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Surgical Nursing And Introduction To Anaesthesia > Surgical Nursing And Introduction To Anaesthesia > Flashcards

Surgical Nursing And Introduction To Anaesthesia Flashcards

1
Q

What is general anaesthesia?

A

Medically inducing loss of consciousness

General anaesthesia is used during surgical procedures to ensure the patient is completely unconscious.

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2
Q

What is epidural anaesthesia?

A

Pain control by injecting the anaesthetic into the epidural space

This type of anaesthesia is often used during childbirth and certain surgeries.

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3
Q

What does regional anaesthesia do?

A

Blocks sensation & pain in an area of the body

It is commonly used for procedures on the lower body.

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4
Q

Define local anaesthesia.

A

Absence of all sensation in a specific part of the body

Local anaesthesia is often used for minor surgical procedures.

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5
Q

What is topical anaesthesia?

A

To numb the surface of the body

It is typically applied to the skin or mucous membranes.

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6
Q

What are the principles of anaesthesia?

A

Control pain, restrain fractious patients, facilitate examination by immobilizing the patient, control status epilepticus, perform euthanasia, transportation

These principles guide the use of anaesthesia in clinical settings.

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7
Q

What is one use of anaesthesia in clinical care?

A

Orthopaedic examination & manipulation

Anaesthesia helps in performing certain examinations and treatments without causing pain.

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8
Q

What is airway management in anaesthesia?

A

Ensuring the patient can breathe adequately during procedures

This is crucial for patient safety during anaesthesia.

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9
Q

List criteria for selecting drugs/techniques in anaesthesia.

A
  • Species
  • Breed
  • Age
  • Weight & body type
  • Behaviour
  • Physical status
  • Co-existing disease processes
  • Nature, location & severity of pain
  • Current & past medications
  • Knowledge/experience of personnel
  • Familiarity with available equipment/techniques
  • Duration/type of procedure
  • Patients are ASA graded prior to

These criteria ensure the appropriate anaesthetic is used for each patient.

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10
Q

What are the components of the triad of anaesthesia?

A

Muscle relaxation, unconsciousness, analgesia

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11
Q

What are the principles of balanced anaesthesia?

A

Use of combination of drugs to reduce the dose of individual drugs and provision of better quality GA.

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12
Q

What are the benefits of balanced anaesthesia?

A

Reduction of cardiovascular & respiratory side effects.

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13
Q

What is stage one of balanced anaesthesia?

A

Pre-med with sedative & analgesia drug.

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14
Q

What is stage two of balanced anaesthesia?

A

Induce with intravenous agent.

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15
Q

What is stage three of balanced anaesthesia?

A

Maintain with inhalent agent.

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16
Q

What is further analgesia in balanced anaesthesia?

A

Constant rate infusions (CRI) if required.

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17
Q

What are the components of pre-anaesthetic instructions?

A

Medical history, physical examination, ASA scoring & identifiable pre-anaesthetic risks, pre-anaesthetic lab tests, purpose of anaesthetic, arrival time, fasting period, medication guidance, info sheet on anaesthetic risks, details of procedure, gaining informed consent.

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18
Q

What should be included in the medical history of a patient?

A

Patient’s ID number, age, species & breed, neuter status, history of adverse medication reactions, systemic diseases, previous medical history from previous vets, previous anaesthetics or sedation.

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19
Q

What is the purpose of physical examinations in patient assessment?

A

To identify abnormalities, promote an individual approach, and create an individualised anaesthetic protocol.

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20
Q

What should be done if abnormalities are detected during physical examinations?

A

Discuss the detected abnormalities with the vet surgeon.

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21
Q

What is ASA SCOring?

A

A system to identify pre-anaesthetic risks and create an intervention plan with the vet surgeon.

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22
Q

What does ASA E stand for?

A

Emergency.

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23
Q

What does ASA 1 indicate?

A

Normal, healthy patient.

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24
Q

What does ASA 2 indicate?

A

Mild systemic disease.

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25
What does ASA 3 indicate?
Obvious systemic disease.
26
What does ASA 4 indicate?
Severe systemic disease - constant threat to life.
27
What does ASA 5 indicate?
Not expected to survive without operation.
28
What are pre-anaesthetic lab tests used for?
To identify underlying issues such as diseases and indicators for organ failure.
29
What are some examples of pre-anaesthetic lab tests?
Biochemistry, haematology, electrolytes.
30
What are the pre-anaesthetic considerations?
1) Pre-anaesthetic instructions 2) Obtain informed consent 3) Physical exam 4) Pre-op bloods 5) IV fluid therapy & IV catheter 6) Pre-med plan 7) Monitoring equipment & set up multi-parameter 8) Induction agent 9) Endotracheal tube selection 10) Safety checklist 11) Crash trolley.
31
What is the purpose of placing IV catheters?
Allows for intravenous fluid therapy and administration of intravenous drugs.
32
When should IV catheters be placed in relation to pre-medications?
IV catheters should be placed before pre-medications to avoid potential adverse reactions to other drugs.
33
What is the recommended time to use Emia before placing an IV?
Emia should be used 20 minutes prior to placing the IV to numb the area for patient compliance.
34
What are the purposes of IV fluid therapy?
Supports patients under anesthesia, replaces fluid loss, prevents dehydration, supports organ function, and supports the circulatory system.
35
What is the gas supply in an anaesthetic machine?
Gases are contained in gas cylinders and supplied at high pressure via pipeline with cylinders on the anaesthesia machine for emergency backup.
36
What are the color codes for gas containers?
Oxygen is white, nitrous oxide is blue, and medical air is black, white, and grey.
37
What is a pin index safety system?
A pin index safety system is a mechanism that uses specific pin positions to match with the machine of delivery system.
38
What is an oxygen generator?
Used to generate oxygen in practice rather than piped or gas cylinder.
39
What is the purpose of a pressure gauge?
Indicates how much gas is left. Check before using, but does NOT give reliable info for nitrous oxide levels. ## Footnote Requires to be weighed due to being a liquid.
40
What is the function of a pressure reducing valve?
Reduces pressure from gas in cylinder, maintaining constant pressure to prevent surge. Only present when using a gas cylinder; regulator would be the source if using a pipeline.
41
What does a flowmeter do?
Provides final stage for reduction of pressure of gas and allows manual adjustment for volume of gas. A bobbin is used depending on what is available on the machine.
42
What is emergency oxygen?
Provides oxygen directly, flushing past the vaporiser. Caution is required as it is delivered at a high flow rate, which can cause barotrauma.
43
What happens during an oxygen failure?
An alarm will ring if there is a drop in pressure of the oxygen supply, causing the patient to become anaerobic.
44
What do mini Schrader sockers provide?
Oxygen or air to power ventilators.
45
What does the Schrader probe connect to?
The socket.
46
What is the purpose of the Schrader probe?
Prevents misconnection.
47
How does oxygen enter the flowmeter?
Oxygen enters the machine at the lower back of the flowmeter.
48
Where does oxygen exit the flowmeter?
Oxygen exits the flowmeter near the top.
49
What happens to oxygen after it exits the flowmeter?
Oxygen enters the vaporiser and collects the anaesthetic agent.
50
What occurs after the oxygen and agent mixture exits the vaporiser?
The gas and agent enter the breathing bag and inhalation tube and are inhaled.
51
What does the vaporiser do in response to temperature changes?
The vaporiser automatically compensates if temperature changes to ensure maintenance of constant concentrations of inhalant agent in the delivered gas mixture.
52
What is the purpose of airway management?
To support the patient's respiratory system and deliver fresh oxygen and inhaled agents.
53
How does airway management protect the patient's airway?
It protects the patient's airway through unconsciousness.
54
What does airway management enable in case of an anaesthetic emergency?
It enables rapid intervention.
55
What is the provision for IPPV or mechanical ventilation?
It allows for CPR.
56
What are the types of airway management?
Endotracheal tube, supraglottic device, masks, FIO2 by nasal tubing.
57
What equipment is needed for airway management?
Anaesthetic machine & vaporiser, laryngoscope, local anaesthetic agent, lubricant, appropriately sized ET tubes or supraglottic devices.
58
How are ET tubes measured?
ET tubes are measured by their inner diameter.
59
What is a tube tie used for?
A tube tie is used to secure the airway device.
60
What is the purpose of a cuff inflator?
A cuff inflator is used for pressure measurement.
61
What is a stylet used for?
A stylet is used for brachycephalic patients.
62
What are the types of ET tubes?
Magill (simple bevel, shorter end), Murphy (acute bevel, Murphy's eye), PVC, rubber or silicone.
63
What is a high pressure, low volume cuff?
A high pressure, low volume cuff (Magill) creates high pressure within the trachea.
64
What is a low pressure, high volume cuff?
A low pressure, high volume cuff requires more air to seal and distributes pressure over a wider area.
65
What is the importance of appropriate cuff inflation?
Appropriate cuff inflation reduces the risk of aspirating mucus, vomit, or liquids.
66
What equipment is needed for ET tube placement preparation?
1) Laryngoscope 2) Appropriate size leak tested tubes (one above, one below = ideal) 3) Tie 4) Sterile lubricant 5) Intubation device 6) Cuff inflation device
67
What are the benefits of supraglottic devices?
1) Quick & easy to place 2) Reduced risk of trauma to larynx 3) Can remain in-situ for longer on recovery 4) More reliant on capnography to confirm placement ## Footnote Reduced protection against aspiration; sometimes slip if not correct size.
68
What is the complication of ET tube placement into the esophagus?
ET tube into esophagus instead of trachea, use laryngoscope.
69
What is endobrachial intubation?
ET tube placed into a single bronchus, cut to the right length.
70
What are complications related to trauma during intubation?
Repeated attempts can lead to cavitation, poor technique, rupture, or puncture.
71
What is laryngospasm?
Reduced air flow and exaggerated chest movements.
72
What causes airway obstruction?
Mucous plugs or occlusion of the airway.
73
What are leakages in veterinary terms?
Inappropriate depth of anesthesia, smell of anesthetic gases.
74
What is extubation?
The recovery period has a higher mortality rate than general anesthesia (GA). ## Footnote 47% of GA deaths in canines and felines occurred in recovery. Ensure the patient can maintain their own airway; brachycephalic breeds are prone to adverse airway events.
75
What is intubation?
Intubation is regulated under Schedule 3 of The Veterinary Surgeons Act 1966.
76
What is the purpose of anaesthesia breathing circuits?
To remove carbon dioxide (CO₂) exhaled by the patient, supply oxygen, and supply anaesthetic gases.
77
What does intermittent positive pressure ventilation (IPPV) allow?
It allows for the delivery of breaths to the patient.
78
What is rebreathing in anaesthesia breathing circuits?
Rebreathing occurs when carbon dioxide (CO₂) is absorbed and the gases are reused.
79
What is non-rebreathing in anaesthesia breathing circuits?
Non-rebreathing occurs when CO₂ is flushed out by a continuous flow of fresh gas.
80
What is rebreathing?
A system where exhaled gases are recirculated to the patient. ## Footnote Examples include the Humphrey ADE circle system.
81
What is non-rebreathing?
A system that prevents exhaled gases from being recirculated to the patient. ## Footnote Examples include Ayers modified T-piece, Bain, coaxial lack, Magill, Humphrey ADE, and parallel lack.
82
What are the advantages of rebreathing?
Requires low gas flow rates and reduces heat loss from the patient, requiring less warming.
83
What are the disadvantages of rebreathing?
Altering the level of volatile agent in the circuit takes time, and CO2 absorbent valves create resistance.
84
What are the advantages of non-rebreathing?
Concentration of volatile agent can be altered quickly and has minimal circuit resistance.
85
What are the disadvantages of non-rebreathing?
Potential for rebreathing if the patient breathes too rapidly, requiring an increased flow rate, and significant heat loss through the respiratory tract.
86
What are the circuit factors for breathing systems?
Arcuit factors: - Piece: 2.5 - 3 L, Weight: 10Kg - Mini Lack: 1 - 1.5 L, Weight: 10Kg - Lack: 1 - 1.5 L, Weight: 10-40 Kg - Bain: 2.5 - 3 L, Weight: 10 - 30 Kg
87
What are the advantages of a circle system?
Advantages: - Low fresh gas flow requirements - Ideal for IPPV - Reduced heat loss from patient
88
What are the disadvantages of a circle system?
Disadvantages: - Cannister needs to be filled with CO2 absorbent - Unsuitable for patients that are hypothermic
89
What does soda lime indicate?
Soda lime: - Colour changes to indicate fresh to exhausted ## Footnote White to purple or pink to white
90
What are the problems associated with GA breathing systems?
Problems: - Infection transmission - Excessive resistance to breathing - Leaks - Inadvertent closure of APL valve

Surgical Nursing And Introduction To Anaesthesia (1 decks)

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