question

Anesthesia is used daily in most veterinary practices to provide ... (6)

answer

sedation, tranquilization, immobility, muscle relaxation, unconsciousness, and pain control

question

Define Anesthesia

answer

Loss of sensation; One extreme in a continuum level of CNS depression

question

Define General Anesthesia

answer

Reversible state of unconsciousness, immobility, muscle relaxation, and loss of sensation

question

Define Surgical Anesthesia

answer

1- A stage of general anesthesia 2- Analgesia and muscle relaxation 3- Eliminate pain and patient movement during the procedure

question

Explain the Continuum of CNS Depression (chart)

answer

(chart)

question

Sedation vs. Tranquilization

answer

Sedation = CNS depression Drowsiness Drug-induced Various levels Slightly aware or unaware of surroundings Aroused by noxious stimulation Uses: minor procedures Tranquilization = Calmness Patient is reluctant to move Aware of surroundings but doesn't care

question

Hypnosis vs. Narcosis

answer

Hypnosis = Drug-induced Sleeplike state Impairs patient's ability to respond to stimuli Patient can be aroused with sufficient stimulation Narcosis = Drug-induced sleep Patient is not easily aroused Associated with narcotic drugs

question

Define Local Anesthesia

answer

1- Targets a small, specific area of the body 2- Loss of sensation to a specific area 3- Drug is infiltrated into the desired area

question

Define Topical Anesthesia

answer

1- Applied to body surfaces or a wound 2- Produces a superficial loss of sensation

question

Define Regional Anesthesia

answer

1- Loss of sensation to a limited area of the body For example, Nerve blocks & Epidural anesthesia

question

Define Balanced Anesthesia

answer

1- Using multiple drugs in smaller quantities Maximizes benefits & Minimizes adverse effects Gives anesthetist greater control

question

The Credentialed Veterinary Technician's Role as an Anesthetist (4)

answer

1- Anesthetic machine (a) Preparation (b) Operation (c) Maintenance 2- Administer anesthetic agents 3- Endotracheal intubation 4- Patient monitoring

question

Anesthesia Challenges and Risks (5)

answer

1_ Dose calculation and rate adjustment 2- Vital signs and anesthetic depth 3- Assess multiple pieces of information 4- Patient management 5- Anesthetic accidents

question

Anesthetics have a Wide or Narrow therapeutic index?

answer

NARROW

question

Miscalculation during anesthesia can result in...

answer

serious consequences Most anesthetic agents have a very narrow therapeutic index, so the consequences of a calculation or administration error may be serious. Therefore care and attention to detail are critical when dosages are calculated and rates of administration are adjusted

question

What does "Assess Multiple Pieces of Information" during anesthetic monitoring mean?

answer

The anesthetist must accurately interpret a wide spectrum of visual, tactile, and auditory information from the patient, anesthetic equipment, and monitoring devices. To do this successfully, he or she must be able to rapidly assess multiple pieces of information and distinguish those that require action from those that do not.

question

What are "Anesthetic Accidents"?

answer

Death, stroke (in humans) The outcome can be devastating or lethal Owners may pursue legal action Prevent accidents by using high standards Keep meticulous records

question

Role of the Veterinary Anesthetist (6)

answer

Minimum patient database Proper patient fasting Preinduction patient care All supplies are available All equipment is in working order Preanesthetic medication

question

Minimum Patient Database (MPD)... 3 things

answer

Patient history Physical examination and assessment Preanesthetic diagnostic workup

question

Patient Preparation "To Do" List (7 things)-- Chart

answer

(chart)

question

When obtaining patient history, remember to obtain these 5 things for each aspect...

answer

Information given freely Duration Severity or volume Frequency Appearance or character

question

When obtaining the history, determine each of the following: (5)

answer

The signalment Current and past illnesses Medications currently being administered Allergies or drug reactions The status of preventive care

question

Patient History - SIGNALMENT (5)

answer

Species Breed Age Sex Reproductive status

question

Anticholinergics avoided in ...

answer

ruminants

question

Ventilation and physical support for...?

answer

large animals

question

Excess airway secretions occur in ...?

answer

cats and ruminants

question

Exotic animals are handled ...?

answer

differently; they're weird

question

___ and ____ are more sensitive to opioids

answer

Horses and cats

question

____ and ____ are sensitive to acepromazine

answer

Boxers and giant breeds

question

____ are resistant to acepromazine

answer

Terriers

question

_______ are difficult to intubate

answer

Brachiocephalic dogs

question

______ are sensitive to barbiturates

answer

Sighthounds

question

_____ are sensitive to sedatives

answer

Draft horses

question

Don't use thiobarbiturates on _______ (and give examples)

answer

sight hounds Which are = Greyhounds Irish Wolf hounds Saluki Afghan Borzoi Whippet Basenji Pharaoh hound

question

During the Anesthesia Pre anesthetic evaluation, Signalment can alert to possible problems, give 3 examples

answer

1- Age 2- Sex (Status) 3- Breed Young patients may have Hypothermia or Hypoglycemia. Old patient may have Decrease liver and kidney function. Decreased muscle mass May also affect dose. Sex and reproductive status; are they In heat ? Pregnant?

question

Acepromazine is contraindicated in ...?

answer

stallions

question

Xylazine is contraindicated in pregnant ___ and ____.

answer

cows and ewes

question

Re: Patient History—Medications; May influence effect of anesthetic agents, give 5 different ways

answer

1- Sympathomimetics 2- Tricyclic antidepressants 3- Antibiotics 4- Monoamine oxidase inhibitors 5- Antihistamines Detailed explinations = 1- Epinephrine and cyclohexamines, xylazine, barbiturates, and halothane can cause cardiac arrhythmias. 2- Amitriptyline and clomipramine can cause cardiac arrhythmias. 3- Chloramphenicol can cause decreased biotransformation of barbiturate anesthetics and lead to prolonged recovery. 4- Amitraz and selegeline can increase the effects of morphine and other opioids. They can also lead to additive effects with anticholinergics or CNS depressants. 5- Antihistamines can cause CNS and respiratory depression with opioids.

question

What does an average Cat ketamine recovery look like?

answer

prolonged

question

What will Dogs have after acepromazine sedation?

answer

behavioral change

question

Patient History—Record Preventive Care includes... (2+ species specific)

answer

1- Vaccination—date and type 2- Fecal analysis and parasite control Heartworm status—dogs FLV and FIV testing—cats Tetanus toxoid—horses

question

Physical Examination (PE) vs. Physical Assessment (PA)

answer

PE = Performed by a veterinarian To determine diagnosis and treatment planning PA = Performed by a veterinary technician To provide maximum patient care, respond to patient needs, detect changes in patient condition

question

What organ systems are most affected by anesthetic agents?

answer

Cardiovascular, nervous, and pulmonary systems are most affected by anesthetic agents

question

Describe the body condition scales of 1-9 and 1-5 for dogs and cats

answer

1-9 scale 4-5 in dogs or 5 in cats is the ideal weight 1 is extreme cachexia; 9 is extreme obesity 1-5 scale 3 is the ideal weight for both 1 is extreme cachexia; 5 is extreme obesity

question

A B/A/R patient is....

answer

bright, alert, and responsive—he is noticeably engaged and interested in his environment.

question

A Q/A/R patient is...

answer

quiet, alert, and responsive—he is not really engaged or interested in what is going on around him.

question

What does an elevated or decreased body temp indicate?

answer

Elevated = inflammation Decreased = numerous systemic disorders ----------------------------------------------- A high body temperature most commonly indicates an inflammatory condition, which must be identified and may require pretreatment with antibiotics, antiinflammatories, or other medication. A significantly low body temperature may be associated with one of a number of serious systemic disorders.

question

Normal vital signs for a dog

answer

Body temp 100-102.5 HR 60-180 Heart Rhythm NSR or SA RR 10-30 (panting is normal)

question

Normal vital signs in a cat

answer

Body Temp 100-102.5 HR 120-240 Heart Rhythm NSR only RR 15-30

question

Normal vital signs for a horse

answer

Body Temp 99-100.5 HR 30-45 Heart Rhythm NSR, SA or 1st or 2nd degree AV block RR 8-20

question

Normal vital signs for a cow

answer

Body Temp 100-102.5 HR 60-80 Heart Rhythm NSR or SA RR 8-20

question

Acronym for Eyes, ears, nose, oral cavity (throat)

answer

EENT

question

What does PLR stand for?

answer

Pupillary Light Reflex

question

Normal sinus rhythm (NSR) can be expected in healthy....

answer

Dogs, cats, rodents, ferrets, rabbits, horses, ruminants No rhythm irregularities

question

Sinus arrhythmia (SA) can be expected in HEALTHY....

answer

Dogs, horses, ruminants Heart rate is affected by respiration but they're still healthy Sinus arrhythmia is a rhythm in which the heart rate cyclically increases during inspiration and decreases during expiration. This rhythm may be pronounced in young, healthy dogs and can sound to the inexperienced anesthetist as if there are skipped or premature beats. Abnormal rhythms can be differentiated from sinus arrhythmia by observing the respirations while listening to the heart.

question

How to find and listen to a heart murmur

answer

Listen over each valve; Cranial-most aspect of left axilla—PDA They are Caused by blood flow turbulence and May result in increased patient anesthetic risk Murmurs can be associated with leaking valves, stenotic valves, stenotic vessels, and abnormal communication between heart chambers.

question

Pulse palpation points in Dogs and cats....

answer

femoral artery

question

Pulse palpation points in large animals...

answer

animals—facial artery, ventral tail artery, or auricular artery

question

How do you find the femoral artery in a dog or cat?

answer

In the conscious dog and cat the pulse is most easily palpated at the femoral artery, on the medial side of the rear leg. The patient should be standing quietly, and the femoral artery should be located by cupping the hand around the medial aspect of the thigh with the pad of the first or second finger in the groin just over the femur

question

Pale mucous membranes or prolonged capillary refill time are indicative of ...

answer

decreased perfusion from shock, vasoconstriction, hypotension, or a variety of other issues including anemia.

question

Cyanotic mucous membranes indicate what?

answer

reduced oxygen saturation, which is a medical emergency.

question

Dyspnea and cyanosis are both what?

answer

medical emergencies and should be brought to the veterinarian's attention immediately.

question

Avoid _________ dyspneic or cyanotic patients... because why?

answer

STRESSING; as they are very intolerant of handling and can die during examination.

question

RE: Respiratory System Examination Lung Auscultation, what are Discontinuous sounds?

answer

crackles, rales, or rhonchi

question

RE: Respiratory System Examination Lung Auscultation, what are Continuous sounds?

answer

wheezes

question

RE: Respiratory System Examination Lung Auscultation, what may Discontinuous or Continuous be an indication of?

answer

either pulmonary conditions (including pneumonia, bronchial disease, or asthma) or heart failure

question

A distended abdomen may indicate ....?

answer

fluid accumulation, pregnancy, organ enlargement, or tumor

question

RE: Abdominal Palpation and Auscultation, normal is....?

answer

soft and not painful

question

RE: Preanesthetic Diagnostic Workup.... No one standardized diagnostic workup fits every patient to be anesthetized, give 3 examples of types of workups that could occur

answer

Geriatric patient workup Elective surgery patient workup Sick patient workup Workup based on financial considerations

question

What blood test is in-house and an excellent indicator of the likelihood of perioperative bleeding?

answer

The buccal mucosal bleeding time is a simple in-house screening test that is an excellent indicator of the likelihood of perioperative bleeding

question

What things are RED FLAGS and should be pointed out to the attending DVM immediately?

answer

The following findings should be reported to the attending veterinarian immediately: A PCV ;25% in a dog or ;20% in a cat, horse, or cow A PP ;4.0 in any species Any decrease in the platelet count Any coagulation test result outside the normal range

question

Preanesthetic Diagnostic Tests and Procedures... name some (6+)

answer

Complete blood count (CBC) Urinalysis Blood chemistry Blood coagulation screens Electrocardiogram (ECG) Radiography Other tests as deemed necessary

question

Blood test Ideally done day of or day prior for dogs categorized by age 7yrs

answer

Laboratory evaluation of patient Young dogs7yr: PCV, TPP, GLU, BUN, CREA,, ALT, ALK PHOS, +/- additional chemistries, and electrolytes (Na+, K+, Cl-)

question

Patient Status: American Society of Anesthesiologists standards; Class I

answer

Class I Normal patient with no organic disease

question

Patient Status: American Society of Anesthesiologists standards; Class II

answer

Class II Patient with mild systemic disease

question

Patient Status: American Society of Anesthesiologists standards; Class III

answer

Class III Patient with severe systemic disease limits activity but not incapacitating

question

Patient Status: American Society of Anesthesiologists standards; Class IV

answer

Class IV Patient with incapacitating systemic disease that is a constant threat to li

question

Patient Status: American Society of Anesthesiologists standards; Class V

answer

Class V Moribund patient is not expected to live 24 hours with or without surgery

question

How to Designate emergency operation?

answer

Designate emergency operation by "E" after appropriate classification

question

Classification is based on an evaluation of the Minimum Patient Database; explain

answer

Class P1 = minimal anesthetic risk Class P5 = extreme anesthetic risk Classes P1 and P2 use standard anesthetic protocol Classes P3 to P5 need special protocols and stabilization In general, class PS1 and class PS2 patients can be anesthetized with standard anesthetic protocols. Class PS3 to PS5 patients often require special protocols, and should be stabilized before surgery if possible.

question

_________ is a preanesthetic that is also an antiemetic—it will prevent vomiting

answer

Acetpromazine

question

_______ will induce vomiting so the stomach can be emptied.

answer

Xylazine

question

Reasons for placing an IV catheter (5)

answer

1- Fluid administration 2- Rapid IV access in an emergency 3- Constant rate infusion (CRI) of drugs or anesthetic agents 4- Administration of vesicants 5- Sequential administration of incompatible drugs

question

Sizes of IV catheters used in small animals and large animals

answer

Most commonly used 16-24 gauge, 3/4- to 2-inch catheter (small animals) 12-16 gauge, 5¼-inch catheter (large animals)

question

Two main types of IV catheters are in common use for fluid and drug administration in veterinary patients....

answer

through-the-needle catheters and over-the-needle catheters

question

Although commonly used in critical care patients, ___________catheters are not frequently used for anesthesia because they are more complex, expensive, and time-consuming to place, especially if the technician is not experienced with their use.

answer

through-the-needle catheters

question

When placing and maintaining an IV catheter for use during surgery, consider the following... (8)

answer

1- Choose a catheter of sufficient length to minimize the risk of dislodgement. 2- Choose a catheter of large diameter. 3- Choose a location that will not interfere with the procedure. 4- Use an administration set with an injection port. 5- After positioning the patient, check that fluids are flowing freely. 6- Avoid excessive catheter and patient movement during transfer. 7- Administer IV drugs slowly. 8- Use saline flush following IV injection of a drug.

question

Placing an IV Catheter in a Small Animal Patient (name the parts in the chart)

answer

a, Catheter (20 to 24 gauge, ¾ to 1 ½ inches long for cats; 16 to 22 gauge, 1 to 2 inches long for dogs); b, two approximately 6-inch-long strips of 1-inch porous adhesive tape, one approximately 6-inch-long and one approximately 3-inch-long strip of ½-inch tape; c, clipper with #40 blade; d, 1:1 chlorhexidine surgical scrub/water-soaked cotton balls and alcohol-soaked cotton balls; e, ½-inch plastic strip with antiseptic ointment; f, T-port, cap, or administration set (both the catheter and T-port should be flushed with saline before catheterization).

question

Placing an IV Catheter in a Small Animal Patient (1)

answer

Standard aseptic technique uses three chlorhexidine-soaked alcohol cotton balls followed by three alcohol-soaked cotton balls. Assistant is needed to hold off the vein. Apply tension in a ventral direction to tense the skin. Position the catheter with the needle fully inserted and with the bevel up.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd -2)

answer

Advance the catheter and needle assembly as a unit through the skin and the near wall of the vein. Blood will flashback into the needle hub when the vein is entered. Advance the unit a few more millimeters until the end of the catheter is firmly seated in the vein.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-3)

answer

Holding the needle stationary, advance the catheter over the end of the needle until it is inserted to the hub. Remove the needle. Have the assistant apply pressure at the insertion site to prevent bleeding.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-4)

answer

Flush the catheter with several milliliters of normal saline through the injection port.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-5)

answer

Twist the 3-inch-long strip of ½-inch tape into a "bow-tie" configuration.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-7)

answer

Chlorhexidine ointment is used on the plastic strip.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-8)

answer

Tear a ½-inch "V" in a 6-inch length of 1-inch tape about 1 inch from the end. Slip it under the catheter with the torn area directly under the catheter hub.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-9)

answer

Apply the remainder of this length of tape over the plastic strip to secure.

question

Placing an IV Catheter in a Small Animal Patient (Cont'd-10)

answer

Apply the remaining 6-inch-long strip of 1-inch tape around the administration set line or T-port to create a tension loop.

question

Giving an IV Injection Through an IV Administration Set Port -1

answer

IV fluids should be flowing at the standard infusion rate.

question

Giving an IV Injection Through an IV Administration Set Port (Cont'd-2)

answer

Pinching off the administration set line between the injection port and the fluid bag will prevent backflow of agent into the fluid bag during injection.

question

Giving an IV Injection Through an IV Administration Set Port (Cont'd-3)

answer

Give the medication at an appropriate rate as dictated by the VIC. For most medications, a slow IV bolus is appropriate.

question

Giving an IV Injection Through an IV Administration Set Port (Cont'd-4)

answer

Following injection, the administration set line must be released so that the entire dose of medication is flushed into the patient. As much as 0.5 to 2 mL of agent will remain in the fluid line and catheter until flushed out. When administering an induction agent, administer additional doses to effect by following these same steps. As soon as the patient is at an anesthetic depth adequate to permit intubation, remove the needle and syringe to prevent accidental overdose.

question

Composition of Body Fluids

answer

In adult animals, about 60% of the body weight is water. Of the 60% of the body weight that consists of water, about two thirds (or 40% of the body weight) is intracellular fluid (ICF). Although estimates of extracellular fluid (ECF) vary widely (about 15% to 30% of body weight for small animals), most clinicians use the figure 20% for the purpose of calculating fluid needs. About three fourths of the ECF (15% of the body weight) is interstitial fluid (fluid between the cells), and one fourth (5% of the total body weight) is intravascular fluid (plasma) .

question

Plasma is ____ of body weight

answer

5%

question

Blood volume is ______ of body weight—dogs and large animals and _____ of body weight—cats

answer

8-9% of body weight—dogs and large animals 6-7% of body weight—cats

question

Calculating blood volume; Dogs and large animal and cats (2)

answer

Dogs and large animals = 90 mL/kg lean body weight Cats = 60 mL/kg lean body weight

question

Body fluids consist of water and ________.

answer

solutes

question

Body fluid solutes are either atoms or molecules dissolved in body water. The solutes most important in fluid therapy are small-molecular-weight electrically charged particles called _______, large-molecular-weight plasma proteins called _______, and small nonionic particles such as ______ and _________ ________.

answer

ions, colloids, glucose and small proteins.

question

Cations have a ______ charge Anions have a ______ charge

answer

positive , negative

question

Important Electrolytes: Anions (4)

answer

Chloride (Cl?) Bicarbonate (HCO3?) Phosphates (HPO42? and H2PO4?) Proteins

question

Important Electrolytes: Cations

answer

Sodium (Na+) Potassium (K+) Magnesium (Mg2+) Calcium (Ca2+)

question

What are Electrolytes?

answer

Electrolytes are substances that when dissolved separate into positively charged ions, called cations (so called because they migrate toward the cathode during electrolysis), and negatively charged ions, called anions (so called because they migrate toward the anode).

question

Define Homeostasis

answer

A constant state within the body created and maintained by normal physiologic processes Homeostasis is the state of health.

question

Solute concentration (osmolarity) in any fluid compartment must be __________..... WHY?

answer

300 mOms/L. Because Solutes must provide osmotic pressure to pull water into a compartment. In any given compartment, positively and negatively charged particle numbers must be equal.

question

What % of IV fluids will stay in the intravascular and interstitial space? WHY?

answer

One-third of IV fluids administered will stay in the intravascular space. Two-thirds will diffuse into the interstitial space. Colloids don't pass freely through the vascular endothelium. The presence of colloids in the intravascular space draws water into the space creating osmotic or oncotic pressure.

question

What 2 solutes must be monitored closely to make sure normal heart and muscle function continue?

answer

Some solute concentrations (Ca2+, K+) must be kept within a narrow range to maintain normal heart and muscle function.

question

Profound perioperative hemorrhage involves what?

answer

significant loss of albumin, blood cells, and other constituents of blood in addition to electrolytes and water. Patients with low albumin may require colloids or blood plasma (fluids containing large solutes), which provide oncotically active particles that remain in the vascular space for longer periods and help maintain blood volume and pressure.

question

To support patients experiencing severe perioperative hemorrhage, administration of WHAT may be necessary, and why?

answer

blood products may be necessary to provide RBCs or hemoglobin to support oxygen-carrying capacity, and in some cases clotting factors and platelets to support normal coagulation.

question

Perioperative hemorrhage involves what?

answer

fluid loss from the intravascular space, part of the ECF space.

question

Patients with perioperative hemorrhage may also benefit from what?

answer

Patients with perioperative hemorrhage may also benefit from hypertonic saline or colloid solutions, both of which draw water into the vascular space and raise blood pressure.

question

What are the 2 Classifications of IV fluids?

answer

These fluids are most commonly classified as either crystalloids or colloids based in the molecular weight of the primary solutes they contain All IV fluids are solutions consisting of one or more solutes dissolved in water. Most IV fluids contain one or more electrolytes. Dextrose, a naturally occurring form of glucose, is another ingredient present in some fluids. Some fluids also contain the buffers lactate, gluconate, or acetate, which are converted to HCO3- by the liver and help regulate pH. Others contain colloids (large-molecular-weight solutes). There are many intravenous solutions, each with different solute profiles.

question

Replacement fluids have high concentrations of ___ and ____ (as ECF does) and are designed to replace fluid losses.

answer

Na+ and Cl-

question

Maintenance fluids have lower concentrations of Na+ and Cl- but somewhat more ____ and are designed to maintain fluid balance over a longer period.

answer

K+

question

General Facts about Crystalloid Intravenous Fluids (3)

answer

Water and small-molecular-weight solutes May contain dextrose and/or buffers Often used in anesthetized patients

question

Isotonic, polyionic replacement solutions (4)

answer

Lactated Ringer's solution (LR) Normosol-R (NR) Plasma-Lyte A and R (PA and PR) Isolyte S (IS)

question

____ & ________ and cannot be administered with blood products

answer

LR and PR contain calcium

question

Isotonic, polyionic maintenance solutions contain less ___ and _____

answer

Contain less sodium and chloride

question

Isotonic, polyionic maintenance solutions contain more _____

answer

potassium

question

Isotonic, polyionic maintenance solutions contain lower concentrations of _____

answer

buffer

question

Isotonic, polyionic maintenance solutions contain _____

answer

DEXTROSE

question

Isotonic, polyionic maintenance solutions INCLUDE _____ and _______

answer

Normosol-M in 5% dextrose (NM5) Plasma-Lyte 56 in 5% dextrose (PL5)

question

Normal saline (NS) includes.... (3)

answer

Physiologic saline 0.9% saline sodium chloride 0.9%

question

Normal saline (NS) is Sometimes used instead of ...?

answer

isotonic, polyionic replacement crystalloid solution

question

Normal saline (NS) is used to....(3)

answer

Used to bathe tissues during surgery Used to flush the IV catheter Used to flush body cavities

question

_____________ are the first choice for fluid therapy of healthy patients undergoing routine surgery as well as many sick patients, as long as the PCV is over ______ and the plasma protein is over _______

answer

Isotonic, polyionic replacement crystalloids, 20% , 3.5 gm/dL.

question

The hypertonicity results in ....?

answer

fluid being drawn into the intravascular space to maintain blood pressure

question

Concentrated saline solution (3%, 7%, and 23.4% [diluted to less than or equal to 7.5%]) is given with isotonic crystalloids in acute care settings to treat ....?

answer

patients with hypovolemic, traumatic, or endotoxic shock

question

Hypertonic saline rapidly but temporarily draws water ______ the intravascular space and supports blood pressure, but, like other crystalloids, _______________ into the interstitial space and so must be followed with _________ if the patient needs long-term blood volume expansion.

answer

into, rapidly diffuses, colloids

question

Dextrose solutions with or without electrolytes are used to support .....?

answer

blood glucose in neonatal, hypoglycemic, or debilitated patients and in patients with diabetes mellitus that are receiving insulin, or as a part of therapy for hyperkalemia.

question

Dextrose solutions are considered ________ solutions

answer

hypotonic

question

Dextrose solutions come in what %s?

answer

5% dextrose in water (D5W) or 2.5% dextrose

question

Colloids are used to support ...?

answer

expansion of blood volume and blood pressure.

question

Colloid solutions stay in the intravascular space longer because ?

answer

...of the large solutes that cannot pass through the endothelium. Colloids solutions (also referred to as colloids) contain large-molecular-weight solutes that do not freely diffuse across vascular endothelium and therefore stay in the intravascular space.

question

Give an example of a Synthetic colloid solutions

answer

Hetastarch

question

Fluid therapy is an exact or inexact science.

answer

INEXACT. Although there are generally accepted fluid choices and administration rates for animals that are in shock, ill, experiencing blood loss, or undergoing surgery, each patient must be managed in a unique manner appropriate to its condition. Even though these standard rates are used as a starting point, ultimately the veterinarian will use his or her professional judgment to determine the final rate for each patient.

question

Fluid Administration Rate During routine anesthesia and surgery

answer

10 mL/kg/hr during the first hour 5 mL/kg/hr during remainder of the procedure For both small and large animals, a rate of 10 mL/kg/hr during the first hour followed by 5 mL/kg/hr for the remainder of the procedure is commonly used as the IV administration rate for crystalloids during routine anesthesia and surgery. The authors of the 2013 AAHA/AAFP Fluid Therapy Guidelines for Dogs and Cats consider that this may be unnecessarily high for many patients, especially cats, which are more susceptible to overhydration. They therefore recommend an initial rate of 5 mL/kg/hr in dogs and 3 mL/kg/hr in cats, followed by a reduced rate if the patient is anesthetized for more than 1 hour.

question

Fluid Administration Rate Isotonic Crystalloids; Excessive hemorrhage or hypotension

answer

40 mL/kg/hr (dogs and large animals) 20 mL/kg/hr (cats) As mentioned in the previous section, isotonic, polyionic replacement crystalloids including LR, PLA, PL148, and NR are the first choice fluid for healthy patients undergoing routine surgery as well as many sick patients as long as the PCV is over 20% and the plasma protein is over 3.5 gm/dL. Consequently these fluids are used in the vast majority of anesthetized patients.

question

Fluid Administration Rate Isotonic Crystalloids; Shock

answer

90 mL/kg/hr as rapidly as possibly (dogs and large animals) 55 mL/kg/hr as rapidly as possible (cats) As mentioned in the previous section, isotonic, polyionic replacement crystalloids including LR, PLA, PL148, and NR are the first choice fluid for healthy patients undergoing routine surgery as well as many sick patients as long as the PCV is over 20% and the plasma protein is over 3.5 gm/dL. Consequently these fluids are used in the vast majority of anesthetized patients.

question

Fluid Administration Rate Isotonic Crystalloids; Shock and blood loss (large and small animals)

answer

7% hypertonic saline 3-4 mL/kg slowly over 5 minutes Followed by isotonic crystalloid solution As mentioned in the previous section, isotonic, polyionic replacement crystalloids including LR, PLA, PL148, and NR are the first choice fluid for healthy patients undergoing routine surgery as well as many sick patients as long as the PCV is over 20% and the plasma protein is over 3.5 gm/dL. Consequently these fluids are used in the vast majority of anesthetized patients.

question

Hetastarch can cause ____ and _____ if administered too rapidly

answer

nausea and vomiting

question

Fluid Administration Rate Colloids; Administer as a slow bolus

answer

Over 15-60 minutes (dogs and large animals) Over 30-60 minutes (cats) Synthetic colloids should be administered to dogs and large animals as a slow bolus of 5 mL/kg over 15 to 60 minutes and to cats as a slow bolus of 2.5 to 3 mL/kg over 30 to 60 minutes with reassessment before giving additional boluses, up to a maximum of 10 to 20 mL/kg/day for dogs and for large animals and 5 to 10 mL/kg/day for cats.

question

Adverse Effects of Fluid Administration

answer

1- Volume overload Pulmonary or cerebral edema Use slower infusion rate 2- Overhydration Ocular and nasal discharge Chemosis (edema and swelling of the conjunctiva), Subcutaneous edema Increased lung sounds Increased respiratory rate and dyspnea Coughing and restlessness if patient is awake Hemodilution (dilution of the RBCs and plasma proteins)

question

Who is at greater risk for fluid Volume overload?

answer

Animals weighing less than 5 kg and those with cardiac or renal disease are at greatest risk.

question

Use macrodrip sets (10 or 15 gtt/mL) for infusion rates equal to or greater than _______

answer

100 mL/hr.

question

Use microdrip sets (60 drops/mL) for infusion rates less than ________

answer

100 mL/hr.

question

Preanesthetic/Preoperative Medications (5)

answer

Antibiotics Preemptive analgesia Antiemetics Anticonvulsants Antiinflammatory drugs

question

Anesthetic agent is....?

answer

any drug used to induce a loss of sensation with or without unconsciousness

question

Adjunct is...?

answer

a drug that is not a true anesthetic, but that is used during anesthesia to produce other desired effects such as sedation, muscle relaxation, analgesia, reversal, neuromuscular blockade, or parasympathetic blockade

question

Route of administration for Anesthetic Agents and Adjuncts (4)

answer

Inhalant Injectable Oral Topical

question

Time of administration periods (3)

answer

Preanesthetic Induction Maintenance

question

Agonists does what?

answer

Bind to and stimulate target tissue Most anesthetic agents and adjuncts are Agonists

question

Antagonists do what?

answer

Bind to target tissue but don't stimulate Reversal agents are Antagonists Antagonists competitively bind to target tissues preventing the corresponding agonist from causing more stimulation. Must use the proper antagonist when "waking" a patient from anesthesia.

question

Partial Agonists and Agonist-Antagonists

answer

Opioids Partial agonists Agonist-antagonists Used to block pure agonists

Intro to Anesthesia Ch 1 & 2; Thomas F17 – Flashcards

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