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(5) effects of pain
immunosuppression, increased tissue catabolism, reduced healing, increased autonomic activity, emotional distress
(7) signs of pain
protection of affected area, vocalization, licking or biting, scratching or shaking, restlessness or pacing, sweating increased respiratory or heat rate.
mild to profound degree of CNS depression (which the patient is drowsy but may be aroused by pain)
state of relaxation and calmness characterized by a lack of anxiety or concern without significant drowsiness
(goals of every) anesthetic-analgesic plan
to predict, prevent, recognize and correct any complications
(7) steps of anesthesia
patient history, patient preparation, prepare equipment and supplies, preanesthetic medication, induction, maintenance, recovery
(before anesthesia) withhold food for
8-12 hours, water for 2-4 hours (pediatric or smaller patients 2-4 hours)
ensures an airway, facilitates patient ventilation, provides easy delivery of volatile anesthetics
facilitates visualization of the glottis as the endotracheal tube passes through into the trachea
do not have a carbon dioxide absorber (removal of carbon dioxide depends on fresh gas flow rates)
circle system (amount of carbon dioxide rebreathed depends on the degree of absorption and the fresh gas flow rate)
blocks the action of acetylcholine in the parasympathetic nervous system (also known as cholinergic blocking agents, antispasmodics, and parasympatholytic agents)
increased heart rate, decreased salivation and bronchial secretions, mydriasis (dilated pupils), bronchodilation, decreased gastric and intestinal motility, reduced tear formation
ketamine, tiletamine (in combo acepromazine, alpha 2 agonists, opioids or a benzodiazepine)
insufficient oxygenation of the blood, a common sign of pulmonary compromise during anesthesia and reason for oxygen enrichment of inspired air
reduced rate and depth of ventilation as determined by increased arterial carbon dioxide levels (hypercarbia or hypercapnia)
decrease the anesthetic concentration, ensure adequate circulation, insulate from cold surfaces, dry the body surface, apply warm blankets, warm inspired air, and decrease fresh gas flow to minimum requirements.
decrease anesthetic concentration, increase oxygen flow, increase the rate of IV fluid delivery, support ventilation (if tachycardia persists, prepare for cardiac arrest)
bradycardia (excessive anesthesia responses)
decreased anesthetic concentration and support with oxygen and fluids
controlled by appropriate fluid administration and lowering the anesthetic concentration
hypercarbia and hypercapnea (responses)
managed by increasing ventilation (bagging) to remove carbon dioxide from the patient
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