Post-operative Care

Question 1

What are the 5 freedoms?

Answer 1

1. Freedome from thirst, hunger, and malnutrition
2. Freedom from discomfort
3. Freedom from pain, injury, and disease
4. Freedom to express normal behavior
5. Freedome from fear and distress

Question 2

Explain the negative energy balance in the post-operative patient…

Answer 2

Increased metabolic demand + decreased caloric intake

Question 3

What are the consequences of protein calorie malnutrition in the post-op patient?

Answer 3

1. Impaired immunocompetence
2. Decreased wound healing
3. Decreased resistance to infection
4. Anemia
5. Hpoproteinemia
6. Organ/muscle atrophy
7. Death

Question 4

What is enteral hyperalimentation?

Answer 4

Providing nutrients to a FUNCTIONAL GI tract via nasoesophageal, pharyngostomy, esophagostomy, or gastrotomy tubes

Question 5

What is parenteral hyperalimentation?

Answer 5

Providing nutrients intravenously

Question 6

Pain management is used to DECREASE 3 things.

What are they?

Answer 6

Peripheral sensitization

Central sensitization

Wind-up

Question 7

What 2 things work against peripheral pain sensitization?

Answer 7

1. NSAIDs
2. Good surgical technique

Question 8

When must analgesias be given?

Answer 8

BEFORE painful stimulus

Helps prevent central nervous system “wind-up”

Question 9

What are the 3 types of pain?

Answer 9

Somatic

Visceral

Neuropathic

Question 10

Damage to which types of tissue would cause SOMATIC pain?

Answer 10

Damage to BONES, JOINTS, MUSCLE, or SKIN

Question 11

What description might one use to describe SOMATIC pain?

Answer 11

Localized

Constant

Sharp

Question 12

What types of changes might cause VISCERAL pain?

Answer 12

Stretching, distention, or inflammation of viscera

Question 13

How might one describe VISCERAL pain?

Answer 13

Deep

Aching

Without good localization

Question 14

What types of injury might cause NEUROPATHIC pain?

Answer 14

Injury of the PNS or CNS

Question 15

How might one describe NEUROPATHIC pain?

Answer 15

Burning

Shooting

+/- neurological deficits

Question 16

What are the risks of having an “unarousable” patient?

Answer 16

Hypoventilation

Hypoxemia

Gastro-esophogeal regurgitation

Aspiration pneumonia

Question 17

Which do you treat first, pain or stress?

Answer 17

Pain

Question 18

What are 3 medications that can be used for anxiety, fear, or stress?

Answer 18

Acepromazine

Alpraxolam

Trazazone

Question 19

What types of changes does a full bladder causes within a dog?

Answer 19

Increased sympathetic stimulation

Tachycardia

Panting

Vocalization

Question 20

What should be your protocol for bladder expression during surgery?

Answer 20

Express ALL bladders at the end of surgery

THEN: assess bladder size every 6 hours post-op if not urinating

Question 21

What effect does Dexmedetomidine have on urine production?

Answer 21

Increases it

Question 22

What effect do opioids have on urine production?

Answer 22

Decrease it

Increase sphincter tone

Question 23

What should you consider doing if an enlarged bladder CANNOT be expressed?

Answer 23

Opioid reversal!