Nursing Review - Chapters 2 and 3

d

Why are leading questions inappropriate to ask during the history taking? a) they make the owner feel compelled to answer a certain way. b) they may encourage the owner to answer inaccurately. c) they are appropriate and should be asked. d) both a and b

ALT

hepatic screen

local anesthetic

lidocaine and bupivacaine

blood glucose

measures carb metabolism and endocrine function of pancreas.

NSAIDs

meloxicam and carprofen

opidoids

morphine and hydromorphone

c

A surgical consent form includes which of the following? a) all of the patient's prior surgeries, medical history, and current medications. b) an estimate for the surgical procedures to be performed. c) identification of the patient, the specific procedures to be performed along with the potential risks to the patient, and the physicians who will perform the procedures and the signature of the owner consenting to the procedure. d) the patients current diet.

c

All of the following are goals of balanced anesthesia EXCEPT: a) maximize the positive effects of certain drugs. b) minimize the side effects of certain drugs. c) Maximize the likelihood of allergic reactions. d) minimize cardiac depression.

BUN

Azostix uses whole blood not serum or plasma.

no

Does the target pattern sterilize the skin?

anticholinergics

Dries oral secretions. Ex: atropine and glycopyrolate

1-2 hours before surgery

For maximum effect when should NSAIDs be administered preoperatively?

Atropine and glycopyrrolate

Give 2 examples of anticholinergic drugs.

cape card and collar

How can the patient's identity be verified?

patients weight

How is the endotracheal tube size determined for the patient?

start at the incision site and go in a circular motion going outwards until you reach the hair then stop

How is the target pattern performed?

3 - right of the anus, left of the anus, anus itself

How many target patterns are in the perineal particular sequence?

every 15 minuets

How often should body temperature be monitored?

true

It is accepted practice to scrub a patient initial with a povidone-iodine product.

PCV, TS/TP, BG, BUN, and ALT

MDB for young, healthy surgical candidate should include.....

70% alcohol, sterile water or saline

Name 2 rinsing agents

providone-iodine, chlorhexidine gluconate

Name 2 scrubbing agents

endotracheal tube size, bag size, breathing circuit

Name key information pieces that should be on the anesthesia form.

analgesia - complete absence of pain

Name one of the 3 major benefits of local anesthetics.

antibiotics

Prophylaxis, decreases the chance of post op infection.

Sedatives

Reduces stress, fear and anxiety all of which increase the severity of pain. Ex: ace, diazepam, midazolam

a

The basic principles of pain management involve which of the following? a) preemptive analgesia, multimodal analgesia, and appropriate follow up analgesia. b) the use of NSAIDs. c) the use of an opioid as a premedication.

d

The minimum database (MDB) for a young, healthy feline patient having elective surgery would most likely include which of the following diagnostic tests? a) CBC, parvovirus test, electrolytes, and blood typing. b) CBC, blood serum chemistry panel, FeLV/FIV test, intestinal parasite test, and urinalysis. c)FeLV/FIV test, abdominal radiographs, and ECG. d) PCV/TS, estimate of BUN, BG, and ALT.

warm air circulating blanket, circulation warm water, microwave heat pads

What are 3 ways of keeping an animal warm?

e

What are some safe techniques for preventing hypothermia in small animal surgical patients? a) circulating warm water pads. b) electric heating pads. c) SnuggleSafe discs. d) all of the above. e) both a and c

cough, fogging, air movement, palpation

What are some ways to confirm proper placement of your endotracheal tube?

preemptive analgesia, multimodal analgesia, appropriate follow up analgesia

What are the basic principles of current pain management?

through the needle, over the needle, and butterfly

What are the three most common types of catheters?

administer oxygen and inhalant anesthetics, assist with resuscitation.

What are two main reasons for using an endotracheal tube?

extreme cooling effect, if allowed to pool can cause thermal burn

What are two things that should be considered when using alcohol as a rinsing agent?

d

What can be done to help prevent a deep-chested dog from tilting to the side while in dorsal recumbency? a) using a V trough. b) bracing the chest with sandbags. c) tying the forelegs crossed over the chest. d) all of the above.

decreased RBC production, RBC life span and blood loss.

What causes the PCV to decrease?

dehydration or absolute polycythemia.

What causes the PCV to increase?

eating raises and fasting lowers

What causes the blood glucose levels to raise and lower.

age, gender, breed

What information is included in the patient's signalment?

packed cell volume

What is PCV?

age, breed, sex, reproductive status

What is a patient's signalment

target pattern

What is the most common pattern when scrubbing a patient for surgery?

legal doc and tells a story

What is the primary purpose of the anesthesia form?

patient is relaxed, pain management, ease transition out of anesthesia

What is the purpose of premedicating a patient before inducing anesthesia for surgery?

d

What is the purpose of premedicating a patient before inducing anesthesia for surgery? a) to provide a smooth transition to anesthesia. b) to prove preemptive analgesia. c) to facilitate a smooth recovery from anesthesia. d) all of the above.

d

What needs to be done to the patient after the hair clip and before the patient is moved into the surgery suite? a) vacuum the clipped hair and clipped area of skin. b) check to see whether the bladder needs expressing. c) perform initial skin scrub. d) all of the above.

b

What position is the patient placed in for abdominal exploratory surgery? a) sternal recumbency b) dorsal recumbency c) right or left lateral recumbency, depending on which side of the abdomen need to be accessed.

d

What position is the patient placed in on the surgery table for thoracic surgery? a) dorsal recumbency. b) right lateral recumbency. c) left lateral recumbency. d) any of the above may be appropriate.

surgery room

What room is the final scrub done in?

IV fluids, IV admin set, catheter, t port, scrub solution and alcohol and applicators, tape-3 strips, clippers, bandage material

What supplies are needed for placing an IV catheter?

peripheral - over the needle and butterfly

What type of catheter should be placed for short term use?

date, weight,procedures, tempt, HR, RR, MM color, test results, ASA status, describe patient before and meds.

What values are noted for pre-anesthetic values and disposition on the anesthesia monitoring form?

cephalic, medial saphenous, and femoral veins

Where are peripheral catheters placed in cats?

cephalic and lateral saphenous veins

Where are peripheral catheters placed in dogs?

miller

Which laryngoscope blades are curved?

wisconsin

Which laryngoscope blades are straight?

e

Which of the following contributes to hypothermia in the anesthetized patient? a) anesthetic-induced muscle relaxation. b) the surgical prep using water and alcohol. c) administering room-temp IV fluids. d) breathing cold gases from compressed cylinders. e) all of the above.

d

Which of the following is the next step after the patient has be induced with anesthesia and the intended surgical site has been clipped and had initial prep performed? a) the patient is moved to the surgery room, positioned on and secured to the table, then draped, and the surgeon begins surgery by making an incision. b) the final prep is applied, and the patient is moved to the surgery room and position on and secured to the table. c) the patient is moved to the surgery room, the final prep is performed, and the patient is position on and secured to the table. d) the patient is moved to the surgery room and is positioned on and secured to the surgery table and final prep is performed.

e

Which of the following is true regarding position patients on the surgery table? a) the particular position of the limbs in insignificant because the patient is anesthetized and cannot feel any pain that might be associated with awkward positioning. b) Bony prominences should be cushioned to protect against excessive compression. c) the patients legs should not be forced into unnatural anatomic alignment. d) all of the above. e) both b and c.

d

Which of the following provide multimodal anesthesia? a) gas anesthetics, morphine, butorphanol, and fentanyl b) nonsteroidal anti-inflammatory drugs (NSAIDs), such as carprofen and meloxicam. c) Xylazine and medetomidine. d) Opioids, NSAIDs, local anesthetic agents, and adrenergic agonists.

e

Which of the following should be assessed during the history taking? a) patient's attitude and mental status. b) patient's previous medical problems and treatments. c) patient's ability to see and hear. d) patient's gait and body condition. e) all of the above.

d

Which of the following should be performed on the day of the surgery? a) thorough physical examination. b) review of the patient's medical history with the owner. c) verbal review of the consent form and obtaining the owner's signed consent for anesthesia and surgery. d) all of the above.

c

Which tactic(s) may stop a cat from purring during thoracic auscultation? a) Gently squeezing the thorax with one hand while the other hand holds the stethoscope on the chest wall. b) Massaging under the cats chin. c) Holding the cat near a sink or faucet, with or without the water running. d) all of the above.

added when profound and sustained bradycardia is expected

Why are anticholinergic drugs added to premedication protocols?

if the surgeon has to rotate the leg it can already be sterile

Why does an orthopedic "clip and prep" of an extremity need to include a circumferential clip around the entire limb?

d

Why is it important to review all medications and supplements that a patient is taking before beginning the surgery? a) to avoid possible drug interactions b) to know whether other diagnostic tests are indicated c) to make any necessary adjustments to the anesthetic protocol d) all of the above

b

Why should taking the patients temperature be saved for the end of the physical examination? a) it is the least important part of the PE. b) Most animals dislike having their temperatures taken rectally, and it is easier to perform a PE on a cooperative patient; taking the temp early during the PE may make the patient uncooperative for the rest of the exam. c) by the end of the PE, the examiner should have already ascertained whether the patient is febrile, and only then does the temperature need to be taken.

d

Why should the patient's identity be verified before the animal is anesthetized for surgery? a) to avoid anesthetizing the wrong patient. b) the avoid perform surgery on the wrong patient. c) it is not necessary to cross-check the patient's correct identity because any good technician should be able to distinguish all black cats in the hospital on any given day on the basis of physical appearance. d) both a and b.

TS/TP

albumin, globulin, fibrinogen

multimodal analgesia

combining different analgesics as premeds for surgery. Ex: local anesthetics, NSAIDs, opioids.

Alpha2-Adrenergic Agonists

dexdormiter

27-48%

normal range for PCV in cats.

37-54%

normal range for PCV in dogs.

6.5-8.2 (g/dL)

normal range of TP in cats.

5.5-7.5 (g/dL)

normal range of TP in dogs.

70-180 (mg/dL)

normal range of blood glucose for cats.

80-130 (mg/dL)

normal range of blood glucose for dogs.

PCV

percent of whole blood made up of RBC.

false

true or false. Anesthesia (as provided by gas anesthetics) provides multimodal anesthesia.

true

true or false. Central venous pressure measurements require that a central line be placed.

false

true or false. For orthopedic surgeries of the extremity, only the side of the limb to incised need to be clipped and prepped.

false

true or false. It is appropriate to premedicate a patient with a preexisting cardiovascular disease with xylazine.

true

true or false. Peripheral catheters generally suffice for short term use (1-3 days), and central lines are more appropriate for long-term vascular access.

false (it should go in the trash first)

true or false. The first spray of the final prep should be directly of the incision site.

false

true or false. When scrubbing the skin of the intended surgical site, sufficient friction should be generated to cause hyperemia.

false

true or false. chlorhexidine scrub or solution can be used as the final, sterile surgical paint.