperthermia in the following clinical signs
- Inflammatory response
- vascular statis
- extravasation
- edema

A

Immune

77
Q

What body system may cause hyperthermia in the following clinical signs
- DIC
- Hemorrhage

A

Hematpietic

78
Q

What body system may cause hyperthermia in the following clinical signs
- Tachycardia
- hypotension
- Cardiac failure due to high CO

A

CV

79
Q

What body system may cause hyperthermia in the following clinical signs
- Increased ventilation

A

respiratory

80
Q

What body system may cause hyperthermia in the following clinical signs
- Acute tubular necrosis
- low urine output

A

Renal

81
Q

What body system may cause hyperthermia in the following clinical signs
- Intestinal ischemia infarction
- translocation of bacterial

A

GI

82
Q

What body system may cause hyperthermia in the following clinical signs
- Production of PGE2
- Failure of function

A

Hepatic

83
Q

What body system may cause hyperthermia in the following clinical signs
- severe hypoglycemia
- depletion of glycogen stores

A

Metabolic

84
Q

What body system may cause hyperthermia in the following clinical signs
- Neurologic dysfunction
- delirium, coma, or seizures

A

Neurological

85
Q

How do you convert from celsius to Fahrenheit

A

Celsius temp x 1.8 + 32 = X

86
Q

An animal has a temp of 36.5 C. What is this temperaure in F

A

(36.5 x 1.8) + 32 =97.7F

87
Q

When the patient is done with surgery, drapes are removed, instruments and nonessential monitors from patient, what is left on the animal?

A

Leave ETCO2 +/- SpO2

palpate pulses or use stethoscope

88
Q

After surgery when inhalent is turned off, empty the reservior bag into the scaveging system. What do you turn the O2 flow rate up to?

A

Rule of thumb: double of what is was during surgery

Normally it is turned up to 50-100 ml/kg/min

89
Q

In simple terms how do you define dysphoria?

A

Lights are on but no one is home

90
Q

In simple terms how do you define pain

A

Lights are on and someone is home

91
Q

Now the patient is extubated, how long should you monitor the temp of the animal and what temp should be try and reach?

A

15-30 min until 98F

92
Q

When should you assess pain for a patient?

A

While they are awake and conscious. NEVER while they are stil asleep/ under anesthesia

93
Q

When should the animal be released to the owner?

A

When the animal is able to walk out on their own

94
Q

What sort of instruction should you provide the owner/caretaker?

A
  • Written discharge instruction
  • Verbal Instructions

(Try to do this before you bring the patient in the room as the client will get easily distracted)

95
Q

What should be on the Discharge Instruction

A
  • what behaviors to expect
  • Restrict activity and/or limit areas of house
  • Recheck date and if and when sutures need to be removed; any badges to monitor/change
  • When to offer food and water and how much
  • When to start any meds and should they be offered with food
  • Signs they should monitor their pet for and when to call if concered
96
Q

What treatment orders are included in post operative care for hospitilized patients?

A
  • vitals
  • serial pain scoring
  • Body weight
  • Urine and feces output
  • Hydration status
  • Feeding and water instruction or NPO
  • IV fluids
  • Exercise and other physical activity
  • all other nursing care instructions
97
Q

What is the IVF (IV fluids) maintenance rate for treatment

A

40-60 ml/kg/day

98
Q

You need to set up a 20kg dog on a maintenance IVF rate of normasol-M (Maintenance) after surgery. What would you set the fluid pump at (in mL/hr) to meet this patients maintenacne needs? Assume no dehydration, ongoing, or insensible looses are occuring

A

20 kg x 50 = 1000

1000 or 1 L / day

1000 / 24 =41.66 mL/hr

for normal pt / nurse records say 40 mL/hr to make it easier

99
Q

What is prolonged recovery?

A

Ecexssive time from discontinuation of inhalant anesthesia and the patient has not been extubated (30-45 min)

  • prolonged time to standing horses (around 1 hour)
  • check vitals
  • actively warm pt if needed
  • Check electrolytes and BG
  • Consider reversal of certain drugs
  • IV fluids +- dextrose and/or Ca2+

2025 Anesthesia (9 decks)

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