Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RUSVM Anesthesiology > Patient Evaluation and Preparation > Flashcards

Patient Evaluation and Preparation Flashcards

1
Q

who should preform the preanesthetic evaluation?

A

the clinician who refers the patient - comunicate results with anesthetist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what should the anesthetist do?

A

read all patient related documentation

personally examone the patient

request/perfomr additional tests if necessary

make anesthetic plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

it is misconduct not to….

A

examine the patient yourself before anesthesia

ALWAYS: see, touch, and auscultate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

parts of preanesthetic examination

A

signalment

history

physical exam

laboratory examinations

advanced diagnostics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Species and breed specific conditions: Doberman Pinschers

A

Von Willebrands Dz

DCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Species and breed specific conditions: Miniature Schnauzers

A

Sick Sinus Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Species and breed specific conditions: Pugs

A

Brachycephalic Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Species and breed specific conditions: Quarter Horses

A

Hyperkalemic Periodic Paralysis (HYPP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Species and breed specific conditions: Rabbits

A

have atropine estherase

(used Glycopyrrolate instead)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the history can provide information about:

A

previous - trauma, Dz, Sx, anesthetic events/ complications, vax

current (or recent) - symptoms, medications, feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

current medications that can interfere with anesthesia

A

liver microsomal enzyme activity - inducers (phenobarb, phenytoin); inhibitors (cimetidine)

NSAIDS - nephrotoxicity

ACE inhibitors - hypotension

chemotherapeutics - toxicitiy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what should you be checking to assess ventilation

A

rate, regularity, effort, thoracic auscultation

palpate the larynx and trachea (intubation) - this also helps to estimate ET tube size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do you check to asses oxygenation

A

mucous membrane color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

whats the difference between oxygenation and ventillation

A

ventillation - act of moving air in an out and the removal of CO2

oxygenation - refers to gas exchange, amount of O2 in the arterial blood

Breathing does not mean they are oxygenating!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is CRT an indicator of

A

peripheral perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

normal CRT

A

1-2 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

increased CRT

A

<1 sec

may indicate hyperdynamic state and vasodilation (also bright red mm)

associated with sepsis, distributed shock, hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

prolonged CRT

A

may indicate decreased peripheral perfusion

associated with shock and dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F CRT is important to examine but it is not considered to be a very specific test

A

True

other influential factors: vasodilation, strength of compression, site tested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

normal mucous membranes are:

A

pink and moist (may be pigmented)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pale mucous membranes can indicate

A

anemia, vasoconstriction, hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

brick red mucous membranes can indicate:

A

hyperdynamic status (e.g. sepsis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

petechial bleeding can indicate

A

thrombocytopenia, thrombocytopathy

24
Q

yellow mucous membranes can indicate

A

icterus, hyperbilirubinemia

25
Q

clinical signs: <5 % dehydration

A

not detectable

26
Q

clinical signs: 5-6 % dehydration

A

subtle loss of skin elasticity

27
Q

clinical signs: 6-8% dehydration

A

definite delay in return of skin to normal position

slightly prolonged CRT

eyes possibly sunken

possible dry mucous membranes

28
Q

clinical signs: 10-12 % dehydration

A

tented skin stands in place

definite prolonged CRT

eyes sunken in orbits

dry mm.

possible signs of shock

29
Q

clinical signs: 12-15% dehydration

A

definite signs of shock - tachycardia, cool extremities, rapid and weak pulses

death imminent

30
Q

T/F preanesthetic laboratoary examinations should be less than 1 week old

A

True

31
Q

general recommendations for healthy <2year old small animals

A

PCV, TP, glucose, BUN

canine: CBC becuase of the platelet related tick born diseases

32
Q

general recommendations for sick and old patients

A

CBC

Chem

U/A

tests for specific cases: BMT, coag, etc

33
Q

advanced diagnostics

A

ECG, Radiography, U/S, BP

34
Q

T/F: a physical status classification should be done aafter patient evaluation is complete

A

True

proposed by the ASA (American Society of Anesthesiologist)

35
Q

ASA - I

A

healthy animal, no systemic disease

age is not a disease!

36
Q

ASA - II

A

mild systemic disease (no functional impact)

mild anemia or fever, pregnancy, obesity, diabetes mullitus controlled by insulin

37
Q

ASA - III

A

Moderate or severe systemic disease

morbid obesity, heart disease (moderate), some colic horses

38
Q

ASA - IV

A

severe systemic disease that is a constant threat to life (can die at any moment)

emergency colic Sx, GDV, congestive heart failure, sepsis, shock, actively hemorrhaging splenic tumor

39
Q

ASA - V

A

Moribund patient that is not expected to survive 24 hours with or without surgery (these animals are normally euthanized- more for human med)

  • end stage of shock, multiple organ/system dysfunction

massive trauma

40
Q

emergency patients are give a physical status classification of:

A

E

41
Q

Low risk

A

ASA - I and II

no limitations in organ function

42
Q

moderate risk

A

ASA - III

some limitation in organ function

43
Q

high risk

A

ASA - IV and V

severe limitations in organ function

44
Q

the risk of the procedure depends on:

A

risk of anesthesia

risk of surgery

45
Q

risks of anesthesia include:

A

physical staus of patient

skills of anesthestist

anesthestic techniques

duration of anesthesia

peri-operative care

46
Q

risks of surgery include

A

type of surgery

skills of the surgeon

blood loss

47
Q

indications for pre-anesthetic fasting

A

decreased food and fluid in stomach

decreased risk of aspiration

distended stomach (rumen) impairs ventilation and gas exchange

horses - full stomach may rupture at induction

48
Q

reflux

A

open lower esophageal sphincter, gastric content enters the esophagus - invisible, silent reflux is very common during anesthesia

49
Q

regurgutation

A

passive discharge of gastric content from the mouth

50
Q

vomitting

A

active process (projectile)

51
Q

T/F feeding small amounts of wet food prior to anestheia could decrease the occurrence of reflux and increase gastric pH

A

True

52
Q

how long should healthy dogs and cats be fasted

A

8-12 hours

except: very young, diabetes mellitus, other severe disease

53
Q

who should not be fasted

A

rabbits and rats - don’t vomit, no need to fast

small birds

suckling youngsters!!

54
Q

T/F pre-anesthetic water deprivation is normally not needed

A

True

may be needed in ruminants to decrease ruminal content

55
Q

dont forget to obtain…

A

Signed owner consent form!!

RUSVM Anesthesiology (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions