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77 Cards in this Set
- Front
- Back
What is the rule of 30? |
An animal under anesthesia should maintain a heart rate that is within 30% of its resting heart rate. |
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What is the normal Iso setting in Robinson Hall? |
2% |
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What are 4 ways to check for reflexes? |
Check for jaw tone/anal tone, appearance of 3rd eyelid, squeeze toes, medial canthus of the eye |
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Which BP monitor is most indirect? |
Doppler |
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Systolic BP measurement tells us what? |
When it pumps from the ventricles to the rest of the body. |
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What are the 3 different types of BPs we can measure? |
Systolic, diastolic, MAP |
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What is the difference between systolic and diastolic BPs? |
Systolic = the number produced by contraction of the LEFT VENTRICLE; all BP monitoring instruments can measure this. Diastolic = pressure that remains in the arteries when heart is in resting phase between contractions; not all BP monitoring instruments can measure this. |
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What is meant by MAP? |
Mean Arterial Pressure; the average pressure throughout the cardiac cycle. |
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Which BP monitor is most direct? |
Pressure Transducer |
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How does the Pressure Transducer BP monitor work? |
Readings are obtained via a catheter inserted into an artery, providing continuous readings throughout the cardia cycle (most accurate but most invasive) |
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Describe as example of an indirect BP monitor. |
External cuff placed over an artery, using doppler method. |
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What are the 2 kinds of indirect BP monitors? |
Doppler & oscillometric |
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What type of BP does a doppler measure? |
Systolic |
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Describe the flow of the electrical impulse path through the heart. |
Sinus node activity is activated>AV node is stimulated>Atrial contraction>impulse travels within the AV bundle branches to the Purkinje fibers>the impulse is distributed by the Purkinje fibers and relayed throughout the ventricular myocardium=Atrial contraction completed, leads to ventricular contraction. |
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Name the 5 types of waves on an ECG reading. |
P wave, PR interval, QRS complex, ST segment, T wave |
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Describe the P wave. |
the 1st wave; precedes atrial contraction; rounded, appears double humped in large animals (bifid); measured from point it leaves baseline to point it returns to baseline. |
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Describe the PR interval. |
Represents the time required for the impulse to move from the sinoatrial node to the Purkinje fibers; measured from the beginning of the P wave to the beginning of the QRS complex. |
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Describe the QRS complex. |
Represents contraction of ventricles; largest waveform, pointed; points up (positive) in small animals; points down (negative) in large animals; measured from the point it leaves the baseline to the point it returns to the baseline. |
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Describe the ST segment. |
Located between the QRS complex and the T wave; should leave the baseline only slightly, if at all. |
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Describe the T wave. |
Represents repolarization of ventricles in preparation for the next contraction; measured from the end of the ST segment to the point it returns to the baseline. |
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Which arrhythmia is normal in dogs but not cats? |
Sinus arrhythmia |
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Sinus arrhythmia is normal in which species? |
Dogs |
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How often do we monitor and chart the patient's vitals during surgery? |
Every 5 minutes |
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When monitoring, if the BP reads AIR LEAK, how do you respond to that? |
Sometimes it can be based on position of the patient, or the cuff may be loose or the wrong size. |
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What is the clamp called that goes on the tongue during surgery? |
Pulse oximeter |
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What does the pulse oximeter measure? |
Saturation of oxygen |
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How does the pulse oximeter measure the saturation of oxygen? |
It utilizes infrared wavelength light technology with digital readout while the probe is placed on the patient's tongue. |
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Explain why anesthetic monitoring is required. |
Patient safety and anesthetic depth regulation |
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What are the different stages of anesthesia? |
Stage I, Stage II, Stage III (Plane 1, Place 2, Plane 3) Stage IIII |
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What are the 3 planes of Stage III of anesthesia? |
(1) LIGHT anesthesia (2) SURGICAL anesthesia (3) DEEP anesthesia |
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Which stage of anesthesia is preferred for surgical procedures? |
Stage III Plane 2: SURGICAL anesthesia |
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Which anesthetic stage/plane is the most dangerous for the patient to be in? |
Stage IIII Anesthetic overdose |
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What is an important point to remember when working with animals under anesthesia in the 2nd stage? |
Animals are NOT in conscious control of their actions; make this stage as short as possible. |
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How does the 2nd anesthesia stage end? |
Muscle relaxation, decreased RR, decreased reflexes |
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Which anesthetic plane may be necessary for orthopedic surgery? |
Stage III Plane 3: we don't usually want a patient to reach this phase, unless it is for a surgery that can be extremely painful. |
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What are some signs the patient has reached the 4th stage of anesthesia? |
Little to no RR/HR, circulatory collapse, death |
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What are the dogs' normal monitoring parameters under anesthesia for: BP, ETCO2, & Sao2? |
BP: Systolic (90-160); Diastolic (50-90); MAP (70-99) Sao2: 95-99% ETCO2: 35-45mmHg |
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What does the Sao2 refer to when monitoring a patient? |
Arterial Oxygen Saturation, normal is between 95-99% |
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What does the ETCO2 refer to when monitoring a patient? |
End-tidal carbon dioxide level, normal is 35-45 mmHg |
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What things are monitored during anesthesia? |
Vital signs, reflexes, movements/muscle tones |
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What are some abnormal findings while monitoring during anesthesia? |
Spontaneous movements, chewing on tube, salivation |
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What are 2 common causes of bradycardia? |
Excessive anesthetic depth, adverse drug reactions. |
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How do you treat bradycardia during anesthesia? |
Use reversal agents or Atropine to speed up heart rate |
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What are 3 common causes of tachycardia during anesthesia? |
Not deep enough anesthesia, adverse drug reactions, pain stimulation. |
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How do you treat tachycardia during anesthesia? |
Treat according to what is causing the fast heart rate. |
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Describe an AV heart block. |
A delay of the electrical impulse conduction through AV node. |
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What is fibrillation? |
Uncoordinated, small muscle contractions within atria and ventricles. |
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What are the 2 types of fibrillation?
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Atrial & Ventricular fibrillation |
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Describe Atrial fibrillation. |
Absence of P waves, irregular ventricular rate |
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Describe Ventricular fibrillation. |
Undulating baseline absence of QRS complex, chaotic electrical activity unassociated with organized contraction of the heart muscle. |
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Describe Pulseless Electrical Activity (PEA) |
Cessation of heart contractions, or palpable pulse in presence of normal ECG |
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Describe Ventilation. |
The forced transfer of gases, pushing gas out and sucking it back in; no chemical change from oxygen to carbon dioxide; the machine is breathing for the animal. |
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Describe respiration (in comparison to ventilation) |
The animal breathes on its own, and their body chemically uses the oxygen and expels the CO2, naturally breathing. |
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What is tidal volume? |
How small/large of a breath the patient takes; the deeper breath they take, the larger the tidal volume is. |
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Describe the respiratory character. |
Which type of breath the patient is taking; deep, shallow, labored, shaky. |
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What does the Apnea monitor read? |
Alerts if the patient is holding their breath or doesn't breathe for a certain amount of time. |
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What is the capnograph? |
A sensor that sits between the patient and machine, attaches to the ET tube; measures the RR and the CO2 they are breathing out. |
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Why is the Capnograph also called End Tidal CO2? |
Because it measures the amount of CO2 at the END of each breath |
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What are abnormalities with the capnogram? |
Hypercapnia & Hypocapnia |
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What is Hypercapnia? How do you respond to it? |
Increase in ETCO2 value; HYPOVENTILATION. Increase respiratory rate |
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What is Hypocapnia? How do you respond to it? |
Decrease in ETCO2 value; HYPERVENTILATION. Decrease respiratory rate. |
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What are 3 causes of hypercapnia? |
Too deep under anesthesia, positioning, airway obstruction. |
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What are 4 causes of hypocapnia? |
Too light under anesthesia, painful, hypothermia, decrease cardiac output.
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What is the corneal reflex? |
Placement of the eye itself; apply eye drop, for example, see if eye itself responds to liquid. usually only used if patient is suspected to be too deep under anesthesia. |
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What is the palpebral reflex? |
"Blink" reflex, touch the corner of the eye, watch for movement/reaction |
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What is the pupillary light reflex? |
Pupils should constrict or dilate depending on it light is shown into the eye or not, both eyes should respond the same as the other. |
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What are the 2 indicators of circulation? |
Heart rate & heart rhythm |
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What is an indicator of oxygenation? |
Normal MM coloring |
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How often do we monitor body temperature during surgery? |
Every 15-30 minutes manually with a rectal thermometer |
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What are some factors that influence body temperature? |
Age, size, type of procedure (open surgery, etc.) |
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What factor delays recovery time? |
Hypothermia |
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What are 3 risks of hypothermia during anesthesia? |
Slows metabolism (more drugs needed), leads to CNS depression, leads to heart malfunction |
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Name 4 ways to minimize heat loss during anesthesia. |
Warm IV fluids for cavity flush, avoid cold environment/room/tables, barrier between patient and table, forced warm air blanket |
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How do we report reflexes during monitoring? |
Reported as: Present, Decreased, Absent |
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Which 6 reflexes are evaluated during anesthesia? |
Palpebral, pedal, laryngeal, pupillary light reflex, corneal, swallowing |
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Why is the SA node called the pace maker of the heart? |
The SA node has a cluster of cells that are situated in the upper part of the right atrium wall where electrical impulses are generated. |
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Explain how an ECG provides useful information about cardiac function. |
It displays the electrical impulses generated by the cardiac conduction system that indicated each heartbeat. The monitor generates real time tracing of heart rhythm. |