Intra & Post-Op Care QUIZ & LAB Flashcards
In which of the four phases of anesthesia do the most anesthetic deaths occur?
1. Recovery
2. Induction
3. Pre-anesthesia
4. Maintenance
- Recovery
T/F: Post anesthetic delirium in the recovery period can be difficult to distinguish from pain.
True
T/F: A Penrose drain is a gravity dependent passive drain that needs frequent care
True
T/F: Dehiscence refers to necrosis of tissue around the incision site
True
T/F: Re-warming of a patient should continue until the body temperature is at least 103
False
A ___ is a collection of fluid in a pocket, whereas a ___ is a collection of blood in a pocket. A ___ is more likely to become infected as it is a culture medium.
- Seroma
- Hematoma
- Hematoma
Why is the cuff of the endotracheal tube left inflated until the patient is able to spontaneously swallow?
Prevent aspiration
How long after potential aspiration should radiographs be taken to evaluate for aspiration pneumonia?
a. 6 days
b. 6 hours
c. 6 weeks
d. 60 minutes
b. 6 hours
You are recovering a patient. The patient is swallowing so you deflate the cuff and remove the endotracheal tube. Suddenly you notice green fluid trickling from the patient’s mouth. What are the first three actions you should take (in order) and why? (3)
- Hang head off elevated surface to drain fluids & suction mouth
- Clear airways - Eval pulse ox & breathing effort
- May need to re intubate - Notify DVM
- If diagnostic steps need to be made & DVM should know as this can lead to pneumonia
“Millie” a 6-month-old female (now spayed) Maltese is your next discharge appointment. “Millie” had an uneventful ovariohysterectomy yesterday. She ate breakfast today and had her morning analgesia, but will need an oral dose this evening.
List 5 parameters you will discuss with the owners regarding monitoring/care of “Millie” until her suture removal in 10 days.
- Limit exercise (take out on leash for bathroom, no playing/rough housing) & limit to one room/space, keep e-collar on to prevent self-trauma, and don’t getting incision site wet
- How much to feed & what to expect for appetite post-op
- Look out for swelling, irritation, inflammation, redness, etc around wound site two to three times daily. Vomiting, lethargy, GI issues, ataxia (etc) too.
- How to administer medications & when
- Best way to reach us if they have any questions or concerns!
- Assessment of BP at 10am?
- What can be done to normalize? (3)
- Assessment of Pt body temp during this procedure?
- What can be done to normalize/prevent this? (2)
- Hypotensive
- Normalize:
- Increase IV fluids
- Lower ISO
- Provide external heat source - Hypothermic
- Normalize/Prevent:
- Warm IV fluids
- Blanket/warmies on patient
- What is your assessment of the patient EtCO2?
- How many total fluids did the patient get during this procedure?
- What was the fluid rate that the patient was on during this procedure?
- Good. Slightly low at 10:30am.
- 2725mL
- 1020mL/hr
- What are possible side-effects of oxymorphone in the dog?
- What are possible side-effects of ketamine in the dog?
- Oxymorphone:
- Respiration depression
- Vomiting
- Impaired thermoregulation - Ketamine:
- Hypertensive
- Hallucination/delirium
- Eyes open
- Hypo/Hyperthermia
- How often should be checked/recorded on this patient after the end of anesthesia and PRIOR to extubation?
- How often should be checked/recorded on this patient after the end of anesthesia and AFTER extubation?
- When does the “post-anesthesia” monitoring stop?
- Constantly, Every 5min
- Every 10-15min
- When all patient reflexes have returned
Why specifically is the time period after anesthesia considered more dangerous than during anesthesia? (5)
- Self trauma
- Vomiting
- Aspiration
- Pain
- Bleeding
Jake is a 4yr N/M Chihuahua who presented for a cystotomy. 3 days post-op his owners notice a soft swelling at the incision site. Jake comes in for a recheck and a sample is taken of the fluid. The DVM confirms this fluid is serum.
a. What is happening with Jake?
b. What could have caused this?
c. What would you tell the owners to do at home to help resolve this issue?
a. Seroma
b. Dead space, inflammation, tissue trauma.
c. Monitor swelling, pain, & signs of irritation & color (skin).
- Warm compress
- Limit exercise
Randy is a 12yr N/M Chocolate Lab who recently had a soft tissue sarcoma removed from the R pelvic limb. During his 2 week incision recheck, you see this. Owners report that Randy got his cone off yesterday while they were at work.
a. What is happening with Randy?
b. How is this caused?
c. What would you tell the owner to prevent this from happening again?
a. Dehiscence
b. Infection, allergic reaction to sutures, or suture tension.
c. Monitor wound (infection, irritation, inflammation, swelling, redness).
- Avoid/limit exercise
- Secure E-collar to actual collar
Sadie is a 3yr S/F Border Collie who suffered severe burns to her body when a pot of boiling water fell on her about 4 weeks ago. She has been undergoing therapy at your hospital.
a. At what phase of wound healing is Sadie at during this appointment?
b. What is happening during this phase of wound healing?
c. What service could you recommend to the client that is non-invasive and painless, that would promote healing and reduce pain & inflammation?
a. Repair
b. Invasion of fibroblasts & development of granulation tissue.
c. Laser therapy
Mac is a 10mo M DSH who is indoor/outdoor. He came in for a presumed cat bite to the hind end that became necrotic. The DVM performed a wound repair but due to dead space under the skin, this device was placed.
a. What is the device placed at Mac’s surgical site called?
b. What is the purpose of this device?
c. What are 2 things the owner can do at home to maintain this device?
a. Penrose drain
b. Prevent/release fluid build-up under the skin.
c. Warm compress (2-3x daily & clean) & prevent chewing (e-collar)
