Quizzes 1-3 Flashcards
The absence of pathogenic microorganisms that cause infection is known as…
asepsis
The sterile field for a surgical gown is?
2 inches above the elbow to the edge of the cuff and the front of the chest to the level of the surgical table
Contamination of the sterile field that occurs through the passage of fluid through or a puncture in the microbial barrier is
Strike-through
Which of the following is usually not the responsibility of the circulating nurse?
they perform retraction during surgery
When planning the surgery schedule for the day one should schedule
the cleanest procedures first and progress with the dirties procedures last
When scrubbing in for a surgical procedure, which are considered the dirtiest area
under the fingernails and the webbing between the fingers
Open gloving would not be used for which of the following procedures
dog abdominal exploratory
Which of the following is true when handling a curved surgery needle
when placing suture material through the eye of a surgical needle, the suture passes through the eye from the inside of the curve to the outside
When quarter draping, what is the sequence of placing drapes
close, caudal, cranial, far
Which of the following states are true for suture patterns
the subcuticular pattern is placed at the skin margin just superficial to the subcutaneous and can circumvent the need for external skin sutures
the simple interrupted pattern has more knots which can lead to the increased possibility of the tissue reaction
the interrupted vertical mattress pattern offers tissue security with less compromised of blood supply compared to the horizontal mattress pattern
Which is true for surgical suction
the suction tube should be in a sterile package
the suction could be mechanical or manual
the suction tube end connected to the suction tip should be kept sterile
This suction tip is best for abdominal fluid suction during surgery
poole
Which needle holder has imbedded scissors in the jaw
Olsen-Hegar
Which forceps are best for intestinal surgery requiring an anastomosis?
Doyens
Which biopsy instrument is most appropriate for bone?
Michele
Which instrument is like a melon baller and is used to scoop out necrotic bone?
bone curette
Surgical wire
is usually made of stainless steel
has a gauge size that with increased gauge size there is decreased thickness
has little to no tissue reactivity
Which of the following surgical needles is most commonly used in veterinary surgery?
reverse cutting
Synthetic suture
if absorbable is done so by hydrolysis
Which of the following suture material has more ability to harbor bacterial contaminants
regular vicryl
when should a charcoal canister in a passive scavenging anesthetic system be changed based on weight of canister or time in use
at 50 grams of weight or 12 hours of use
before an anesthetic procedure occurs, the recommended minimum psi in the E tank that requires the tank to be switched out is
500 psi
Which of the following is true for using the oxygen flush valve when the anesthesia machine is connected to an anesthesia patient using a partial rebreathing system
it can dilute the anesthetic gas being delivered to the patient
it can be dangerous for the patient by delivering 35 to 75 mL/minute oxygen which can lead to alveolar rupture
it can bypass the flowmeter and vaporizer and deliver 100% oxygen
Inhalation anesthetic agents commonly in use today will require what type of vaporizer
precision vaporizer out of the circuit
What is the maximum pressure you should deliver when manually ventilating a small animal anesthetic patient
20 cm H20
How frequently should a test for low pressure leaks on an anesthetic system be performed
before each use
Why should PPE, a respiratory protective mask and gloves, be worn when changing the carbon dioxide absorbent granules
inhalation of the dust is corrosive to mucous membranes
A rebreathing system
should be used on patients that weigh 7 kg or more
uses less oxygen flow than a non-rebreathing system
conserves heat and moisture
Of the following which of the types of dead space can we control and modify
mechanical
The surgical/anesthesia owner consent form for a patient should include
signalment
procedure
owner contact information
Which are normal PCV %s for the dog and cat?
Dogs 36%-54%
Cats 25%-46%
What are normal total plasma protein levels
Dogs 5.5-7.5 g/dL
Cats 6.5-8.2 g/dL
Which lab results gauge indicative of hypoglycemia
blood glucose of 55 mg/dL
Using multiple anesthetic agents in smaller dosages to maximize positive effects and to minimize negative effects is the definition for
balanced anesthesia
Using multiple drugs to target multiple nociceptive pathways is known as
multimodal analgesia
These analgesics work in the peripheral and central nervous system. Members of this group can be agonists, partial agonists and agonist-antagonists
Opioids
These analgesics are effective in reducing inflammation and work well given as pre-anesthetic agents. They may decrease platelet function and harm the production of cartilage.
NSAIDs
These analgesics inhibit the release of norepinephrine and therefore inhibit nerve impulse transmission. They also cause sedation and muscle relaxation. Dexmedatomidine is a member of this group. Some of the side effects include hypertension and bradycardia.
Alpha 2 agonists
These analgesics are a good alternative to general anesthesia and numb an area after injection. If toxicity occurs it is usually due to an overdose of the analgesic
local anesthetics
Sedatives and tranquilizers are helpful in reducing stress, fear, and anxiety of a patient. Analgesic medications have better effects when patients receive these drug pairs.
Acepromazine and Midazolam
Which of the following is true to confirm proper ET tube placement in an anesthetic patient
feeling air movement from the distal end of the ET tube
fogging of the tube from moist exhaled air
palpating only one firm central structure in the neck-trachea
The anatomic opening through which an ET tube is passed
glottis
Providone iodine characteristics
it can be used as a solution for ophthalmic surgery
it can be deactivated by organic debris
Chlorhexadine gluconate characteristics
it is toxic to the eye and can damage the cornea
When are the anesthetic patients most stable
induction and recovery
Excitatory stage of anesthesia where the patient struggles
Stage 2
ET tube intubation occurs during this stage
stage 3-light anesthesia
This is true for laryngospasm in the anesthetic patient
can occur more commonly in cats than in dogs
can be elicited by ET tube stimulation
can be treated or subdued with topical lidocaine
Clinical signs for an adult medium canine with the appropriate surgical level of anesthesia
ventrodorsal rotation of the globe (eye), absent palpebral reflex, 10 breaths/minute, 120 heart beats/minute, very slight jaw tone
Should occur during the recovery period
the patient is extubated when swallowing reflex returns
the patient should receive 100% oxygen with no anesthetic agent until extubated
The patient should be stimulated and turned to avoid hypostatic congestion (blood settling to one side of the lungs)
Sinus arrythmia is not considered a normal finding in this species
cats
What is a 2nd degree AV heart block
when occasionally there is a P wave without a corresponding QRS-T segment
Which ECG lead is to be placed on the right front leg
white
What should the mean arterial pressure (MAP) be in an anesthetized dog or cat
70-90 mm Hg
When evaluating mucous membrane color, cyanosis is seen as what color
purple/blue
What is normal SpO2 of an anesthetized patient on 100% oxygen
should be above 95%
can be determined by a pulse oximeter
can be determined by a blood gas analyzer
Which two monitoring parameters can be determined by the use of equipment designed to use in the esophagus
temperature and heart rate
Normal ETCO2 is
35mmHg-45mmHg
In which of the following clinical situations would an anesthesia patient need mechanical ventilation
the patient is obese
the patient is undergoing thoracic surgery
the patient received a neuromuscular blocking agent
Onsior and meloxicam are in this drug class. They are pain relievers, non-controlled substances and decrease inflammation that may cause pain
NSAIDS
This class of analgesic drugs have members that may have multiple different types binding activity )agonists, partial agonists, agonist-antagonists).
opioids
What is an effect of NSAIDs
inhibiting the COX-1 and COX-2 enzymes
effective when incorporated into the surgical premedication protocol
can impair platelet function
What is an effect of local anesthetic agents
inhibit transduction and transmission of nerve impulses
Which of the following are signs of administering an anticholinergic/parasympatholytic
bronchodilation
dilation of the pupils
increased cardiac output
Why don’t veterinarians use atropine in cats
cats can produce thick mucous causing ET tube obstruction as a result of atropine administration
Physostigmine is a reversal agent for
glycopyrrolate
Alpha 2 agnoists
cause bradycardia, vasoconstriction, and respiratory depression
Which of the following opioid receptors when stimulated does not produce analgesia
sigma
Which of the following can be adverse effects of opioid use
respiratory depression
constipation
increased sensitivity to noise
Which of the following is an example of neuroleptanalgesia
hydromorphone and midazolam
Which barbiturate is primarily used as a euthanasia agent
pentobarbital
Ketamine and Tilemine are dissassociative anesthetics. These cyclohexamines are painful when administered IM
ketamine can be used as a CRI and offers analgesia by inhibiting NMDA receptors in the CNS
tilemine in veterinary medicine is combined with Zolazepam and sold as Telazol
they can have effects such as tachycardia, apneustic breathing, increased intraocular and CSF pressure
Ketamine is frequently given in conjunction with other agents to facilitate muscle relaxation. Which is a combination of ketamine and a benzodiazepine
ketamine and midazolam
Propofol is an injectable hypnotic agent that in some areas of the country is a controlled substance. It is a white milky emulsion and can be used as an indication or maintenance when administered IV. In addition…
propofol has a rapid induction and should be titrated to effect
Which anesthetic agent is a neuroactive steroid that enhances GABA receptors by allowing an influx of chloride ions into cells
Alfaxalone
Alfaxalone when compared to Propofol
has less cardiovascular suppression
has a lower risk of apnea
is a federally controlled substance in the US
This anesthetic agent is a sedative hypnotic imidazole. It is administered IV and has minimal cardiovascular effects
Etomidate
adverse effects of Etomidate
painful IV injection
vomiting
formation of sterile abscesses with perivascular injection
Which medication frequently administered with other agents is administered IV primarily as a muscle relaxant offering poor sedation and poor analgesia
Guaifenesin
is not a halogenated organic compound inhalation agent
nitrous oxide
Inhalation anesthetic agents enter the bloodstream because of
the concentration gradient and lipid solubility at the level of the alveoli
What is the target organ for the anesthetic effect of inhalation agents
brain
The main method of elimination of commonly used anesthetic inhalation halogenated organic compounds
lungs
An inhalation agent with a low solubility/parturition coefficient
has a quick induction and recovery time
when comparing Sevoflurane and Isoflurane
Sevoflurane is less potent than Isoflurane
Sevoflurane has a quicker onset of action than Isoflurane
Sevoflurane is a better choice form mask induction than Isoflurane
Based on MAC value, what is the target setting of a precision vaporizer using an inhalation agent to maintain a surgical plane of anesthesia
1.5 x the MAC value
What are some of the adverse effects of most inhalation anesthetic agents
respiratory depression
decreased glomerular filtration rate with the need to use caution with NSAIDs
depressed myocardial function
Which of the following inhalation agents is said to have a single breath induction
Desflurane
This inhalation agent does not require a precision vaporizer. Its use can also decrease the anesthetic setting of the primary inhalation agent (second gas effect). It should never be used in a closed circuit, thoracic surgery or gastrointestinal surgery.
Nitrous oxide
