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| Section | Objectives |
|---|---|
| Topic 1: Diagnostic Imaging | - Radiography positioning and safety - Image processing and interpretation basics |
| Topic 2: Laboratory Procedures | - Urinalysis and microbiology - Hematology and clinical pathology |
| Topic 3: Surgical Nursing | - Preoperative and postoperative care - Sterile technique and instrumentation |
| Topic 4: Pain Management and Analgesia | - Analgesic drug use - Pain assessment techniques |
| Topic 5: Dentistry | - Dental prophylaxis procedures - Oral anatomy and disease recognition |
| Topic 6: Emergency Medicine and Critical Care | - Triage and stabilization - Shock management and CPR |
| Topic 7: Animal Care and Nursing | - Nutrition and husbandry - Patient handling and restraint |
| Topic 8: Pharmacology | - Dosage calculations and administration - Drug classifications and uses |
| Topic 9: Anesthesia | - Anesthetic protocols and equipment - Anesthetic monitoring |
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NEW QUESTION # 522
When monitoring vital signs, the American College of Veterinary Anesthesia and Analgesia's (ACVAA) Recommendations for Monitoring Anesthetized Veterinary Patients group vital signs into three classifications, including all of the following except:
Answer: C
Explanation:
The ACVAA's group on monitoring anesthesia discusses vital signs as only loosely correlated with anesthetic depth. However, knowing when a patient's heart rate, rhythm, respiratory rate and depth, capillary refill time, temperature, blood pressure, and mucous membrane colors are abnormal may help you determine what surgical plane of anesthesia you should be in time. Various factors affect the surgical plane and the body's response to surgery, anesthesia, pain, and other stimuli. Thus, we cannot solely rely on the classic vital signs to determine if a patient is stable and in the correct surgical anesthetic plane.
The ACVAA classifies vital signs into 3 groups.
Indicators of circulation. These include:
*Heart rate
*Blood pressure (Indirect measure via Doppler or oscillometric monitor or directly via an arterial catheter)
*Capillary refill time
*Mucous membrane color
*Pulse strength (determined by palpation of a peripheral artery such as the femoral, carotid, lingual, or in small animals, the dorsal pedal, and in large animals, the facial, digital, dorsal pedal, or auricular arteries) Indicators of oxygenation. These include:
*Pulse oximetry
*Measuring dissolved blood oxygen via a blood gas
*Mucous membrane color, the only physical indicator of oxygenation, will change, but once the change is visibly evident (cyanosis), intervention is often too late, and it is not accurate in the presence of anemia; thus, just a crude indicator of oxygenation.
Indicators of ventilation. These include:
*Respiratory rate
*Respiratory effort
*Tidal Volume
*Capnography
*Blood gas analysis
The first of these three is visually monitoring the expansion and contraction of the reservoir bag, unidirectional flow through the valves, via monitoring equipment, or simply by watching the chest wall rise and fall.
Ideally, you will have evaluated the animal's normal quality and depth of respiration when awake to determine if there is a significant change from normal once anesthetized.
The above three indicators are what the ACVAA classifies as the three key vital sign classifications. However, there are other indicators of anesthetic depth, including reflexes. Reflexes, involuntary, protective responses by the body can further assess anesthetic depth based on the procedure being performed. These include:
*Palpebral reflex
*Swallowing reflex
*Pedal reflex
*Corneal reflex
*Muscle jaw tone
*Eye position and pupil size
Most patients' eye position and pupil size for a proper surgical anesthetic plane will have ventromedial deviation. For some horses, the eyes may change from ventromedial to central and revert back. On the other hand, nystagmus often signifies a light plane of anesthesia.
Finally, a response to surgical stimuli can also help determine the anesthetic depth, and monitoring key parameters at times when you know there will be an increase in noxious stimuli is paramount and part of your job as a technician monitoring anesthesia and the patient's overall well-being and safety during the procedure.
NEW QUESTION # 523
If a patient's anesthetic depth seems too deep, all of the following could help to explain this except:
Answer: C
Explanation:
Signs of deepening anesthetic depth include increased abdominal respiration, intercostal paralysis, decreased respiratory rate, weak but fast pulse, pupils fixed and centrally rotated, reduced blood pressure, and no response to surgical stimuli. It can easily progress to respiratory paralysis, lack of neurological reflexes, bradycardia, and eventual apnea, without intervention.
If the CO2 absorbent is exhausted, we expect a patient to be too light under anesthesia. This means they are rebreathing the CO2, leading to respiratory acidosis and failure to obtain sufficient gas anesthetic to provide adequate anesthesia.
Common reasons for excessive anesthetic depth include:
*The vaporizer is malfunctioning, overfilled, or no longer properly calibrated
*Equipment malfunction
*Underlying pre-existing medical conditions that could be interfering with proper gas exchange or proper metabolism of the drugs used Additional causes for increased anesthetic depth include hypotension and hypercapnia.
NEW QUESTION # 524
A 12-kg patient's orders are to receive 5 mg/kg of enrofloxacin diluted 1:1 in sterile water before giving IV. The stock vial of enrofloxacin is 22.7 mg/mL.
What is the total fluid volume to be administered IV to the patient?
Answer: D
Explanation:
Calculate the dose from the dosage: 12 kg x 5 mg/kg = 60 mg
Convert mg to mL: 60 mg / (22.7 mg/mL) = 2.6 mL of drug from the stock vial To dilute in a 1:1 ratio, add 2.6 mL of sterile water to 2.6 mL of drug = 5.2 mL total
NEW QUESTION # 525
The term "floating" refers to which procedure?
Answer: A
Explanation:
Floating refers to rasping down the sharp edges of teeth in horses. This means mechanically altering the occlusal tooth surface. This must be performed regularly to keep the grinding surfaces of the teeth smooth; otherwise, this can cause pain, trauma to the oral mucosa, and difficulty eating.
NEW QUESTION # 526
What factor makes mask inductions impractical?
Answer: C
Explanation:
When mask inductions are performed, it is common for patients to struggle. Other concerns include waste anesthetic gas exposure, inability to protect the patient's airway, and difficulty quickly transitioning to a smooth anesthetic plane. Patients struggle due to anxiety, stress, and fear. In patients that are conscious, it is not recommended to use masks or box inductions without injectable medications on board.
The remaining options are incorrect: mask inductions are not financially prohibitive, they are able to be used with several different inhalants, and equipment is readily available.
NEW QUESTION # 527
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