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Pt Monitoring / Cautions
JJC Vet Tech 117
77
Veterinary Medicine
Undergraduate 1
04/23/2014

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Cards

Term
What is a "caution"?
Definition
Level at which you should check the patient parameters before the situation becomes critical.
Term
HR caution for dogs/cats?
Definition
dogs < 80 Bpm
cats < 100 Bpm
Term
RR caution for dogs/cats?
Definition
< 12 bpm, but also quality of breaths
Term
3 best indicators of perfusion? Other indicators?
Definition
3: BP, periph. pulse, CRT
Other: MM color, temp
Term
Define perfusion.
Definition
oxygenated blood flow to the tissues
Term
CRT caution?
Definition
less than or equal to 1sec, more than or equal to 2sec
Term
Body temp caution?
Definition
change of 2F or down to 99
Term
Body temp is considered critical at what temp?
Definition
94F
Term
Name the reflexes we test, in order:
Definition
1. swallow
2. pedal
3. palpebral
4. corneal
Term
How to test the swallow reflex?
Definition
rub throat over larynx, or gently tug tongue
Term
How to test the pedal reflex?
Definition
thumb nail into the dorsal surface of toe, watch for twitches on flank
Term
Once the ___ reflex is gone, the vet can start using the scalpel because sensation of ___ ___ is gone.
Definition
pedal; deep pain
Term
How to test the palpebral reflex?
Definition
gently tap canthus or brush lashes, watch for facial twitches (may need to "reset" eye first)
Term
How to test the corneal reflex?
Definition
Open eye, gently touch cornea
Term
Dr. Keller will not perform surgery on an animal with ____ located eyes.
Definition
centrally
Term
If testing the corneal reflex, what else would you check at that time?
Definition
PLR (pupillary light reflex)
Term
What muscle tones do we check?
Definition
jaw tone, anal tone
Term
Eye position in Stage II?
Definition
central
Term
Eye position in Stage III plane 1 or 2?
Definition
medio-ventral
Term
Eye position in Stage III plane 3 or 4?
Definition
central
Term
MAP stands for...
Definition
Mean Arterial Pressure
Term
CVP stands for...
Definition
Central Venous Pressure
Term
What Sx equipment is essentially just a speaker?
Definition
Audio Patient Monitor
Term
APM
Definition
Audio Patient Monitor
Term
The APM is used in conjunction with the...
Definition
Esophageal Stethoscope
Term
Blood pressure cautions?
Definition
systolic < 100 mmHg
diastolic < 80 mmHg
Term
How is measuring BP in animals different from in humans?
Definition
-less accurate
-only measure systole in animals
-white coat syndrome
Term
Dr. Keller's preferred brand of Autio Patient Monitor?
Definition
Parks model
Term
Direct measures of BP:
Definition
-CVP
-arterial catheter
Term
Indirect measures of BP:
Definition
-Doppler
-oscillometry
Term
Full name of Doppler?
Definition
Doppler Flow Detector
Term
How does the Doppler work?
Definition
-amplifier with crystal
-concave side down on patient
-trim hair, use gel
Term
How to achieve consistent readings with sphygmomanometer?
Definition
-hold at level of heart
-same person doing it
-pt in same position
-same cuff size
-take 5 readings, throw out hi/lo and avg the rest
Term
A cat's BP measured with a ____ is ____ (lower/higher) than their actual BP.
Definition
A cat's BP measured with a sphygmomanometer is 14pts lower than their actual BP.
Term
What is oscillometry?
Definition
BP cuff with sensors, shows reading on monitor
Term
MAP is the most accurate digital reader when it comes to what sort of BP monitor?
Definition
oscillometry
Term
CVP normal value?
Definition
< 8 cmH2O
Term
How does CVP work?
Definition
-jug/fem catheter to RA
-catheter cnx to "thermometer" of water, level moves as they breathe
Term
What is pulse oximetry?
Definition
measures Saturation % of hemoglobin with O2
Term
SpO2 normal? Caution?
Definition

N = >95%

C less than or equal to 90% (89% is really bad!)

Term
What is capnography?
Definition
measuring the level of CO2 in respiratory gases
Term
How is SpO2 read?
Definition
light sensor on probe/clip, jaws must be parallel
Term
How is EtCO2 read?
Definition
sample of ETT measures level of CO2
Term
EtCO2 stands for...
Definition
End Tidal CO2
Term
PaO2 stands for...
Definition
Partial pressure of O2 in arterial blood
Term
How is PaO2 read?
Definition
take blood sample during Sx
Term
EtCo2 caution?
Definition
< 25 mmHg or > 45 mmHg
Term
What parameter would indicate that the patient needs to be bagged?
Definition
if EtCO2 was > 45 mmHg
Term
What parameter would indicate that the patient may be hyperventilating?
Definition
if EtCO2 was < 25 mmHg
Term
The best way to tell if a patient is successfully going under is by observing this parameter:
Definition
EtCO2
Term
Which type of equipment monitor has just 2 toggle switches? What are they for?
Definition
APM - on/off, feedback
Term
Stage I
Definition
-voluntary excitement
-all reflexes
-central eyes
Term
Stage II
Definition
-involuntary excitement
-all reflexes
-nystagmus, eyes not central or MV
Term
Stage III Plane 1
Definition
-light anesthesia
-lose swallow reflex (can intubate)
-eyes MV more or less
Term
Stage III Plane 2
Definition
-medium/surgical anesthesia
-no swallow, pedal (can cut)
-eyes MV
Term
Stage III Plane 3
Definition
-deep anesthesia (eg ortho Sx)
-no swallow, pedal, palpebral
-eyes +/- central
Term
Stage III Plane 4
Definition
-too deep, anesthetic emergency, OD
-lose corneal and PLR
-eyes central
Term
Stage IV
Definition
-danger
-moribund, dying
-no reflexes
-eyes central, fixed, dilated
Term
At what stage/plane of anesthesia can you intubate?
Definition
Stage III Plane 1
Term
At what stage/plane of anesthesia can you start using the scalpel?
Definition
Stage III Plane 2
Term
75% of surgeries occur at what stage/plane of anesthesia?
Definition
Stage III Plane 2
Term
At what stage/plane of anesthesia does breathing become shallow, abdominal, jerky, hiccup-like?
Definition
Stage III Plane 4
Term
At what stage/plane of anesthesia does respiratory failure occur?
Definition
Stage IV
Term
How does Ketamine affect patient monitoring?
Definition
-muscle rigidity = no palpebral reflex
Term
How does Atropine affect patient monitoring?
Definition
-dilates the pupils
-dries out secretions (moisten probes!)
Term
Last, dying breath can be called...
Definition
agonal breath
Term
At what stage/plane of anesthesia is the patient at or below all cautions?
Definition
Stage III Plane 3
Term
At what stage/plane of anesthesia would you need to turn off the anesthetic and probably start CPR?
Definition
Stage III Plane 4
Term
At what stage/plane of anesthesia does the patient have pale MM?
Definition
Stage III Plane 4
Term
How does atropine affect saliva and tear production?
Definition
decreases
Term
How does atropine affect pupil size?
Definition
dilates (mydriasis)
Term
How does atropine affect bronchi?
Definition
dilates
Term
How does atropine affect GIT?
Definition
slows motility
Term
How does atropine affect HR?
Definition
increases rate
Term
What instrument can you use to assist in intubation?
Definition
laryngoscope
Term
What anatomy can work as landmarks for intubation?
Definition
-arytenoid cartilages
-vocal folds
-glottis
-epiglottis
-soft palate
Term
Why do ETTs have beveled patient ends?
Definition
less traumatic
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