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Anesthesiology and Surgical Nursing > Quiz 5 study guide > Flashcards

Quiz 5 study guide Flashcards

1
Q

What is blood collected directly from a donor into a blood transfusion bag containing anti-coagulant

A

Fresh Whole Blood

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2
Q

What does Fresh whole blood contain?

A 
RBC
WBC
Platelets 
All coagulation factors
Albumin
Globulin
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3
Q

How long can you store fresh whole blood?

A

Room temperature for up to 8 hours

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4
Q

What is blood collected directly from a donor into a blood transfusion bag containing anti-coagulant and put in the refrigerator

A

Stored Whole blood

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5
Q

What does stored whole blood contain?

A 
RBC
WBC
All coagulation factors but less
Albumin 
Globulin
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6
Q

What does stored Whole Blood not contain

A

Platelets

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7
Q

How long can you store stored whole blood?

A

Refrigerator for up to 28 days

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8
Q

What is whole blood spun down with the plasma removed?

A

Packed Red Blood Cells

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9
Q

What does Packed Red Blood cells contain?

A

RBC

WBC

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10
Q

What does Packed Red Blood cells not contain?

A

Platelets
Coagulation factors
Proteins

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11
Q

What is the main indication of Packed Red blood cells?

A

Anemia

Replaces RBCs

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12
Q

What does plasma contain?

A

All coagulation factors
Albumin
globulin

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13
Q

What is the most commonly used form of plasma?

A

Fresh Frozen plasma

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14
Q

How long does liquid plasma last?

A

14 days in the refigerator

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15
Q

How long does fresh frozen plasma last?

A

Up to 1 year

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16
Q

How long does frozen plasma last?

A

Up to 5 years

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17
Q

Why do we give plasma?

A

To replace coagulation factors and or proteins

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18
Q

In what conditions do we give plasma for?

A 
Anti-coagulant rodenticide toxicity
Congenital Disease
DIC
Von Willebrans
Hypoproteinemia
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19
Q

What is the bad stuff that can happen when blood products are given

A 
Destroy patient's red blood cells
Develop fever
Develop hives
Fluid in the lungs
Sepsis
Circulatory Overload
Hypocalcemia/Citrate Overload
Hyperammonemia
Infectious disease
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20
Q

Why is blood typing is important?

A

An immune reaction can occur

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21
Q

What does DEA stand for?

A

Dog Erythrocyte Antigen

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22
Q

What is the most important blood type in a dog?

A

DEA 1

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23
Q

There is no true universal donors in dogs or cats. What would a true universal donor be?

A

Negative for all the antigens or only have antigens that 100% of the other dogs have

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24
Q

DEA 4+ is the best for dogs, but what is the most practical?

A

DEA 1 negative

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25
What does Canine In-House Blood Type Testing use?
Antibodies to test for the presence of specific red blood cell antigens
26
Who can get DEA 1+ blood?
DEA 1+ recepient
27
Who can not get DEA 1+ blood
DEA 1-
28
Who can get DEA 1- blood?
Both DEA 1+ and DEA 1-
29
What are the three blood types in cats?
A-most common B-less common AB-rare
30
Why is blood typing a cat important?
Need to administer Type-specific blood
31
What happens if you give A type blood to a B type cat?
Acute hemolysis and Death
32
What is cross-matching?
Testing for a reaction in the lab before a reaction occurs in the actual patient
33
Setting up pRBC transfusions
Use a blood administration set with in-line filter Gravity for dogs Don't give IV meds during transfusion unless there is another IVC Can use a syringe pump for cats with a HemoNate filter
34
Why are syringe pumps and most fluid pumps not used in dog transfusions?
Because they will injure dog RBCs
35
You monitor a transfusion patient every 15 minutes, what vitals are you monitoring?
``` Temperature Pulse RR Vomiting Discolored urine ```
36
What are the types of Hypotonic cystalloids?
5% dextrose 0.45% NaCl Normosol M Plasmalyte 56
37
What are the types of Isotonic crystalloids?
0.9% NaCl Normosol R Plasmalyte 148 LRS
38
What are examples of Hypertonic crystalloids
3% and 7% saline
39
What are types of colloids?
Hetastarch Vetstarch Dextran 70
40
What type of fluid is similar to Extra cellular fluid?
Crystalloid fluids
41
What do crystalloids contain
Less sodium and chloride More potassium Lower concentration of buffer Dextrose
42
What is used to support blood volumes and blood pressure, stays primarily in the intravascular space
Colloids
43
What formulas are used when calculating maintenance rates of crystalloid fluids
40-60 ml/kg/day 30ml/pound/day 30 x kg +70 2-4 ml/kg/hour
44
What does the maintenance phase of fluids meet the daily loss of?
Urination GI system Panting
45
What is the fluid calculation for routine anesthesia?
10 mL/kg/hr for the 1st hour | 3-5 mL/kg/hr during the remainder of the procedure
46
If there is excessive hemorrhage or hypotension what is the fluid rate calculation?
40 mL/kg/hr in dogs | 20 mL/kg/hr in cats
47
What is the shock fluid rate calculation
90 mL/kg/hr in dogs | 55 mL/kg/hr in cats
48
What is the fluid calculation for shock and blood loss
3-4 mL/kg of 7% hypertonic saline over 5 minutes
49
What is the colloid fluid rate calculation in dogs and large animals?
10-20 mL/kg/day
50
What is the colloid fluid rate calculation for cats?
5-10 mL/kg/day
51
How is morphine administered?
``` IV IM SC Intra-articular Epidural ```
52
What is the mechanism of action of morphine?
Pure agonists with affinity for mu and kappa opioid receptors
53
What does morphine cause?
Excitement or dysphoria | Restlessness
54
What are some adverse side effects of morphine?
``` GI stimulation in dogs & cats Ileus & colic in horses Excitement miosis (dogs) mydriasis (cats) Hypothermia hyperthermia (cats) Bradycardia Panting increased intraocular pressure urinary retention ```
55
How is oxymorphone administered?
IV IM SC Epidural
56
What is the mechanism of action of Oxymorphone?
Pure opioid agonist Greater potency & sedative effects than morphine Fewer side effects & longer duration of effect than morphine
57
How is Hydromorphone administered?
IV IM SC in dogs & cats
58
What is the mechanism of action of Hydromorphone?
Opioid agonist | Less potency but similar duration of effect compared with oxymorphone
59
What does a full opioid agonist do?
Full activity of channel
60
What does a partial opioid agonist do?
Reduced activity of channel
61
What does an opioid antagonist do?
Prevents activity of channel
62
What does an opioid agonist-antagonist do?
Agonist at one receptor but an antagonist at another receptor
63
What is an example of a pure antagonist and what does it do?
Naloxone and it fully reverses the effects of opioids
64
What is an example of a mixed agonist-antagonist
Butorphanol Mixed agonist at the kappa receptor Antagonist at the mu receptor Will partially reverse the effects of the pure agonists
65
What is the most potent analgesics known and has a rapid onset of 2 minutes?
Fentanyl
66
How is Fentanyl administered?
``` Continuous IV drip Transdermal patch IM SC Epidural ```
67
What is the mechanism of action of Butorphanol?
``` Stimulates kappa receptors Blocks mu receptors Not as effective as an analgesic Produces less sedation & respiratory depression Used to reverse morphine & fentanyl ```
68
How is butorphanol administered?
IV IM SC Orally
69
What is the mechanism of action of Buprenorphine?
Partial mu agonists Produces some analgesia for mild to moderate pain Can be used to reverse morphine & fentanyl Delayed onset of action & longer duration of analgesia
70
How is Buprenorphine administered?
IV IM Epidural Orally to cats
71
What is the newer combination of buprenorphine?
Simbadol
72
What is a synthetic opioid with characteristics similar to oxymorphone and hydromorphone?
Methadone
73
What is the mechanism of action of methadone?
Antagonist at the NMDA receptor
74
What is another pure opioid agonist with less potent analgesic properties and shorter duration of action?
Merperidine/Pethidine
75
How is Meperidine/Pethidine administered?
SC injection
76
What is Meperidine/Pethidine used in combination with?
Atropine or acepromazine
77
What is the drug of choice for Intra-articular injection?
Morphine
78
Where is an epidural injection commonly given?
Lumbosacral junction
79
What does an epidural injection provide?
``` Analgesia to: Hind limbs Abdomen Caudal thorax Pelvis Tail ```
80
What is the most commonly used drug for epidurals?
Morphine
81
What is the mechanism of action of NSAIDs
Inhibit prostaglandin synthesis by inactivating COX iosenzymes
82
What kind of pain are NSAIDs and what is the onset of action?
Somatic & Visceral pain | 30-60 minutes
83
What do NSAIDs prevent the production of?
Beneficial prostaglandins along with the production of prostaglandins that mediate pain, inflammation, fever
84
Which NSAID produces the least adverse side effects?
COX-2 enzyme inhibitors
85
What are the adverse side effects of NSAIDs?
``` Stomach ulcers Vomiting GI bleeding Lack of appetite Renal toxicity Impaired platelet aggregation Liver damage ```
86
Repeated use of what NSAID causes acute renal failure and death?
Meloxicam
87
What is a new NSAID to be used in cats that is safer?
Onsior or Robenacoxib | COX-2 selective NSAID
88
How is Onsior administered?
Injection | Orally
89
What is a newer NSAID that is used in Dogs
Galliprant
90
What is the mechanism of action for Galliprant?
First-in-class prostaglandin receptor antagonist Non-COX inhibiting Specifically targets the EP4 receptor
91
What has a profound sedative effect, produces significant analgesia via epidural route and can be reveresed?
Alpha-2 Adrenoceptor Agonists
92
What drug can be used as an adjunct to more potent analgesics but does not produce great analgesia by itself?
Ketamine
93
What is the mechanism of action of Ketamine?
Blocks NMDA receptors at the level of the spinal cord to prevent windup
94
What has strong anti-inflammatory properties, decrease prostaglandins but can not be used concurrently with NSAIDS?
Corticosteroids
95
Why should Corticosteroids not be used with NSAIDs?
Because there is a dual effect of negative adverse reaction.
96
What is a non-opiate drug, has activity at the mu receptor, inhibits the reuptake of norepinephrine and serotonin?
Tramadol
97
What was initially used as an anticonvulsant, useful for chronic pain, can have strong sedative effects?
Gabapentin | Good option for cats
98
Do tranquilizers have analgesic properties?
NO but can be combined
99
What are tranquilizers useful for?
Calming the excitement sometimes seen in cats and horses
100
Keys to Great Pain Management
``` Preemptive analgesia Multimodal pain management Observe for and know the signs of pain Nursing care Nonpharmacologic treatment Client education ```
101
What is the key to successful analgesia in patients?
Preemptive Analgesia
102
What does preemptive analgesia consist of?
Administration of pain medication before the pain occurs Commonly involves adding analgesic to premedication prior to anesthesia Reduces overall requirement for analgesia and duration of administration Prevents windup
103
Multimodal Therapy
Use of more than one type of analgesic to relieve pain Fentanyl & meloxicam Morphine & injectable NSAID MLK
104
Nursing Care
Relieving patient discomfort will help pain control
105
Nonpharmacologic Therapies
Used in conjunction with or as an adjunct to pharmacological therapy
106
Laser therapy (Photobiomodulation)
Alters the inflammatory response and affects cell signaling
107
What are the benefits of Laser Therapy?
``` Pain reduction Decreased inflammatory markers in joints Reduced swelling and edema Increased mobility (joint) and function Stimulation of collagen synthesis ```
108
The HHHHHMM Quality of Life Scale.
``` Hurt Hunger Hydration Hygiene Happiness Mobility More good days than bad ```
109
What exercises help a patient develop better awareness of where his or her body is?
Proprioceptive exercises
110
What benefits does walking on an underwater treadmill provide?
Increased joint range of motion Improved muscle flexibility and mobility Enhanced circulation Facilitation of front to rear and side to side balance
111
What relieves pain and increases muscle strength while putting decreased weight on the joints
Hydrotherapy | Under-water therapy
112
What benefits does hydrotherapy provide to neurologic patients?
Many patients can take steps in water before they can perform voluntary motion on land
113
What is a systemic and scientific manipulation of soft tissues of the body for the purpose of obtaining or maintaining health?
Massage
114
What is the use of stretching to prevent the loss of normal range of motion, to return normal range of motion if absent, to increase cartilage nutrition to the joint, and to stimulate cartilage regeneration?
Passive Range of Motion
115
What is the application of electrical current to elicit a muscle contraction?
Neuromuscular electrical stimulation
116
What is the main purpose of Neuromuscular electrical stimulation?
to attain muscle strengthening
117
What are the clinical uses of Neuromuscular electrical stimulation?
Reducing disuse atrophy Reversing muscle atrophy Strengthening selected muscles
118
What are the contraindications of Neuromuscular Electrical Stimulation?
Over heart or cardiac pacemakers Use on animals with seizure disorders Over area of peripheral vascular disease or thrombophelbitis Over areas of decreased pain/temperature sensation Over infection Over neiplasms Over the carotid sinus Any time active motion is contraindicated
119
What is the use of sound waves to treat tissue?
Therapeutic Ultrasound
120
What is the value of therapeutic ultrasound?
``` Increased collagen extensibility Increased blood flow Increased range of motion due to changes in contractility of muscle Decreased pain and muscle spasm Increased enzyme activity Changes in nerve conduction velocity Accelerated wound healing due to facilitation of the inflammatory process Enhanced transdermal delivery ```
121
What are the clinical applications of Therapeutic Ultrasound?
``` Joint contracture and scar tissue Tendonitis and bursitis Pain and muscle spas, Wound healing Calcium reabsorption Chronic wounds ```
122
What is the stimulation of tissue with low-energy lasers to achieve therapeutic effects?
Low-Level laser therapy
123
What are common indications for Low-level laser therapy?
``` Treating pain associated with degenerative joint disease and intervertebral disc deisease Postoperative pain Soft tissue injuries Stimulate healing of wounds and ulcers Stimulate acupuncture points relieve trigger points ```
124
What does LLLT reduce?
Edema Stomatitis Gingivitis Temporomandibular joint dysfunction
125
What are the advantages of Cryotherapy?
Vasoconstriction (reduces postsurgical bleeding and brusing) Slows nerve conduction (decreasing the pain sensation) Decreases Enzyme activity (Decreasing inflammation)
126
What allows reconstruction of the disturbed electrical field?
Pulsed electromagnetic field therapy
127
What are the benefits of Pulsed Electromagnetic Field Therapy?
Returns the natural regeneration capabilities and reactivates the chondrocytes and connective tissue to increase production of proteoglycan and collagen Repairs tendons and ligament injuries
128
When should Pulsed electromagnetic field therapy not be used?
For partial cranial cruciate tears because it removes the early scar tissue critical for stabilization
129
What is transcutaneous electrical nerve stimulation used for?
Treating deep, aching, and chronic pain
130
What is the technician's role in transcutaneous electrical nerve stimulation?
Shave if needed Apply gel and pads Setting the machine to the proper frequency and intensity
131
What exercises involve posture and gait correction that vary in the degree of therapist assistance?
Neuromuscular Re-education
132
What is the general rule of Neuromuscular re-education?
The patient is asked to do as much as physically possibe and the therapist assists as needed to attain correct posture and gait

Anesthesiology and Surgical Nursing (23 decks)

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