Surgical Nursing Flashcards

1
Q

Why should antibiotics not be given indiscriminately to animals having surgery?

A

Antibiotics have side effects, raise the cost of the procedure, and indiscriminate use of antibiotics helps develop resistant strains of bacteria or “superbugs.”

Student #11, JM
McCurnin 10th edition, page: 1050

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2
Q

What procedures can be performed when a hemorrhage is suspected?

A

PCV, TP, abdominocentesis, thoracocentesis, or fine-needle aspiration beneath the incision

Student #11, JM
McCurnin 10th edition, page: 1050

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3
Q

What abnormalities can occur in incisions during the first 1-3 days post-op?

A

Redness, swelling, drainage, and dehiscence

Student #11, JM
McCurnin 10th edition, page: 1052

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4
Q

How long after surgery can sutures be removed and why?

A

Typically sutures can be removed 10-14 days after surgery, because this Is the amount of time the wound needs to begin to strengthen. If internal sutures were placed in the dermis, external suture removal can take place 5-7 days after surgery due to the internal layer holding the incision closed as the healing process continues.

Student #11, JM
McCurnin 10th edition, page: 1053-1054

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5
Q

What is the difference between elective and non-elective surgery?

A

Elective surgeries are performed at the convenience of the owner and veterinarian. Some elective surgeries improve an animal’s quality of life, such as correction of a patellar luxation. Other common examples are spays and neuters. Non-elective surgery is typically an emergency and is performed urgently.

Student #11, JM
McCurnin 10th edition, page: 1055

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6
Q

What treatment options are available for a patient with a hemorrhage?

A

Crystalloid fluid bolus, colloidal fluid administration, blood transfusion, pressure bandage, and reoperation (to stop the source of the hemorrhage)

Student #10, AM
McCurnin 10th edition, page: 1050

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7
Q

What are some mechanisms of active warming that can be used to prevent hypothermia?

A

You can place animals on heated circulating water blankets, wrap paws and/or the body in plastic wrap, wrap warm water bottles with a towel and place them next to the animal, cover areas of the animal that are not involved in the surgery with an insulated blanket, use actively warmed cages and surgery tables, and use a warm air blanket (Bair Hugger).

Student #10, AM
McCurnin 10th edition, page: 1051

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8
Q

When should pain be assessed in a patient?

A

Preoperatively, perioperatively, and postoperatively

Student #10, AM
McCurnin 10th edition, page: 1052

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9
Q

What is a seroma, and how can it form?

A

A seroma is a localized area of fluctuant swelling. It is not usually painful or warm to the touch. Seromas can form as a result of extensive surgical dissection beneath the incision, tissue planes that were not adequately closed, or excessive motion occurring at the incision site.

Student #10, AM
McCurnin 10th edition, page: 1052

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10
Q

What is the difference between an active and a passive drain?

A

Active drains are sealed to the environment and actively collect fluid from the wound into a reservoir, and they should be emptied as needed. Passive drains provide an exit port for fluid to the external environment. They are not ideal due to the risk of ascending bacterial infection and difficulty with their maintenance. They should be covered and changed frequently.

Student #10, AM
McCurnin 10th edition, page: 1054

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11
Q

What are the indications for tail docking?

A

Tail docking is performed in young puppies primarily for aesthetic reasons and to meet breed standards. Occasionally, the tail may be docked in hunting breeds to prevent trauma during hunting.

Student #6, MH
McCurnin 10th edition, page 1056

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12
Q

What are the characteristics of intestinal devitalization?

A

-Lack of motility
-Gray, green or black discoloration
-Severe thinning of the visceral wall
-Lack of bleeding on cut section
-Lack of fluorescein dye uptake
-Lack of doppler blood flow

Student #6, MH
McCurnin 10th edition, page 1061- 1062

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13
Q

Define Pyometra

A

Pyometra is a condition of the uterus in which endometrial hyperplasia has resulted in increased uterine secretions and accumulation of fluid within the uterus with secondary infection.

Student #6, MH
McCurnin 10th edition, page 1069

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14
Q

Why is it best to vaccinate a puppy or kitten 2 weeks prior to surgery rather than the day of the surgery?

A

Because doing it 2 weeks earlier will minimize the effect of anesthesia on the immune response to immunization.

Student #6, MH
McCurnin 10th edition, page 1049

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15
Q

Why should antibiotics never be given indiscriminately to animals undergoing surgery?

A

Because this contributes to the development of strains of bacteria that are resistant and difficult to treat such as methicillin resistant Staphylococcus aureus (MRSA) also called hospital superbugs.

Student #6, MH
McCurnin 10th edition, page 1050

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16
Q

When would you withhold fluids from an animal?

A

Never. Withholding of fluids does not prevent anemia!

TM, #7, McCurnin’s (electronic version) 10th ed. Location 51988 of 67848 (1 out of 5 cards)

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17
Q

When are sutures typically removed?

A

10-14 days, unless internal sutures were placed then they can be removed in 5 to 7 days

TM, #7, McCurnin’s (electronic version) 10th ed. Location 52197-52198 of 67847 (2 out of 5 cards)

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18
Q

Breed standards are set by what organization in the US?

A

The American Kennel Club

TM, #7, McCurnin’s (electronic version) 10th ed. Location 52295 of 67847 (3 out of 5 cards)

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19
Q

What are the techniques used to declaw animals?

A
  1. Nail trimmer (Rescoe)
  2. Scalpel Blade
  3. Carbon dioxide laser

TM, #7, McCurnin’s (electronic version) 10th ed. Location 52372-52373 of 67847 (4 out of 5 cards)

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20
Q

If intestinal dehiscence or leakage occurs, what postoperative disease will develop?

A

Septic peritonitis

TM, #7, McCurnin’s (electronic version) 10th ed. Location 52582 of 67847 (5 out of 5 cards)

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21
Q

Consider declawing analgesia post-operatively. Is waiting and monitoring pain level acceptable?

A

A wait-and-see attitude with regard to pain medication for an onychectomy is unacceptable.

DM,12, McCurnin 10th Ed. Pg. 1059

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22
Q

Indiscriminant use of antibiotics contributes to the development of

A

Resistant strains of bacteria that are difficult to treat (“super bugs”)

DM,12, McCurnin 10th Ed. Pg. 1050

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23
Q

Define seroma

A

Serum accumulated under an incision

DM,12, McCurnin 10th Ed. Pg. 1052

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24
Q

Define anastomosis

A

Suturing of the portions of the GI tract back together to allow ingesta to flow normally

DM,12, McCurnin 10th Ed. Pg. 1061

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25
Define enterotomy
Incision into the intestine DM,12, McCurnin 10th Ed. Pg. 1061
26
This occurs when serum seeps through the bandage to the external environment
Strike-through #8 JM McCurnin 10th Ed pg 1054
27
The separation of the layers of an incision or wound
Wound dehiscence #8 JM McCurnin 10th Ed pg 1053
28
Complete dehiscence of a thoracic wound can result in this condition
Pneumothorax #8 JM McCurnin 10 Ed pg 1053
29
The surgical attachment of the stomach to the body wall to create a permanent adhesion
Gastropexy #8 JM McCurnin 10th Ed pg 1063
30
We can avoid this condition by frequently turning recumbant patients
Decubital ulcers #8 JM McCurnin 10th Ed pg 1083
31
What is a hollow viscus and what are examples?
an organ that isn't solid ie GI tract and urinary bladder #9 RP, McCurnin 10th Ed, pg 1050
32
indications for prophylactic (preventative) ABX (6)
1. Sx time <90min- Sx wound open to bacteria from P skin, operative team and air (longer wound open more chance of getting infected) increased chance of infection during anesthesia bc of atelectasis 2. immunosuppressed: on immunosuppressive (steroids), Cushings, some cancers, chemotherapy or radiation therapy and certain infections 3. a hollow viscus to be entered (a non- solid organ) ie GI tract and urinary bladder 4. Sx site is difficult to prepare ie mouth, toe and ear 5. ortho implant place or joint is entered ((intra- articular inj (IA)) 6. consequences of infection could be devastating (joint replacement and neurosurgery) prophylactic ABX are not recc for short, clean Sx procedures (ie mass removal/ biopsy, spay and castration) #9 RP, McCurnin 10th Ed, pg 1050
33
Define Cellulitis
Infection along tissue planes, generally without large pockets of fluid #13, TN McCurnin 10th Ed, pg 1053
34
When are drains removed?
When the amount of drainage has substantially decreased #13 TN McCurnin 10th Ed pg 1054
35
What are indications for a celiotomy?
Ruptured spleen, organ biopsy, cystostomy, gastropexy, GDV, foreign bodies, cesarean delivery, penetrating foreign bodies #13 TN McCurnin 10th Ed pg 1059
36
Intestinal and pancreatic manipulation can lead to...
Intestinal ileus, nausea, and/or pancreatitis #13 TN McCurnin 10th Ed pg 1060
37
Medical management of closed pyometras should be avoided due to the risk for..
Uterine rupture, septicemia, endotoxemia, and possibly death #13 TN McCurnin 10th Ed pg 1069
38
How long should a healthy adult be fasted before surgery?
6-12 hours. #11 ZZ McCurnin 10th Ed pg1049
39
How long is swelling medically okay until it becomes a seroma or hematoma?
3-7 days post-op any swelling is now considered a sermoa/hematoma. #11 ZZ McCurnin 10th Ed Pg1052
40
What is a urethrostomy?
A procedure to create a new opening in the urethra at the perineum for urine/foreign materials to pass through. #11 ZZ McCurnin 10th Ed Pg1075
41
Is a urethrostomy performed in the same anatomical place in dogs and cats?
No. Dogs typically get a urethrostomy on their scrotum. Cats typically get a urethrostomy perirenally. #11 ZZ McCurnin 10th Ed Pg1075
42
Should tail docking and/or dewclaw removal be performed on adult dogs electively?
No. McCurnin suggests that these procedures should only be done electively for patients who are only a few weeks old. #11 ZZ McCurnin 10th Ed Pg1057
43
How long should a healthy adult cat or dog be fasted before surgery?
Healthy adult animals may be fasted for 6 to 12 hours. Student #3, AF McCurnin 10th Edition page: 1049
44
What should be assessed for anemia before surgery?
A baseline PCV and TP should always be assessed for anemia before surgery. Student #3, AF McCurnin 10th Edition page 1051
45
What are the most common factors that contribute to wound dehiscence?
Inappropriate suture or suturing technique to close a wound, tension on the incision line, incision infection, seroma formation, and disease and/or drug therapy leading to delayed wound healing. Student #3, AF McCurnin 10th Edition page 1053
46
What is a Enterotomy?
Enterotomy is an incision into the intestine. Student #3, AF McCurnin 10th Edition page:1061
47
What is a Gastrotomy?
Gastrotomy is an incision into the stomach. Student #3, AF McCurnin 10th Edition page 1061
48
In general, how are oral lacerations dealt with in cattle? Surgery needed? Proper maintenance?
Most lacerations in cattle heal without surgical intervention by using daily mouth lavage and systemic antibiotics, and by feeding a soft diet. In severe cases that involve the body of the tongue, surgical management might be needed to promote healing and prevent deformity. #1 CE McCurnin 10th Edition page 1109
49
Most animals will not lick or chew at their surgical incision unless the incision is irritating. What are the contributors to incision irritation?
Sutures that are placed too tight Traumatic tissue handling Suture reaction Tension on the suture line Clipper burn Prepping irritation such as clipper burn + solution reactions Incision infection Seroma formation #4 JG Beal, A., & Wortinger, A. (2022). Pharmacology and Pharmacy. In Clinical Textbook for Veterinary Technicians and Nurses (10th ed., p. 1052). Elsevier.
50
A celiotomy is a surgical incision into the abdominal cavity. What are the locations where the incision may be made? What is the most common incision site?
Ventral midline (Most common) Paramedian Paracostal Parapreputial Flank #4 JG Beal, A., & Wortinger, A. (2022). Pharmacology and Pharmacy. In Clinical Textbook for Veterinary Technicians and Nurses (10th ed., p. 1054). Elsevier.
51
What is a rumenotomy procedure?
Rumenotomy is indicated when a ruminant has gorged on feed or ingested a foreign object. a large area of the Left Flank is clipped and prepped in the site is aseptically prepared And the contents of the rumen are now ready to be manually evacuated through surgery after proper blocks are used for pain management. #1 CE McCurnin 10th Edition page 1108
52
While the primary indication for an ovariohysterectomy is the prevention of pregnancy, what are other indications for this procedure?
Endocrine imbalance Infection Injury Cysts Tumors Prevention of unwanted behavior Congenital abnormalities #4 JG Beal, A., & Wortinger, A. (2022). Pharmacology and Pharmacy. In Clinical Textbook for Veterinary Technicians and Nurses (10th ed., p. 1065). Elsevier.
53
How often should the urinary bladder be expressed on post-operative neurologic patients?
Urinary bladder expression should be performed four or five times per day to keep the urinary bladder empty this will in turn keep animals clean and will prevent detrusor muscle atony which can lead to permanent bladder dysfunction if not expressed enough. CE #1 McCurnin 10th Edition Page 1083
54
Endocrine disturbances may be an indication of an ovariohysterectomy. What clinical manifestations may endocrine disturbances be associated with?
Sterility Skin lesions Mammary tumors Pseudocyesis Nymphomania #4 JG Beal, A., & Wortinger, A. (2022). Pharmacology and Pharmacy. In Clinical Textbook for Veterinary Technicians and Nurses (10th ed., p. 1065). Elsevier.
55
What is the definition of an amputation?
Amputation refers to partial or complete removal of a body part such as a limb or toe. CE #1 McCurnin 10th Edition page 1080
56
What is Mammary Neoplasia?
Mammary neoplasia is cancer of the mammary gland; it is the most frequently occurring neoplasm in the female dog and the third most frequently found tumor in the female cat. CE #1 McCurnin 10th Edition page 1080
57
What are the signs of a healed incision?
Confluent Slightly raised Whitish in color No gaps between skin edges #4 JG Beal, A., & Wortinger, A. (2022). Pharmacology and Pharmacy. In Clinical Textbook for Veterinary Technicians and Nurses (10th ed., p. 1054). Elsevier.
58
When are diagnostics best performed before surgery to allow the surgeon to evaluate the patient’s status and establish protocols?
- 1 to 2 before surgery if possible - Diagnostic may include bloodwork, heartworm test, blood gas analysis, EKG interpretation, radiography, fecal analysis, urinalysis. AF #2, McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 33, Page 1049)
59
What is the definition of celiotomy? Where is the most used incision site utilized?
- Celiotomy/Laparotomy: a surgical incision into the abdominal cavity - Ventral midline is utilized the most often. AF #2, McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 33, Page 1059)
60
When are gastrotomy or enterotomy procedures recommended?
To obtain biopsies, remove damaged tissues, remove tumors, or to remove foreign materials. AF #2, McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 33, Page 1061)
61
What are some of the postoperative complications for dogs that underwent GDV surgery?
Arrhythmias, hypotension, hypovolemia, urination (oliguria or anuria), anemia due to continued hemorrhage, +/- gastric wall dehiscence AF #2, McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 33, Page 1064
62
What is the definition of cystotomy? What are the indications for the procedure?
- An incision into the urinary bladder to expose the lumen (interior of the urinary bladder) - Indications: removal of cystic calculi (bladder stones), removal of tumors, correct congenital defects, repair traumatic rupture of the urinary bladder, placement of a cystotomy tube AF #2, McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 33, Page 1074)
63
give 5 examples of absorbable synthetic suture and give one fact about the suture
1. Polyglactin 910 (Vicryl): stable in contaminated wounds 2. Polyglycolic acid (Dexon): weaker than other synthetic absorbable suture 3. Poliglecaprone 25 (Monocryl): one of the strongest synthetic absorbable sutures 4. Polydioxanone (PDS): greater tensile strength than Vicryl and Dexon 5. Polyglyconate (Maxon): similar to PDS #9 RP, McCurnin 10th Ed, pg 1038
64
give 2 examples of non absorbable natural sutures and 1 fact about them
1. silk: has no memory 2. metallic suture (stainless steel): no inflammatory reaction from suture #9 RP, McCurnin 10th Ed, pg 1038
65
give 4 examples of non- absorbable synthetic suture and 1 fact about each
1. Polyamide (Nylon): poor handling characteristics 2. polypropylene (Prolene): high memory 3. Polybutester (Novafil): excellent stretching ability 4. Polyester (Mersilene): not recc for infected wounds #9 RP, McCurnin 10th Ed, pg 1038
66
Hypovolemic shock is common in this condition due to compression of the stomach onto the caudal vena cava
GDV #10 JM McCurnin 10th ed pg 1063
67
A gastropexy is performed is this area of the body
Right ventrolateral body wall near last rib #10 JM McCurnin 10th ed pg 1064
68
Technicians should monitor animals carefully for at least ____ hours after an ovariohysterectomy
24 #10 JM McCurnin 10 ed pg 1067
69
For mature dogs, this is the most favorable time to spay
3-4 months after estrus #10 JM McCurnin 10th ed pg 1067
70
Animals undergoing cervical disk surgery are positioned this way for the procedure
Dorsal recumbency with head and neck slightly extended #10 JM McCurnin 10th ed pg 1082