General post-op care Flashcards
What is the pre-operative period defined as?
The time before surgery
Involves any prior preparations/premeds up until induction/initiation of GA
What is the peri-operative period defined as?
From the start of GA until the patient wakes up/GA is antagonised
What is the post-operative period defined as?
The return to normal after GA and surgery
When does the recovery period end?
When a full level of consciousness is present and physiological values have been normalised
Where should patients be taken for recovery from anaesthesia?
Clean/dry/comfortable/quiet kennel
Ensure safe in case of dysphoria/thrashing/aggression
When should ET tube be removed from dog? (non-brachy)
When the dog begins to swallow or move tongue
When should cats ET tube be removed?
When blink reflex returns - risk of laryngeal spasm (fatal)
How do you make sure the airway remains patent after ET tube removal?
Extend the neck and head and pull the tongue forward
How long should ET tube be kept in brachycephalic breeds?
Until firmly in sternal recumbency/as long as tolerated - aids breathing
What are the general parameters which should be monitored regularly in the post-op period?
TPR Mucous membrane colour Respiratory effort Lung auscultation Blood pressure (?) CRT
Which patients are more likely to require IVFT in the post-op recovery period?
Those at risk of kidney injury/chronic kidney disease
Sick animals (pyometra, peritonitis)
Those with low BP pre/peri-operatively
Why might pain be difficult to assess in the post-operative period?
Determining dysphoria vs. pain
Effects of sedation still present
Species differences (prey)
Subjective
When should water be offered post-operatively?
As soon as patient is able to hold themselves in sternal recumbency unaided
Why wouldn’t you expect an animal to defecate for a while post-operatively?
Will have been starved for 16+ hours
What nursing considerations should be made specifically for rabbits post-operatively?
Provide fresh hay/pellets immediately
Try to get eating ASAP, monitor droppings
Ensure quiet ward away from predators
Ensure hiding places
Continue eye lubrication
Consider pro-kinetics
What are the signs of post-surgery haemorrhage?
Slow CRT Pale MM Low BP Tachycardia Lethargy Dull behaviour
What are the signs/symptoms of aspiration pneumonia?
Fluid from nose
Crackles on lung auscultation
Dyspnoea
What are the 4 classes of medications most likely to be given in the post-operative period?
Pain relief
Anti-emetics
Antibiotics
Probiotics/kaolin
What are the side effects of opioid administration in the post-op period?
Respiratory depression Bradycardia Panting Salivation Vocalisation Urination/defecation
Why might ant-emetics be used in the post-operative period?
Used if signs of nausea present (lip-licking, hypersalivation, inappetence)
Which anti-emetics are commonly used in rabbits post-op?
Ranitidine
Metaclopramide
When might antibiotics be administered post-op?
Orthopaedic procedures
Patients already unwell pre-op
Surgeries over 2 hours long
Dental disease/wound infections where antibiotics are part of the treatment plan
Which antibiotics might be used in the post-op period?
Amoxicillin-cluvanic acid (IV/SC)
Metronidazole (IV)
Cephalosporin (IV)
Why might probiotics/kaolin be used in the post-op period?
Not routine unless diarrhoea post-op
Good idea for rabbits (just in case)
