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Anesthesiology and Surgical Nursing > Quiz 5 study guide > Flashcards

Quiz 5 study guide Flashcards

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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
Q

What does Canine In-House Blood Type Testing use?

A

Antibodies to test for the presence of specific red blood cell antigens

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26
Q

Who can get DEA 1+ blood?

A

DEA 1+ recepient

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27
Q

Who can not get DEA 1+ blood

A

DEA 1-

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28
Q

Who can get DEA 1- blood?

A

Both DEA 1+ and DEA 1-

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29
Q

What are the three blood types in cats?

A

A-most common
B-less common
AB-rare

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30
Q

Why is blood typing a cat important?

A

Need to administer Type-specific blood

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31
Q

What happens if you give A type blood to a B type cat?

A

Acute hemolysis and Death

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32
Q

What is cross-matching?

A

Testing for a reaction in the lab before a reaction occurs in the actual patient

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33
Q

Setting up pRBC transfusions

A

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

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34
Q

Why are syringe pumps and most fluid pumps not used in dog transfusions?

A

Because they will injure dog RBCs

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35
Q

You monitor a transfusion patient every 15 minutes, what vitals are you monitoring?

A 
Temperature
Pulse
RR
Vomiting
Discolored urine
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36
Q

What are the types of Hypotonic cystalloids?

A

5% dextrose
0.45% NaCl
Normosol M
Plasmalyte 56

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37
Q

What are the types of Isotonic crystalloids?

A

0.9% NaCl
Normosol R
Plasmalyte 148
LRS

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38
Q

What are examples of Hypertonic crystalloids

A

3% and 7% saline

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39
Q

What are types of colloids?

A

Hetastarch
Vetstarch
Dextran 70

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40
Q

What type of fluid is similar to Extra cellular fluid?

A

Crystalloid fluids

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41
Q

What do crystalloids contain

A

Less sodium and chloride
More potassium
Lower concentration of buffer
Dextrose

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42
Q

What is used to support blood volumes and blood pressure, stays primarily in the intravascular space

A

Colloids

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43
Q

What formulas are used when calculating maintenance rates of crystalloid fluids

A

40-60 ml/kg/day
30ml/pound/day
30 x kg +70
2-4 ml/kg/hour

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44
Q

What does the maintenance phase of fluids meet the daily loss of?

A

Urination
GI system
Panting

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45
Q

What is the fluid calculation for routine anesthesia?

A

10 mL/kg/hr for the 1st hour

3-5 mL/kg/hr during the remainder of the procedure

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46
Q

If there is excessive hemorrhage or hypotension what is the fluid rate calculation?

A

40 mL/kg/hr in dogs

20 mL/kg/hr in cats

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47
Q

What is the shock fluid rate calculation

A

90 mL/kg/hr in dogs

55 mL/kg/hr in cats

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48
Q

What is the fluid calculation for shock and blood loss

A

3-4 mL/kg of 7% hypertonic saline over 5 minutes

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49
Q

What is the colloid fluid rate calculation in dogs and large animals?

A

10-20 mL/kg/day

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50
Q

What is the colloid fluid rate calculation for cats?

A

5-10 mL/kg/day

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51
Q

How is morphine administered?

A 
IV
IM
SC
Intra-articular
Epidural
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52
Q

What is the mechanism of action of morphine?

A

Pure agonists with affinity for mu and kappa opioid receptors

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53
Q

What does morphine cause?

A

Excitement or dysphoria

Restlessness

54
Q

What are some adverse side effects of morphine?

A 
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
Q

How is oxymorphone administered?

A

IV
IM
SC
Epidural

56
Q

What is the mechanism of action of Oxymorphone?

A

Pure opioid agonist
Greater potency & sedative effects than morphine
Fewer side effects & longer duration of effect than morphine

57
Q

How is Hydromorphone administered?

A

IV
IM
SC in dogs & cats

58
Q

What is the mechanism of action of Hydromorphone?

A

Opioid agonist

Less potency but similar duration of effect compared with oxymorphone

59
Q

What does a full opioid agonist do?

A

Full activity of channel

60
Q

What does a partial opioid agonist do?

A

Reduced activity of channel

61
Q

What does an opioid antagonist do?

A

Prevents activity of channel

62
Q

What does an opioid agonist-antagonist do?

A

Agonist at one receptor but an antagonist at another receptor

63
Q

What is an example of a pure antagonist and what does it do?

A

Naloxone and it fully reverses the effects of opioids

64
Q

What is an example of a mixed agonist-antagonist

A

Butorphanol
Mixed agonist at the kappa receptor
Antagonist at the mu receptor
Will partially reverse the effects of the pure agonists

65
Q

What is the most potent analgesics known and has a rapid onset of 2 minutes?

A

Fentanyl

66
Q

How is Fentanyl administered?

A 
Continuous IV drip
Transdermal patch
IM
SC
Epidural
67
Q

What is the mechanism of action of Butorphanol?

A 
Stimulates kappa receptors 
Blocks mu receptors
Not as effective as an analgesic 
Produces less sedation & respiratory depression
Used to reverse morphine & fentanyl
68
Q

How is butorphanol administered?

A

IV
IM
SC
Orally

69
Q

What is the mechanism of action of Buprenorphine?

A

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
Q

How is Buprenorphine administered?

A

IV
IM
Epidural
Orally to cats

71
Q

What is the newer combination of buprenorphine?

A

Simbadol

72
Q

What is a synthetic opioid with characteristics similar to oxymorphone and hydromorphone?

A

Methadone

73
Q

What is the mechanism of action of methadone?

A

Antagonist at the NMDA receptor

74
Q

What is another pure opioid agonist with less potent analgesic properties and shorter duration of action?

A

Merperidine/Pethidine

75
Q

How is Meperidine/Pethidine administered?

A

SC injection

76
Q

What is Meperidine/Pethidine used in combination with?

A

Atropine or acepromazine

77
Q

What is the drug of choice for Intra-articular injection?

A

Morphine

78
Q

Where is an epidural injection commonly given?

A

Lumbosacral junction

79
Q

What does an epidural injection provide?

A 
Analgesia to:
Hind limbs
Abdomen
Caudal thorax
Pelvis
Tail
80
Q

What is the most commonly used drug for epidurals?

A

Morphine

81
Q

What is the mechanism of action of NSAIDs

A

Inhibit prostaglandin synthesis by inactivating COX iosenzymes

82
Q

What kind of pain are NSAIDs and what is the onset of action?

A

Somatic & Visceral pain

30-60 minutes

83
Q

What do NSAIDs prevent the production of?

A

Beneficial prostaglandins along with the production of prostaglandins that mediate pain, inflammation, fever

84
Q

Which NSAID produces the least adverse side effects?

A

COX-2 enzyme inhibitors

85
Q

What are the adverse side effects of NSAIDs?

A 
Stomach ulcers
Vomiting
GI bleeding
Lack of appetite
Renal toxicity
Impaired platelet aggregation 
Liver damage
86
Q

Repeated use of what NSAID causes acute renal failure and death?

A

Meloxicam

87
Q

What is a new NSAID to be used in cats that is safer?

A

Onsior or Robenacoxib

COX-2 selective NSAID

88
Q

How is Onsior administered?

A

Injection

Orally

89
Q

What is a newer NSAID that is used in Dogs

A

Galliprant

90
Q

What is the mechanism of action for Galliprant?

A

First-in-class prostaglandin receptor antagonist
Non-COX inhibiting
Specifically targets the EP4 receptor

91
Q

What has a profound sedative effect, produces significant analgesia via epidural route and can be reveresed?

A

Alpha-2 Adrenoceptor Agonists

92
Q

What drug can be used as an adjunct to more potent analgesics but does not produce great analgesia by itself?

A

Ketamine

93
Q

What is the mechanism of action of Ketamine?

A

Blocks NMDA receptors at the level of the spinal cord to prevent windup

94
Q

What has strong anti-inflammatory properties, decrease prostaglandins but can not be used concurrently with NSAIDS?

A

Corticosteroids

95
Q

Why should Corticosteroids not be used with NSAIDs?

A

Because there is a dual effect of negative adverse reaction.

96
Q

What is a non-opiate drug, has activity at the mu receptor, inhibits the reuptake of norepinephrine and serotonin?

A

Tramadol

97
Q

What was initially used as an anticonvulsant, useful for chronic pain, can have strong sedative effects?

A

Gabapentin

Good option for cats

98
Q

Do tranquilizers have analgesic properties?

A

NO but can be combined

99
Q

What are tranquilizers useful for?

A

Calming the excitement sometimes seen in cats and horses

100
Q

Keys to Great Pain Management

A 
Preemptive analgesia
Multimodal pain management
Observe for and know the signs of pain
Nursing care
Nonpharmacologic treatment
Client education
101
Q

What is the key to successful analgesia in patients?

A

Preemptive Analgesia

102
Q

What does preemptive analgesia consist of?

A

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
Q

Multimodal Therapy

A

Use of more than one type of analgesic to relieve pain
Fentanyl & meloxicam
Morphine & injectable NSAID
MLK

104
Q

Nursing Care

A

Relieving patient discomfort will help pain control

105
Q

Nonpharmacologic Therapies

A

Used in conjunction with or as an adjunct to pharmacological therapy

106
Q

Laser therapy (Photobiomodulation)

A

Alters the inflammatory response and affects cell signaling

107
Q

What are the benefits of Laser Therapy?

A 
Pain reduction
Decreased inflammatory markers in joints
Reduced swelling and edema
Increased mobility (joint) and function
Stimulation of collagen synthesis
108
Q

The HHHHHMM Quality of Life Scale.

A 
Hurt
Hunger
Hydration
Hygiene
Happiness
Mobility
More good days than bad
109
Q

What exercises help a patient develop better awareness of where his or her body is?

A

Proprioceptive exercises

110
Q

What benefits does walking on an underwater treadmill provide?

A

Increased joint range of motion
Improved muscle flexibility and mobility
Enhanced circulation
Facilitation of front to rear and side to side balance

111
Q

What relieves pain and increases muscle strength while putting decreased weight on the joints

A

Hydrotherapy

Under-water therapy

112
Q

What benefits does hydrotherapy provide to neurologic patients?

A

Many patients can take steps in water before they can perform voluntary motion on land

113
Q

What is a systemic and scientific manipulation of soft tissues of the body for the purpose of obtaining or maintaining health?

A

Massage

114
Q

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?

A

Passive Range of Motion

115
Q

What is the application of electrical current to elicit a muscle contraction?

A

Neuromuscular electrical stimulation

116
Q

What is the main purpose of Neuromuscular electrical stimulation?

A

to attain muscle strengthening

117
Q

What are the clinical uses of Neuromuscular electrical stimulation?

A

Reducing disuse atrophy
Reversing muscle atrophy
Strengthening selected muscles

118
Q

What are the contraindications of Neuromuscular Electrical Stimulation?

A

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
Q

What is the use of sound waves to treat tissue?

A

Therapeutic Ultrasound

120
Q

What is the value of therapeutic ultrasound?

A 
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
Q

What are the clinical applications of Therapeutic Ultrasound?

A 
Joint contracture and scar tissue
Tendonitis and bursitis 
Pain and muscle spas,
Wound healing 
Calcium reabsorption
Chronic wounds
122
Q

What is the stimulation of tissue with low-energy lasers to achieve therapeutic effects?

A

Low-Level laser therapy

123
Q

What are common indications for Low-level laser therapy?

A 
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
Q

What does LLLT reduce?

A

Edema
Stomatitis
Gingivitis
Temporomandibular joint dysfunction

125
Q

What are the advantages of Cryotherapy?

A

Vasoconstriction (reduces postsurgical bleeding and brusing)
Slows nerve conduction (decreasing the pain sensation)
Decreases Enzyme activity (Decreasing inflammation)

126
Q

What allows reconstruction of the disturbed electrical field?

A

Pulsed electromagnetic field therapy

127
Q

What are the benefits of Pulsed Electromagnetic Field Therapy?

A

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
Q

When should Pulsed electromagnetic field therapy not be used?

A

For partial cranial cruciate tears because it removes the early scar tissue critical for stabilization

129
Q

What is transcutaneous electrical nerve stimulation used for?

A

Treating deep, aching, and chronic pain

130
Q

What is the technician’s role in transcutaneous electrical nerve stimulation?

A

Shave if needed
Apply gel and pads
Setting the machine to the proper frequency and intensity

131
Q

What exercises involve posture and gait correction that vary in the degree of therapist assistance?

A

Neuromuscular Re-education

132
Q

What is the general rule of Neuromuscular re-education?

A

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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