Surgical Nursing 2nd Block

What are inverting suture patterns used for?

Used to close and seal wounds in hollow internal organs. Helps prevent leakage

What are everting suture patterns used for?

Used only in skin when excessive tension is pulling wound edges apart

What are appositional suture patterns used for?

Brings wound edges together into apposition (side by side)

What are examples of everting suture patterns?

1. Vertical mattress
2. Horizontal mattress

What are examples of appositional suture patterns?

1. Simple interrupted
2. Simple continuous pattern

Which suture pattern are RVTs NOT allowed to do?

Inverting suture patterns

What is a brachydont animal?

Teeth stop growing at a certain point
Ex: Dogs, cats, humans, monkeys

What is a hypsodont animal?

Teeth are continually growing
Ex: Herbivores, horses

How many teeth do dogs have?

42 teeth

How many teeth do cats have?

30 teeth

How many dental roots are present in incisor teeth?

One root

How many dental roots are present in canine teeth?

One root

How many dental roots are present in the first premolar?

One root

How many dental roots are present in the second and third premolars?

Two roots

How many dental roots are present in the fourth premolar?

Three roots

How many dental roots are present in the molar teeth?

Two or three roots

What does edentulous mean?

Born without teeth

When do teeth first start erupting in puppies and kittens?

About 4 weeks

When do permanent teeth start appearing in puppies and kittens and when are they completed by?

-First permanent teeth appear about 4 months of age
-Teeth completed by 6 months of age

What is brachygnathism?

Overbite

What is prognathism?

Underbite

What problems can occur with retained deciduous teeth?

1. Predispose surrounding teeth to periodontal disease
2. Malocclusions

What problem does dental tartar lead to?

Gingivitis and periodontitis

What are the 3 types of dental tarter?

1. Dental Plaque
2. Salivary Tarter
3. Ceruminal Tarter

What color is dental tarter?

White

What color is salivary tarter?

Yellow hard material

What color is ceruminal tarter?

Thin dark color

What does prophylaxis mean?

Prevention measures

What tooth is most commonly affected by tooth root abscesses?

Carnassial tooth
-Upper 4th premolar
-Lower 1st molar

What is the treatment for a tooth root abscess?

Extraction and antibiotics

What is gingivitis?

Swelling, redness, tenderness, and bleeding of soft tissue around the tooth

Gingivitis leads to.......

....periodontitis

What is periodontitis?

Inflammation of structures around teeth

How do you diagnose periodontitis?

With a periodontal probe, where the pocket depth is 5mm or greater and the bleeding does not stop after probing/cleaning

What are symptoms of a root canal?

1. Animal not eating or painful mouth
2. Fractured tooth
3. Exposed or worn tooth with exposed pulp cavity (Brown soft)

What shape is a curette dental tool?

Rounded

What shape is a scaler dental tool?

Pointed

Is a curette meant for subgingival or surface tooth tarter removal?

Subgingival

What is the purpose of the cuff on the endotracheal tube?

To prevent aspiration pneumonia

What material is used with the dental polisher and what is its purpose?

Pumis paste
-smooths the surface of the tooth enamel

What is the purpose of a periodontal probe?

Measures gum pocket depth

What are examples of natural suture material?

1. Cat gut
2. Silk
3. Cotton

Is PDS (polydioxanone) suture material absorbable or nonabsorbable?

Absorbable

Is Vicryl (Polygalactin) suture material absorbable or nonabsorbable?

Absorbable

Is silk and cotton suture material absorbable or nonabsorbable?

Nonabsorbable

Is Maxon (Polyglyconate) suture material absorbable or nonabsorbable?

Absorbable

Is Prolene (Polyprolene) suture material absorbable or nonabsorbable?

Nonabsorbable

Is Monocryl (Poliglecaprone) suture material absorbable or nonabsorable?

Absorbable

What are eye needles for sutures?

Multiple use needles where you thread the suture material through

What are swaged needles for sutures?

Single use needles with suture material permanently attached

What are the two types of needle points for suturing?

1. Taper Point (Rounded)
2. Cutting Point (Triangle tip)

How long should skin staples stay in before being removed?

10-14 days

What is reverse cutting used for in suturing?

Used to suture tendons and ligaments

What are examples of inverting suture patterns?

1. Lembert
2. Connel
3. Cushing

What does CPA stand for?

Cardiopulmonary Arrest

What does DNR stand for?

Do Not Resuscitate

What are symptoms of CPA?

1. Cyanosis
2. Dyspnea
3. No heart beat
4. Dilated pupils and nonresponsive
5. Asystole - flatline on ECG
6. Hypotension

What does ABC stand for?

A \= establish AIRWAY
B \= BREATHING support
C \= CIRCULATION support

What does DEF stand for?

D \= DRUGS and diagnosis
E \= ELECTROCARDIOGRAPHY
F \= FIBRILLATION

What does GHI stand for?

G \= GAUGHING a patient's response
H \= HOPEFUL measures for the brain
I \= INTENSIVE care

What is more important, compressions or breathes?

Compressions

Hypoxia after how long causes permanent brain damage?

15 mins

What is cardiac pump theory?

Direct compression on the heart causes blood to be forced out of the ventricles

What is thoracic pump theory?

Pressure applied to the thorax causes an increase in the intrathoracic pressure

What is hypercapnia?

High CO2 in blood

For CPR, what recumbency is an animal placed in if it is

Lateral recumbency

For CPR, what recumbency is an animal placed in if it is \>7 kg?

Dorsal recumbency

What are side effects of internal cardiac massage?

1. Invasive procedure
2. Excessive bleeding
3. Infection
4. Damage to heart and lungs

What scenarios would internal cardiac massage be deemed necessary?

1. Pneumothorax (Can't increase thoracic pressure)
2. Hemothorax (Can't increase thoracic pressure)
3. Flail Chest (Broken ribs)
4. Diaphragmatic Hernia (Every pushed into abdomen)
5. Severe pulmonary contusions

When would calcium gluconate or sodium bicarbonate be given during CPR?

Only for metabolic acidosis

What may be side effects to doing compressions for CPR?

Myocarditis or inflammation

What are the 5 domains of CPR?

1. Preparedness and Prevention
2. Basic Life Support (BLS)
3. Advanced Life Support (ALS)
4. Monitoring
5. Post-Cardiac Arrest Care

How many chest compressions should you do a minute

100-120 compressions/min

What does ROSC?

Return of Spontaneous Circulation

True or False: Colloids are primarily used to maintain blood volume.

True

What drug treats cerebral edema?

Mannitol

What are 4 complications of using a ventilator during anesthesia?

1. Oxygen toxicity
2. Damage or rupture of the lungs
3. Apnea if weaned too fast
4. Hypotension

What does IPPV stand for?

intermittent positive pressure ventilation

True or False: It is okay to immediately turn off a ventilator when a patient is under anesthesia.

False; Patient needs to be weaned off ventilator. Turn off vaporizer and let 100% oxygen ventilate

What percentage of oxygen should be used for ventilation greater than 24 hours?

21% to 40%

What does oxygen toxicity lead to?

Pulmonary edema and death

Vaporizer for ventilation should be set at what gas rate?

2% isoflurane

Should the pop off valve for a ventilator be open or closed?

Closed pop off valve

What value should pressure of a ventilator be set at?

20 mmhg

Why is hypotension a complication of using ventilaters?

There is a decrease in blood returning to the heart due to increased intrathoracic pressure

What should the respiration rate be set at during ventilation?

10-15 bpm

Are horses able to vomit?

No

Why must horse shoes be removed before any surgical procedure?

It removes microbes and prevents the horse from harming itself

Why do horses always require a ventilator when under anesthesia?

Their lungs cannot expand due to weight
-Always develop hypoxia

What position should a horse be in for entubation?

Entubation is performed blindly in lateral recumbency with neck extended

Proper positioning and padding during surgery prevents what?

Prevents pressure related myositis and neuritis
(aching muscles and inflamed nerves)

True or False: All horses develop acid/base problems.

True, especially respiratory acidosis

What kind of drug is Guaifenesin?

Centrally acting skeletal muscle relaxant

What are side effects of guaifenesin on horses?

1. Apnea
2. Hypotension
3. Muscle Rigidity

True or False: Horses may develop laminitis even after a successful surgery

True

How long should food be withheld before surgery for ruminants?

24-36 hours to decrease rumen pressure and risk of regurgitation

What are some side effects of preanesthetic agents to ruminants?

1. Cardiovascular and respiratory depression
2. Rumen atony and bloat (Lowered GI motility)
3. Abortion late in pregnancy

True or False: Ruminants require a local or regional nerve block for most surgical procedures

True
-Lidocaine and Bupivacaine (lasts longer, 72 hours)

True or False: Ruminants are sensitive to anesthetic agents.

True

What route are anesthetic agents given for porcine?

IM