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Anesthesiology > Recovery > Flashcards

Recovery Flashcards

1
Q

How frequently do you monitor the vitals on an unconscious or immobile patient?

A

Every 10 minutes until animal regains consciousness.

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2
Q

An unconscious patient needs to be continuously supervised until when?

A

Extubation

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3
Q

What are 2 things that shivering consumes?

A

Oxygen and glucose

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4
Q

What needs to be conserved in an unconscious patient?

A

Body heat

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5
Q

With an unconscious patient, the tongue should be pulled rostrally to prevent what?

A

Pharyngeal occlusion

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6
Q

The endotracheal tube should be maintained until upper airway reflexes and jaw movement return in what type of patient?

A

Brachycephalic

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7
Q

Food and water should not be offered until the patient is what?

A

Standing

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8
Q

What should not be placed with an anesthetized animal?

A

An awake animal.

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9
Q

Caution needs to be used with what type of bandaging?

Especially where?

A
  • Constrictive

- Head and throat

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10
Q

Tight bandaging over the abdomen of a cat can lead to what?

A

Posterior paralysis

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11
Q

What are 2 possible causes that can be mistaken for anesthetic sensitivity?

A
  • Inappropriate dosing

- Inappropriate monitoring

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12
Q

Is anesthetic sensitivity common or rare in dogs?

A

Rare

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13
Q

What information do you need to know with prolonged emergence?

A

What the cause of the animal being asleep is.

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14
Q

How do you systematically evaluate a patient undergoing prolonged emergence?

A

A - Airway: maintain & protect
B - Breathing: ventilate to maintain normal CO2
C - CV: assess HR, BP, perfusion, urine output
D - Drugs: review all combinations
E - Electrolytes
F - Failure to find cause

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15
Q

What are 5 possible pharmacologic factors for prolonged emergence?

A
  • Timing
  • Total dose
  • Half life
  • Route
  • Patient bioavailability
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16
Q

What effect do opioids have on the respiratory system?

How does this affect the inhalant?

A
  • Decrease ventilation

- Delay inhalant elimination

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17
Q

What are 2 types of drugs that can potentiate other general anesthetic agents?

A
  • Benzodiazepines

- Ketamine

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18
Q

What drugs can have a prolonged affect in greyhounds?

A

Barbiturates

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19
Q

Opioid accumulation can lead to what?

A

Prolonged emergence

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20
Q

What are 2 reversal agents for alpha 2 agonists?

A
  • Atipamezole

- Yohimbine

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21
Q

What effect do benzodiazepines have that can cause prolonged emergence?

A

Decrease hepatic blood flow may prolong hepatic metabolism.

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22
Q

What is a reversal agent of benzodiazepines?

A

Flumazenil

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23
Q

What do you want to be careful of when reversing drugs?

A

Reversing analgesic effects.

24
Q

Depressed thermoregulation under anesthesia can lead to what?

A

Hypothermia

25
Q

What are 4 ways heat is lost?

A
  • Evaporation
  • Radiation
  • Conduction
  • Convection
26
Q

What are 3 classes of drugs that alter thermoregulation?

A
  • Opioids
  • Alpha 2 agonists
  • Inhalants
27
Q

Inhalants lower thermal threshold response to what temperature?
What won’t happen in the patient until this level is reached?

A
  • 34.5 C

- Patient won’t shiver.

28
Q

How do you convert from Celsius to Fahrenheit?

A

Multiply by 1.8 and then add 32

29
Q

A patients body temperature decreases over time with what?
How much in dogs?
How much in horses?

A
  • Inhalants
  • 2 C/hr
  • 0.37 C/hr
30
Q

Hypothermia (body temp

A

Reduces hepatic metabolism.

31
Q

What effect does hypothermia have on the CNS?

A

Depresses CNS activity (cold narcosis)

32
Q

What effect does hypothermia have on the solubility of anesthetic agents?
What effect does this have on their DOA?

A
  • Increased solubility

- Longer DOA

33
Q

What are 3 options for treating hypothermia seen with prolonged recovery?

A
  • Circulating warm water pads
  • Forced warm air device
  • Conductive fabric
34
Q

What are 3 organs that may be affected by reduced cardiac output seen with prolonged emergence?

A
  • Lungs
  • Kidney
  • Liver
35
Q

How can prolonged emergence affect protein binding?

Why is this a problem?

A
  • Decreased protein binding.

- Adequate amounts of protein are necessary to take drug to liver to be metabolized.

36
Q

An altered acid base status of

A

Altered mental status

37
Q

What are 4 effects renal failure and azotemia can have that cause prolonged emergence?

A
  • Altered acid base status
  • Decreased protein binding
  • Delayed excretions of drugs & metabolites
  • Electrolyte changes
38
Q

What are 7 examples of endocrine imbalances that can cause prolonged emergence?

A
  • Hypothyroidism
  • Adrenal insufficiency
  • Sepsis
  • SIRS
  • Pancreatitis
  • Uremia
  • Hypoglycemia
39
Q

What are 4 possible causes of hypoglycemia that can cause prolonged emergence?

A
  • Neonates
  • Very small patients (increased metabolic rate)
  • Fasted diabetics treated with insulin
  • Glucocorticoid deficiency
40
Q

What are 7 examples of neurological conditions that can lead to prolonged emergence?

A
  • Hydrocephalus
  • Cerebral hypoperfusion
  • Hypoxia
  • Elevated ICP
  • Cerebral ischemia
  • Cerebral edema
41
Q

Can genetic differences cause prolonged emergence?

A

Yes

42
Q

Can idiosyncratic reactions cause prolonged emergence?

A

Yes

43
Q

What commonly occurs within the first 10 minutes of emergence?

A

Postoperative delirium

44
Q

How long can postoperative delirium last?

A

Up to an hour.

45
Q

Hyperarousal, agitation and hyperactivity can be seen with what?

A

Postoperative delirium

46
Q

What are 6 possible causes of postoperative delirium?

A
  • Surgery
  • Infection
  • Anemia
  • Drugs
  • Hypotension
  • Hypoxia
47
Q

What are 3 things can cause postoperative delirium?

A
  • Decreased Acetylcholine
  • Increased Dopamine
  • Increased Cortisol
48
Q

Postoperative delirium is common in what 3 breeds of dogs?

A
  • Greyhounds
  • Russian Wolfhounds
  • Afghans
49
Q

What are 3 possible treatments for postoperative delirium?

A
  • Reversal agents
  • Quiet, dark, padded room/cage
  • Sedate
50
Q

Wait to extubate and deflate the cuff until what happens?

A

Patient swallows or coughs.

51
Q

What needs to be monitored during recovery?

A

Mucous membrane color and ventilation

52
Q

The patient should be placed in what type of recumbency during recovery?

A

Sternal recumbency

53
Q

What are 3 things that need to be maintained during recovery?

A
  • CV support
  • Pulmonary support
  • Catheter patency
54
Q

What is a concern with feline recovery?

A

Postoperative hyperthermia

55
Q

What are 3 thing to keep available during equine recovery?

A
  • Tranquilizers
  • Ropes
  • ER drugs

Anesthesiology (19 decks)

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