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NSULA Vet Tech Surgery and Anaesthesia > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What is placed first after the patient has been sedated?

A

endotracheal tube

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2
Q

Name 5 parameters the Cardell patient monitoring machine measures:

A 
blood pressure
heart rate
pulse ox
temperature
respiration rate
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3
Q

Explain how to change a Baxter fluid pump from macro to micro

A

1-press and hold down “Select” button
2-Press “On” button
3-Press “Select” button until “Macro” or “Micro” is lite up
4- Press “Run” button twice

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4
Q

What is the purpose of the “Blue bubble” or “Blue egg” in the surgery room and dental room?

A

Its purpose is to warm the intravenous fluids before they enter the patient. This reduces the risk of hypothermia

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5
Q

Name the 5 sources of heat (thermal) support we may use for our patient during and after a surgical procedure

A 
Cage warmers
bair hugger
warm towels
rice socks
Tpump with heating pad
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6
Q

Name the 2 major reasons we will choose to use an anticholinergic such as atropine of glycopyrrolate in the dog during the preanesthetic period

A

prevents bradycardia

dries salivary secretions

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7
Q 
Name one contraindication for each of the following drugs:
atropine sulfate
acepromazine
carprofen (rimadyl)
xylazine (rompun)
A
  • atropine sulfate: patients with pre existing tachycardia
  • acepromazine: patients with a history of seizures
  • carprofen (rimadyl): liver toxicity in high doses
  • xylazine (rompun): history of liver or kidney problems
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8
Q

Acepromazine’s recommended dosage for IM administration in the dog in our labs is? Max is?

A

0.05 mg/lb. The volume is never to exceed 0.4 mL with IM administration.

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9
Q

Atropine sulfate is administered at a dosage rate of? bottle concentration?

A

0.02 mg/lb in our labs. The label reads 0.54 mg/mL

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10
Q

A cat that has received ketamine/xyalazine is almost down to the surgical plane of anesthesia when it begins vomiting undigested food. What is your action to prevent serious complications in this cat?

A

Hang the cat’s head and forelimbs over the edge of the table to let gravity play its role in removing anymore vomit. Then use a bulb suction syringe to clear any remaining vomit from the mouth

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11
Q

What is the surgical stage/plane of anesthesia, and how do you know that your patient has progressed to that level?

A

Stage III, Plane 2
When the patient has reached this stage, little to no reflexes are present. The patient’s reaction to pain is very low or not present at all.

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12
Q

Describe how to check the following reflexes in your patient:
palpebral reflex
Pedal (withdrawal) reflex
Corneal reflex

A
  • palpebral reflex: by tapping the medial and lateral canthus around the eyes. The patient will blink if the reflex is still active
  • Pedal (withdrawal) reflex: pinching a toe. The patient will pull its limb in towards the body if the reflex is still active
  • Corneal reflex: shining a light in the patient’s eye or touching the patient’s eye. The patient will blink if the reflex is still active
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13
Q

Name the most common method used to assess muscle tone of your patient during anesthetic induction

A

opening the jaws to assess jaw tone

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14
Q

What is the eye location of a patient in moderate or surgical level of anesthesia?

A

eyes rotate medial vetrally

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15
Q

When monitoring your anesthetized dog or cat patient, you need to notify the veterinarian if the respiratory rate drops

A

to 8 breaths/minute or lower

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16
Q

Pale mucous membranes are an indication of

A

shock and anemia

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17
Q

A prolonged capillary refill time indicates

A

poor tissue perfusion

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18
Q

Name 2 vessels which may be used to assess pulse in the anesthetized dog or cat:

A

1-lingual artery under the tongue

2-femoral artery on the medial side of the hindlimbs

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19
Q

define agonal breaths.

A

Respiratory “gasps” which occur when the diaphragm spasmodically contracts, but no physiologic exchange of gases is occurring in the lungs

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20
Q

Name one way to confirm that the endotracheal tube is properly placed.

A

The patient will cough and the expelled air will be felt through the end of the tube. It may even blow back the anesthetist’s hair

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21
Q

The clipper blade that is generally used to prepare a small animal patient for surgery is the

A

No. 40 blade

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22
Q

blades usually used for large animal surgery prep are

A

No. 10 or 30 blades

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23
Q

Describe one good method of patient identification

A

Name bands and cage cards containing client and patient names

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24
Q

Name 2 possible serious complications if food is not withheld in the dog prior to anesthesia

A

1-vomiting/nausea

2-aspiration

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25
Q

If a 4 yr old female poodle is presented for routine ovariohysterectomy, and is a known epileptic, which preanesthetic drug do we need to avoid using, and why?

A

We should avoid giving acepromazine because it lowers seizure threshold.

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26
Q

What is a potential serious complication of fasting very young animals?

A

hypoglycemia

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27
Q

If a patient scheduled for surgery is 8% dehydrated, what should be done if possible prior to surgery?

A

Place an IV catheter and begin administering fluids prior to surgery

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28
Q

Before administering anesthetic drugs to a patient, what paperwork should we require the owner to complete?

A

A signed document explaining all parts of the surgical procedure, including estimated cost.

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29
Q

Name 2 important clinical signs of dehydration.

A

1-dry/tacky mucus membranes

2-skin tenting

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30
Q

Name 2 important clinical signs of accidental overhydration of your patient.

A

1-excessive nasal discharge

2-swollen conjunctiva

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31
Q

Name 2 risks associated with IV catheterization and administration of IV fluids

A

1-infection of insertion site

2-introducing an air bubble into the catheter accidentally, resulting in possible air embolism

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32
Q

What is the general recommended IV fluid flow rate during anesthetic/surgical procedures in the dog?

A

5mL/lb/hr

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33
Q

What is the total blood volume per pound of body weight in the dog?

A

40mL/lb

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34
Q

When using crystalloid fluids to replace blood loss, what amount is administered per mL of blood lost?

A

3mL/1mL blood lost

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35
Q

Name 2 commonly used types of crystalloid fluids

A

1-normal saline 0.9%

2-Lactated ringers solution (LRS)

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36
Q

Name 2 types of colloid fluids

A

1-Dextran and hetastarch (synthetic)

2-whole blood/plasma

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37
Q

Anticholinergics are used as preanesthetics for what beneficial reason?

A

decrease salivary secretions

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38
Q

The most commonly used anticholinergic drug as a preanesthetic agent is:

A

atropine sulfate

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39
Q

Atropine sulfate may be administered:

A

IM, IV, SQ

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40
Q

How does atropine sulfate generally affect the heart rate of a dog?

A

prevents bradycardia

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41
Q

Atropine sulfate causes

A

mydriasis

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42
Q

A contraindication for using atropine sulfate in the cat is

A

preexisting tachycardia

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43
Q

A usual advantage of glycopyrrolate over atropine is

A

that it does not cross the blood brain/ placental barriers

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44
Q

Chlorpromazine acts as

A

as an anti-emetic

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45
Q

Emesis is

A

act of vomiting

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46
Q

What drug decreases threshold to seizures

A

Acepromazine

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47
Q

Acepromazine is contraindicated in shock because

A

it may produce hypotension effects

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48
Q

The common trade name for diazepam is

A

Valium

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49
Q

A better choice of drug to use as a preanesthetic to calm a geriatric, debilitated patient is

A

diazepam

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50
Q

A common trade name for xylazine is

A

Rompun

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51
Q

Briefly discuss species variation in dosing xylazine in horses versus cattle.

A

The dose for a cow is 1/5 to 1/10 the dose of a horse weighing the same amount

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52
Q

A potential problem with using xylazine in cats is

A

it frequently causes vomiting as a side effect.

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53
Q

The partial antagonist (reversal agent) for xylazine is

A

yohimbine

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54
Q

Why is xylazine contraindicated for use in pregnant cows in the third trimester?

A

xylazine can cause uterine contractions in the third trimester resulting in premature birth

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55
Q

Give 2 examples of narcotic analgesics:

A

morphine and buprinex

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56
Q

An analgesic is used for

A

pain control

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57
Q

The prototype narcotic analgesic that others are compared to the potency is

A

morphine

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58
Q

Butorphenol is used as a

A

narcotic analgesic and cough suppressant

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59
Q

Which 2 species of domestic animals are particularly susceptible to the excitatory effects of narcotic analgesics?

A

horses and cats

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60
Q

Name 2 rules that must be followed by hospital personnel in handling controlled substances:

A

1-the substances must remain in a double locked box

2-an accurate and up to date drug log should be kept recording dispensed doses

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61
Q

Naloxone is used as an

A

anesthetic reversal agent

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62
Q

Name one NSAID which may be administered as a pre-emptive analgesic in a surgical dog:

A

rimadyl

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63
Q

Name one narcotic analgesic that is provided in a skin patch form:

A

Fentanyl

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64
Q

List necessary tasks for preoperative preparation of the equine surgical patient:

A

remove shoes
set IV cath
physical exam
Shave and wipe area of interest

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65
Q

Name 2 possible major complications post operatively in the horse that had inadequate padding on the surgery table for a 5 hour procedure.

A

1-myopathies/neuropathies

2-cardiopulmonary compromise

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66
Q

Name one possible side effect of each of the following preanesthetics in the horse:
acepromazine
xylazine

A

acepromazine- hypotensive effects

xylazine- bradycardia

67
Q

For each of the following species, tell whether the body temp is more likely to increase or decrease during anesthesia pig, cat, dog

A

pig-increase
cat-decrease
dog-decrease

68
Q

Describe how to pull a horse’s shoes prior to surgery.

A

File down tips of nails bent through the top of the hoof then pull nails and show from the bottom of the hoof

69
Q

What are the recommendations for the length of time food should be withheld prior to anesthesia?
(pigs, large ruminants, goats/sheep, calves/lambs/kids, horse)

A 
pigs: 12-24 hours
large ruminants: 24-36 hours
goats/sheep: 12-24 hours
calves/lambs/kids: 2-4 hours
horse: 24 hours
70
Q

Name 3 frequently encountered problems associated with general anesthesia in cattle:

A

respiratory depression
bradycardia
bloat

71
Q

Xylazine must be dosed at approximately ___the IV horse dose in cattle

A

1/10th

72
Q

Name one common side effect of xylazine in cattle

A

bloat

73
Q

Ocular reflexes are good indicators of the depth of anesthesia in cattle, what are they?

A
  1. the corneal reflex should be active throughout anesthesia, and the palpebral reflex is depressed by gas anesthesia
74
Q

When extubating a ruminant, the cuff of the endotracheal tube should be

A

be partially inflated

75
Q

Name One method for placing the endotracheal tube in the cow is

A

by inserting your arm into the cow’s mouth, pulling down the epiglottis with hand while inserting the tube

76
Q

Name 2 possible complications from over inflation of an ET tube cuff:

A

lumen tube collapse

necrosis of trachea

77
Q

As a preanesthetic, atropine is not often used in ruminants for what 2 reasons?

A

bloat

increased viscosity of salivary secretions

78
Q

Name 2 possible causes of a prolonged CRT in pigs

A

dehydration

hypotension

79
Q

A respiratory stimulant drug is

A

doxapram

80
Q

The species most prone to malignant hyperthermia is

A

pig

81
Q

Rebreathing bag sizes used in horses are typically

A

15-30 liters

82
Q

A bird must be able to freely move its____ to breathe properly during surgery

A

Thorax

83
Q

____ and___ bones of the bird may be pneumatic

A

The humerus and femur

and should not have intraosseous fluids administered in them

84
Q

Uncuffed endotracheal tubes are recommended for use in

A

avian patients

85
Q

how are ECG leads in the snake placed

A

cranial and caudal to the heart

86
Q

is it acceptable to transfuse a cockatoo with pigeon blood

A

as long as it is only done once

87
Q

What complications or factors do we need to consider when administering anesthesia for an abdominal surgical procedure in the bird, due to the fact that the diaphragm is incomplete?

A

The airsacs are easily compromised in the bird due to their “bellows” type breathing system

88
Q

The safest anesthetics to use in the bird are

A

isoflurane and sevoflurane administered via mask or endotracheal tube

89
Q

Describe proper care of birds during post op recovery.

A

It is advised to keep the bird wrapped in a towel until full recovery to prevent self injury. Never place a bird on a perch to recover.

90
Q

How do you treat an anesthetic overdose in the fish?

A

place the fish in a tank of water free of anesthetics; “swim the fish”

91
Q

Which birds require personnel to wear eye protection?

A

long beaked birds such as herons

92
Q

Which birds may disembowel personnel?

A

Ratites such as emus and ostriches

93
Q

The most widely used fish anesthetic is

A

Finquel

94
Q

What anesthetic gas may be used in reptiles and amphibians

A

Isoflurane

95
Q

Chelonians generally______at the surgical plane of anesthesia

A

require respiratory support in the form of IPPV

96
Q

Fasting prior to surgery is not recommended in

A

pet birds

97
Q

Rabbits may produce ____ naturally

A

atropinase

98
Q

Gerbils are generally predisposed to what?

A

seizure disorders, to the point that about 50% will seizure when handled or stressed

99
Q

Describe how to correct soft palate displacement when it causes you to be unable to visualize the larynx as you attempt to intubate a patient.

A

Use a mouth speculum to keep the mouth open. Use a laryngoscope to visualize and pull down the epiglottis to insert the ET tube. Use lidocaine gel if laryngospasm is a problem

100
Q

Two vessels used in the dog to monitor pulse rate and pressure are what?

A

femoral and digital arteries

101
Q 
Name one important consideration when anesthetizing for each patient type:
geriatric patient
pediatric patient
sighthound
obese animals
A
  • geriatric patient: risk of hypothermia due to decreased muscle mass
  • pediatric patient: avoid injectable anesthetics because liver enzymes and passages are not fully developed until about 8 weeks of age
  • sighthounds: avoid barbituates
  • obese animals: dose at ideal body weight
102
Q

What is the appropriate IV drip set calibration to use in patients under 10 pounds?

A

60 gtt/mL

103
Q

For anesthetizing a 3 week old puppy to repair a congenital umbilical hernia, what method is preferred?

A

mask with isoflurane, then intubate and maintain on isoflurane

104
Q

A veterinary patient under 2 months of age is generally considered to be at ___(increased OR decreased) risk when anesthetized, compared with a mature animal

A

Increased

105
Q

Name 3 anatomic characteristics in the brachycephalic dog that may impede respiratory air exchange

A

1- stenotic nares
2- elongated soft palate
3- everted laryngeal folds

106
Q

For C section procedures it is recommended that as much of the___ ___ as possible be done before anesthetizing the patient

A

preoperative preparation

107
Q

What drug is considered safe to use for C section procedures

A

Propofol

108
Q

what is common in the first 72 hours after chest trauma?

A

Cardiac arrhythmias

109
Q

you must “bag” a patient during repair of a diaphragmatic hernia, explain how you would do so

A

pressure to approximately 20 cm H2O is applied every 5 seconds, with the pop off valve being closed. The anesthetic vaporizer setting must be adjusted lower than would be set for the patient that is ventilating itself

110
Q

Name 4 possible causes to quickly check for if an animal on gas anesthesia will not stay anesthetized

A

1- cuff inflated
2- vaporizer on
3- tube properly inserted in the trachea
4- O2 on and full

111
Q

Name 4 possible causes of pale mucous membranes in the anesthetized patient

A

pre existing anemia
blood loss during surgery
hypotension/ vasodilation
pain

112
Q

The first priority in the treatment of shock is generally what?

A

the administration of IV fluids

113
Q

Respiratory arrest must be corrected within ___ minutes to avoid brain cell damage

A

4 minutes

114
Q

List in order your steps in treatment of respiratory arrest

A

1- alert veterinarian
2- turn off vaporizer
3- intubate and bag with 100% oxygen every 5 seconds

115
Q

Describe how to effectively manage the patient who temporarily ceases respiratory efforts immediately following anesthetic induction.

A
  • monitor pulse ox, heart rate, CRT, and MM color
  • bag the patient every 30 seconds for 1-2 minutes
  • alert veterinarian if respiration does not pick up or if other vital signs begin dropping
116
Q

Define Apneustic breathing

A

Patient is holding their breath

117
Q

define apnea breathing

A

cessation of breathing

118
Q

define bradycardia

A

decreased heart rate

119
Q

define tachycardia

A

increased heart rate

120
Q

Describe clinical signs that you would find in the cardiac arrest patient.

A
  • pulse: absent
  • heartbeat: absent
  • mucous membrane color: gray or cyanotic
  • pupils: blown and fixed; negative PLR
  • respiration: absent
  • ECG tracing: can be in asystole, ventricular fibrillation, or electromechanical dissociation
121
Q

List the 6 major steps in cardiopulmonary resuscitation

A 
Airway
Breathing
Circulation
Drugs
ECG
Fluids
122
Q

How do assess whether or not cardiac compressions are being effective in CPR?

A

If a femoral pulse is felt then enough compression is happening. Also, MM will get pinker and CRT will return to <2 seconds

123
Q

The drug most commonly used for initial treatment of cardiac arrest (asystole) is

A

epinephrine

124
Q

The drug most commonly used initially for seizures that occur in the post anesthetic period is

A

diazepam

125
Q

Define the term electromechanical dissociation.

A

A QRS complex is shown on the ECG but no heart contraction is happening. The electrical stimulus is present but the heart is not obeying it

126
Q

You are monitoring a canine patient undergoing an ovariohysterectomy. If the respiratory rate falls to 8 breaths/minutes or below you should consider what?

A

adjusting the vaporizer to a lower setting

127
Q

If the anesthesia machine is assembles so that the F circuit breathing tubes are attached opposite the way intended to the anesthesia machine, what complications will the patient experience?

A

The patient will not be able to inhale oxygen, it will only be able to inhale its own CO2. This will lead to hypercapnia.

128
Q

A decimal error in mathematical calculations of drug dosages minimally causes a __ fold error in the amount of drug administered.

A

10 fold error

129
Q

What checks can you establish for yourself to ascertain that you administer the correct drug by the proper route with an accurate dosage measured and delivered?

A
  • accurate patient weight
  • check drug being used
  • check concentration of the bottle
  • check route of administration
  • repeat calculations to avoid mathematical errors
  • label syringe with patient’s name, dose, route, and drug name
130
Q

A cat recovering from ketamine anesthesia suddenly begins a grand mal seizure. What drugs is the doctor likely to request and in what order?

A

a. first: diazepam
b. second, if the first drug is ineffective in stopping the seizure: phenobarbital
c. third alternative drug: resedate with general anesthesia

131
Q

Laryngospasm is most common in what species?

A

Cat

132
Q

Telazol is made up of what 2 drugs?

A

Tiletimine and Zolazopam

133
Q

You notice your feline OHE patient, while anesthetized with isoflurane on a non rebreathing system on the surgery table, is cyanotic. How do you respond?

A
  • alert the veterinarian
  • turn off the vaporizer and bag with 100% oxygen every 5 seconds
  • Check all connections on anesthesia machine
  • Immediately disconnect the patient from the non rebreathing system , allowing the patient to breathe room air
  • administer doxapram under the direction of the veterinarian
134
Q

Name the possible methods of arousal (waking up) from injectable anesthesia

A
  • redistribution of the drug within the body
  • liver metabolism
  • renal excretion
135
Q

label these drugs as ultra short acting, short acting, intermediate acting, and long acting (methoxy, thiopental, pentobarbital, and phenobarbital)

A

Ultra short acting: methoxy
short acting: thiopental
intermediate acting: pentobarbital
long acting: phenobarbital

136
Q

A barbiturate commonly used as an anticonvulsant is

A

phenobarbital

137
Q

When apnea occurs during anesthetic induction, you first priority should be to:

A

intubate quickly and begin giving the patient 100% oxygen; assess other vital signs

138
Q

Concisely summarize the major concern/ problem or effect encountered with barbiturate anesthesia: (respiratory system, cardiac effect, hypoproteinemic animals, acidotic animals, and sighthounds)

A
  • respiratory system: decreases respiration rate
  • cardiac effect: decreases heart rate
  • hypoproteinemic animals: low circulating protein levels creates and overdose effect from the anesthesia
  • acidotic animals: greater effect in patients with low pH
  • sighthounds: causes an overdose effect due to low body fat
139
Q

Name one complication of injecting pentobarbital perivascularly.

A

patient can remain stuck in the stage II excitatory phase

140
Q

Name 2 clinical uses for pentobarbital today:

A

1- euthanasia

2- treatment for stychhnine toxicity

141
Q

Anesthetic agents which produce profound amnesia and dissociation from one’s environment are termed

A

dissociative agents (cyclohexamines)

142
Q

Effects of Ketamine anesthesia in a cat:

A
  • reflex responses: exaggerated:
  • laryngeal reflex: present
  • sensory stimuli: response
  • muscle tone: increased
  • peripheral analgesia: good
  • visceral analgesia: poor
  • heart rate: increased
  • eyelids: open
143
Q

Telazol can be given IM or IV. what are the doses?

A

`1mL/100lb IV, 1mL/30-45lb IM

144
Q

Propofol has poor storage characteristics, which make it more likely to support ____ ____. How should it be handled?

A
  • bacterial growth
  • For this reason, it is recommended that the drug vials be handled aseptically and that unused product be stored by refrigeration.
145
Q

It is considered acceptable to repeat dosing of propofol if needed for the desired anesthetic effect. Why?

A

Because propofol is metabolized very quickly in the body

146
Q

The most common undesired effect on the patient during induction with propofol is

A

apnea

147
Q

A muscle relaxant used in combination to induce anesthesia in large animals such as horses is what? How is it given?

A

Guafenisen.

It is always given IV

148
Q

How do inhalation agents reach the brain from the anesthesia machine?

A

anesthetic liquid -> vaporized with oxygen -> air passageways -> alveoli -> blood stream -> brain

149
Q

Which 2 older gas anesthetic agents with significant elimination from the body by liver metabolism?

A

halothane and methoxyflurane

150
Q

A measure of the distribution of the inhalation agent between the blood and gas phases in the body is termed

A

solubility coefficient

151
Q

Define minimum alveolar concentration (MAC):

A

this is the lowest amount of agent possible to produce a response in 50% of patients to a pain stimulus

152
Q

Depth of anesthesia may be changed most rapidly with what inhalation gas?

A

sevoflurane

153
Q

Halothane most commonly has ___ ___ associated with administration

A

cardiac arrhythmias

154
Q

Name Anesthetic agents from slowest to most rapid

A

methoxyflurane -> halothane -> isoflurane -> sevoflurane

155
Q

what inhalation gas has a higher concentration for induction?

A

Sevoflurane

156
Q

which inhalation gas is considered to have the least undesirable cardiac effect?

A

Isoflurane

157
Q

Non rebreathing anesthetic systems are recommended for patients less than ___lb body weight

A

15

158
Q

CO2 absorbent should be changed after___ hours of use

A

10 hours

159
Q

Oxygen tanks should be changed when they have reached __ psi

A

500

160
Q

Name 3 classes of drugs which may be used as pre anesthetics to produce calming or relaxation

A

Benzodiazepines
phenothiazines
opioids

161
Q

2 ways to quickly check proper ET tube placement are what?

A

patient cough and fogging of tube

162
Q

If the pop valve is left in a closed position, what could happen?

A

pressure may rapidly rise in the anesthetic circuit. Closure of the pop off valve causes pressure on the patient’s lungs. This prevents the patient from breathing

163
Q

Why is Atropine seldomly used in the cow or horse?

A

because it makes their salivary secretions thick and “ropey”

NSULA Vet Tech Surgery and Anaesthesia (5 decks)

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