Term
| According to the Tear text, when does the postoperative recovery period begin for the surgical patient? |
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Definition
| Starts with the cessation of anesthesia and continues until the pt’s vital signs and level of consciousness have returned to normal |
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Term
| What is the term that used to describe the excitement and exaggerated and uncontrollable movements some patients exhibit during the recovery phrase of anesthesia |
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Definition
Emergence delirium – occurs for several reasons
- In some cases, the pt passes slowly through stage II and spends several minutes exhibiting signs of excitement
- Analgesic and anesthetic side effects contribute to the development of emergence delirium
- Opiods are given for analgesic effects but these can sensitize pt to loud auditory stimuli and bright visual stimuli. When stimulates, pts may be aroused and exhibit erratic behavior
- Dissociatives may cause hallucinations
- Animal may overheat or hurt itself thrashing |
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Term
| According to the Tear text, which conditions would contribute to a prolonged recovery from anesthesia? |
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Definition
- Excessive anes depth
- Breed predisposition (“sight hounds” sensitive to barbiturate anesthetics)
- Hypotension, poor perfusion, shock
- Liver or kidney dz
- Intracranial dz
- Hypoglycemia (esp neonatal pts due to sm size/immature livers)
- hypothermia |
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Term
| Dextrose tx for hypoglycemia in the anesthetized/recovering pt |
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Definition
- Dextrose IV diluted 1:1 with sterile water (sterile 50% Dextrose)
- Admin slowly to pts w/ marked hypoglycemia
- Desired effect includes increased awareness and consciousness
- CRI of 2.5 – 3% dextrose soln may be needed to maintain BG levels high enough to eliminate signs of low BG
- Do not give orally, pt may aspirate
- Do not give by IM or SQ inj, dextrose soln is hypertonic and will draw fluid into the SQ space, causing cellular dehydration and cell death, and the dextrose will not be efficiently absorbed into the bloodstream because of poor perfusion |
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Term
- Dextrose IV diluted 1:1 with sterile water (sterile 50% Dextrose)
- Admin slowly to pts w/ marked hypoglycemia
- Desired effect includes increased awareness and consciousness
- CRI of 2.5 – 3% dextrose soln may be needed to maintain BG levels high enough to eliminate signs of low BG
- Do not give orally, pt may aspirate
- Do not give by IM or SQ inj, dextrose soln is hypertonic and will draw fluid into the SQ space, causing cellular dehydration and cell death, and the dextrose will not be efficiently absorbed into the bloodstream because of poor perfusion |
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Definition
- The premature loss of sutures that allows the sx site to open
- Exposes underlying areas to contamination
- Any or all layers of surgical closure may undergo dehiscence
May be caused by:
- Licking
- Infxn of site may weaken tissues, causing suture to tear through
- Blunt trauma may cause sutures to rip through healthy tissue
- Active playing or falls |
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Term
| . A patient in a post-surgery recovery cage is hypothermic. What is the first step(s) you should take? |
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Definition
- Hypothermia (mild is no lower than 97 F, <93 F is worrisome)
- As body temp drops, normal metabolism slows down, adversely affecting the functioning of all organs of the body, esp brain and heart
- Circulating warm water or air, rice bags, water bag
- Under a “tent” made by blankets and warming objects, air in tent is warmer and also helps to warm from inside
- Warm IV/SQ fluids ~ 98 – 99F
- No heating pads |
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Term
| What steps should be taken to immediately control mild to moderate hemorrhage in a post-surgical patient? |
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Definition
- Routinely inspect incision during recovery/post op monitoring
- Any bleeding needs attended to
- Direct pressure to site for 5 – 10 min
- If doesn’t stop, apply bandage if possible
- Excessive bleeding that doesn’t stop may indicate pt is bleeding internally |
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Term
| Clinical signs of internal bleeding |
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Definition
- Pale mm
- Decreased CRT ( >2s)
- Rapid RR
abdo bloating
- Swelling at or around site
- Hypotension, ultimately culminating in hypovolemic shock |
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Term
| Reasons for excessive post-op bleeding |
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Definition
- Coagulation disorder
- Surgical ligature may have been dislodged
- Smaller arteries that were not bleeding intra-op due to low BP may begin to bleed as pt regains normal BP |
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Term
| What will result from unresolved post surgical hemorrhage? |
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Definition
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Term
| Know what a seroma is and what is most likely to cause them. |
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Definition
- A collection of tissue fluid in a pocket under the skin that forms at an area of excessive movement
- Pt overactive post op
- Irritation from scraping of rough sutures causes inflammation
- When tissues inflamed, serum leaks from capillaries
- Serum collects in potential space between skin and muscle layers
- Interferes with normal healing process
- If serum leaks through suture line, bacteria from skin may contaminate the serum in the pocket and an abscess may form
- An abscess, hematoma or hernia all resemble a seroma |
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Term
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Definition
- Differential dx: aseptically aspirating the mass w/ 22g needle/syringe
- Seroma – straw-colored or light fluid
- Abscess – purulent fluid
- Hematoma – blood
- Hernia – empty syringe or sm amt liquefied fat |
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Term
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Definition
- Tx much like hematomas
- Sm seromas may be managed with warm, moist compresses applied multiple times/day
- Pocket can be drained using a needle/syringe, followed by a pressure bandage
- Lg seromas need to be drained surgically, also allows vet to explore sx site to ensure that all muscle-layer sutures are intact |
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Term
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Definition
- Inflammatory – begins immed after injury, characterized by formation of blood clot; platelets stim other stages by release of growth factors
- Debridement – part of inflammatory phrase; characterized by influx of WBCs (macrophages, monocytes) into wound; occurs~ 6 hrs after injury; wound healing is sustained by release of growth factors from multiple cell types
- Repair (Fibroblastic) – begins 3 – 4 days after wounding; characterized by invasion of fibroblasts and development of granulation tissue; wound strength increases exponentially
- Maturation – characterized by remodeling of the collagen of the scar and slow gain in wound strength; begins approx 3 wks after injury and may take wks to yrs to complete |
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Term
| . A post-anesthesia patient is most likely to be considered recovered when what happens? |
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Definition
| When all physiologic parameters, incl neurologic responses, are normal |
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Term
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Definition
| surgical wounds made under asceptic conditions are considered “clean”. Ex: sx sites of castration or OVH |
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Term
| Clean-contaminated wounds |
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Definition
| surgical wounds that are contaminated w/ contents from the GI , resp, or urinary tract |
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Term
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Definition
| – heavy contamination (foreign material (eg grass, asphalt) and compromised tissue is incorporated into the wound. Can become compromised when there is major spillage from the GI tract |
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Term
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Definition
| old traumatic wound; active infxn w/ purulent exudate |
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Term
| Fundamentals of wound management |
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Definition
1. temp cover the wound to prevent further contamination
2. assess the traumatized animal and stabilize its condition
3. clip and aseptically prepare the area around the wound
4. culture the wound
5. debride dead tissue and remove foreign debris from the wound
6. lavage the wound thoroughly
7. provide wound drainage
8. promote healing by stabilizing and protecting the cleaned wound
9. perform approp wound closure |
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