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Vet - Anesthesia > W2 (2) > Flashcards

W2 (2) Flashcards

1
Q

Oncotic pressure

A

Colloids presence in the vascular space provides colloid osmotic pressure

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2
Q

Describe the body as a closed system

A

Any fluid lost must come from either the ICF or the ECF​
Example:​ If an animal is hemorrhaging​
- Fluid is lost from the intravascular space (plasma)​
- Cells are lost from the ICF (red and white blood cells)​

Addition to losses : Fluid can and does move between compartments dynamically and changing fashion to maintain equilibrium​

  • Technician’s responsibility​ : Keep in mind which compartment needs to be replenished and what needs to corrected​
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3
Q

Why would you administer fluid

A
  • Correction of dehydration​
  • Expansion and support of intravascular vole​
  • Correction of electrolyte disturbances ​(Sodium (Na+), Chloride (Cl-), Potassium (K+), Magnesium (Mg++), Calcium (Ca++), Phosphate (HPO4–), Bicarbonate (HCO3-)​)
  • Ensure appropriate redistribution of fluids that may be in the incorrect compartment ​
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4
Q

Oliguria

A

The production of abnormally small amounts of urine

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5
Q

Hypovolemia

A

The loss of fluid in the intravascular space

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6
Q

Compare dehydration to hypovolemia

A

Dehydration - The water deficit in the interstitial and intracellular compartments
Hypovolemia - The loss of fluid in the intravascular space

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7
Q

How to assess hydration status in a patient

A
  • Skin tent test (turgor)
  • mucous membrane moisture
  • Oliguria
  • Increased packed cell and total protein levels
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8
Q

Administration of blood products vs hypertonic saline vs blood plasma

A

​
- Administration of blood products​ : To provide RBC’s or hemoglobin to support oxygen carrying capacity​, Clotting factors and platelets to support clotting (normal coagulation)​

  • Administration of hypertonic saline or colloid solutions​ : To draw water into the vascular space and raise the blood pressure
  • Administration colloids or blood plasma (fluid containing large solutes) : Remain longer in the vascular space​, Maintain blood pressure and volume​
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9
Q

Routes of administration of Fluids

A

Intravenous (IV) Route​

Intraosseus (IO) Route​ - Catheter in the medullary cavity of a bone​

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10
Q

What is a characteristic of all IV fluids?

A

All intravenous fluid are solutions​

  • Contain one or more solutes dissolved in water​
  • Most contain one or more electrolyte​
  • Some may contain Dextrose (form of glucose)​
  • Some may contain buffers​ : Lactate, gluconate​;Acetate (liver converts in sodium bicarbonate / Help regulate pH​)
  • Some may contain colloids​ : Larger solutes
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11
Q

How are fluids classified

A

Classified based on their molecular weight and solutes the solution contains​

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12
Q

Crystalloid vs colloid classifications

A

Classified by:​ Mix and quantity of solutes, Replacement or maintenance fluids​, Isotonic, hypotonic, or hypertonic​

  • Replacement Fluids have high concentrations of sodium and chloride​ : Designed to replace fluid losses​
  • Maintenance Fluids have lower concentrations of sodium and chloride, but also more Potassium​ : Designed to maintain fluid balance of a period of time​
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13
Q

Isotonic fluids

A

Have an osmolarity near to blood plasma​

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14
Q

Hypotonic and hypertonic fluids

A

Have an osmolarity either lower or higher than plasma​

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15
Q

Characteristics of crystalloid solutions

A

Contain water and small weight solutes (electroyltes, dextrose, buffers)

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16
Q

Types of Crystalloid solutions

A

Isotonic replacement solutions, Isotonic maintenance solutions, Normal saline solutions, Hypertonic Saline solution s

17
Q

Isotonic Replacement solutions

A

Lactated Ringer’s Solution (LRS) - has calcium, no magnesium
Plasma-Lyte A (PLA) - has magnesium, no calcium
Plasma-Lyte 148 (PL148) - has magnesium, no calcium
Normosol-R (NR) - No calcium, has magnesium

18
Q

Isotonic maintenance solutions

A

For maintenance fluid therapy over a longer period of time; reflects the solute composition of total body water
- Normosol-M (NM%) / Plasma-Lyte 56 in 5% dextrose (PL5) - both solutions have less sodium and chloride and more potassium

19
Q

Normal saline solutions

A

AKA - Physiologic saline, 0.9% saline, or sodium chorlide 0.9% normal saline solution (NS)

  • contains only sodium and chloride ions in water
  • an unbalanced replacement solution
  • Used in : Addison’s disease, Administering blood transfusions, Bathe exposed tissue or body cavities during surgery, Flush intravenous catheters (+/- heparin)
  • does not contain any potassium and can cause hypokalemia (need potassium supplement)
20
Q

Hypertonic saline solutions

A
  • Highly concentrated solutions (3%,7%…)
  • Treat patients with hypovolemic, traumatic, or endotoxin shock
  • Rapidly draws water into the intravascular space and supports blood pressure ( rapidly diffuses into the intersititial space
21
Q

Dextrose solutions

A

Contains dextrose as the only solute in the solution​

  • Are available on the market or can be mixed in house​ (2.5% or 5% solutions​)
  • Not usually used for replacement fluid therapy​
  • Used for specific purposes​ : Support blood glucose in neonates, hypoglycemic or debilitated patients, diabetic patients​
22
Q

Characteristics of colloid solutions

A

Are larger molecular weight solutes that do not freely diffuse across the vascular endothelium​

  • Stay in the intravascular space​
  • Support expansion of blood volume and blood pressure​
  • Two basic types of colloids​ : Synthetic and blood product
23
Q

Why are fluid rates high? compensating?

A

For anesthesia the fluid rates are higher than the volume required to maintain hydration in the patient and compensate for:​

  • Vasodilation​
  • Decreased cardiac output​
  • Increased insensible fluid loss (loss of fluid through skin, respiratory tract, feces)​
24
Q

Volume overload

A

Fluid Administration too rapid can result in volume overload​ –>Pulmonary edema / Cerebral edema​

All patients under anesthesia must be monitored for signs over hydration!​
(esp Patients under 5 kg (10 lbs.)​, Renal disease​, Cardiopulmonary disease​)

25
Q

Signs of over hydration

A
  • Ocular and nasal discharge​
  • Edema and swelling of the conjunctiva​
  • Subcutaneous edema​
  • Increased lung sounds (wetness)​
  • Increased respiratory rate​
  • Dyspnea (difficult or labored breathing)​
26
Q

How to avoid over hydration

A
  • Good monitoring techniques!​
  • Administer fluids via fluid pump or monitor fluid bag carefully​ (Fluid bag should be labeled with a time and volume scale for every hour​)
  • Use of a burette for smaller patients​
27
Q

What are the duties of the Tech during the preanesthetic period?

A

During the preanesthetic period, the technician has many duties. He or she must help the attending veterinarian develop a minimum patient database, ensure that fasting instructions were followed, place an intravenous (IV) catheter, administer fluids, stabilize the patient, prepare equipment, and administer medications

28
Q

How important is the patient history

A

An accurate and complete patient history is at least as important, if not more important, than results of diagnostic tests in shaping patient management prior to anesthesia​

29
Q

What are some conditions and diseases that require treatment and impact anesthetic management

A

Dehydration, anemia, abnormal bleeding, respiratory or cardiovascular system disease, kidney or liver dysfunction, and conditions that require treatment while the patient is under anesthesia are physical findings that may influence anesthetic management​

30
Q

What is the physical Status Classification?

A

This system is used to assess the patient’s overall health preoperatively by placing the patient into one of five grades ranging from a normal, healthy patient (class PS1) to one that is moribund and not expected to survive without the surgery (class PS5).

31
Q

What are factors that play into the selection of anesthesia

A

Established protocols in the clinic​ : Veterinary Technician is familiar with the protocol​, Remember to evaluate each patient on individual bases​, The veterinarian bears responsibility for the patient and must make the final decision regarding the anesthetic protocol​

  • Facilities and Equipment​
  • Familiar with the anesthetic agents​ : It is not advisable to anesthetize a high-risk patient with a new combination of drugs that the anesthetist may have heard or read about but has never tried before​
  • Type of Procedures​ : Procedures vary in their duration and complexity. ​Require different degrees of analgesia, immobilization, muscle relaxation, and CNS depression ​
  • Cost​
  • Degree of Urgency​ : Critically injured patients​, Rapid blood loss, shock, chest or abdominal injury​ –> Selection of agents that allow preservation of adequate blood pressure and rapid induction to place the patient under anesthesia​

Vet - Anesthesia (8 decks)

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