Intro to Anesthesia p2

Question 1

Importance of anesthetic logs (6)

Answer 1

1. Serves as legal doc
2. Set anesthetic protocol for any future events for patient
3. Documents vital signs & trends intraoperatively, so problems are recognized early!
4. Fill out completely and accurately
5. “Tells the story” of anesthetic event
6. Very important to Pt medical record

Question 2

What do we monitor every 5min? (2)

Answer 2

1. Cardiovascular: Perfusion
   - HR/rhythm
   - Pulse rate & quality
   - MM color & CRT
   - Blood pressure
2. Respiratory
   - Rate
   - Saturation
   - ETCO2

Question 3

What do we monitor every 15min? (2)

Answer 3

1. Body temp
2. Fluids given

Question 4

What do we monitor on an anesthetic log? (8)

Answer 4

1. Cardiovascular system
2. Respiratory
3. Body temp
4. Fluids given
5. Breathing system
6. Drugs administered
7. Anesthetic settings
8. Anesthetic & Sx events

Question 5

Tech senses
1. Sight
2. Sound
3. Smell
4. Touch

Answer 5

1. Sight: Watch for changes in MM color, Pt movement, change in respirations.
2. Sound: Listen to HR & rhythms.
3. Smell: Presence of anesthetic gas
4. Touch: Feel changes in pulse rates

Question 6

What is this?

Answer 6

Question 7

Pulse oximeter measures how much (%) of the available ___ is ___ with O2. The probe sensors emit wavelengths of ___ which are transmitted thru ___ and detector senses the ___.

Answer 7

1 & 2. Hemoglobin is saturated
3. Light
4. Tissue
5. Light

Question 8

SPO2 %
___% Good
___% Look for cause
___% Find & correct

Answer 8

> 95% Good
92-94% Look for cause
<92% Find & correct

Question 9

Lingual sensor can be used where? (3)

Answer 9

1. Tongue
2. Ear pinna
3. Toe webbing
   Really any hairless region

Question 10

Reflectance probe can be used where using a protective sleeve? (2)

Answer 10

Rectum or underside base of tail

Question 11

Universal C-clamp can be used where? (2)

Answer 11

1. Feet
2. Hocks
   Among other regions

Question 12

Blood pressure
Systolic is during ___ contraction. Diastolic is ___ pressure during cycle. The mean is the average pressure over ___ cycle (MAP).

Answer 12

1. Ventricular
2. Lowest
3. One cycle

Question 13

Normal BP values
Systolic:
MAP:

Answer 13

Systolic: 80-140mmHg
MAP: 70-90mmHg

Question 14

Name two indirect BP monitors

Answer 14

Doppler & Oscillometric

Question 15

Doppler measures ___ only

Answer 15

Blood pressure

Question 16

1. Probe placements (3)
2. Cuff % to Pt leg
   - Canine __%
   - Feline __%

Answer 16

1. Metacarpal, caudal to metatarsal, or tail
2. Cuff %
   - Canine 40% circumference
   - Feline 30% circumference

Question 17

Doppler cuff sizing
Too wide:
Too narrow:

Answer 17

Wide: Underestimate BP
Narrow: Overestimate BP

Question 18

Oscillometric measures pressure ___ under the cuff. As cuff slowly deflates & flow returns the ___ & ___ are found and the ___ is calculated.

Answer 18

1. Oscillations
2. Systolic
3. Diastolic
4. Mean, MAP

Question 19

Direct BP requires ___ catheter & is indicated for ___ patients. It gives ___ time readings. Can be very hands off and ___ ___ for the patient.

Answer 19

1. Arterial
2. Critical
3. Real time
4. Stress free

Question 20

Capnometer (or Capnograph) measures and evaluates CO2 in patients ____ by measurement of ____.

Answer 20

1. Breath
2. Ventilation

Question 21

Capnometer or Capnograph ranges
Safe:
Too high:
Too low:

Answer 21

Safe: 30-45mmHg
Too high: Hypoventilation. Pt producing too much CO2 or not expelling sufficient CO2.
Too low: Hyperventilation

Question 22

Why is ventilation important? (3)

Answer 22

1. not ventilating, not inhaling anesthetic gas, patient will wake up during Sx
2. If hypoventilating, blood pH will become acidotic
3. Hyperventilating, blood pH will become alkalotic

Question 23

Apnea monitor
1. What does it assess?
2. No assess?

Answer 23

1. Beeps following Pt expiration and will alarm after X amount of time without detected expiration.
2. Doesn’t assess quality of breath

Question 24

ECG/EKG lead placement in right lateral recumbency
Front right:
Front left:
Rear right:
Rear left:

Answer 24

Front right: White
Front left: Black
Rear right: Green
Rear left: Red
“Snow on grass”
“Smoke over fire”

Question 25

The electrocardiogram (ECG/EKG) is used as an indicator of ___ activity in the heart

Answer 25

Electrical

Question 26

What are four questions to ask/answer for rapid analysis of an ECG/EKG?

Answer 26

1. Is the rate normal or abnormal?
2. Is the rhythm normal or abnormal?
3. If there is an abnormality, is it ventricular or supraventricular in origin?
4. Is there is an abnormality, do I need to treat it?

Question 27

Name these EKG readings

Answer 27

Question 28

Name these EKG readings

Answer 28