Small animal surgical nursing : skills and concepts /

Table Of Contents:

PART I PREOPERATIVE CONSIDERATIONS

The Preoperative Patient 3(46)

History Taking 4(1)

Physical Examination 4(5)

General Body Condition and Mentation 5(1)

Head and Neck 5(1)

Chest and Front Legs 6(2)

Abdomen and Haunches 8(1)

Integument 9(1)

Consent Form 9(1)

Preanesthetic Diagnostic Tests 10(4)

Minimum Database 10(3)

Additional Tests 13(1)

Preoperative Medications (Premedications) 14(6)

Principles of Pain Management 14(1)

Analgesics 14(5)

Sedation and Tranquilization 19(1)

Anticholinergics 19(1)

Intravenous Catheters 20(8)

Supplies 20(4)

Jugular Catheters 24(4)

Endotracheal Intubation 28(6)

Components of Tube 28(1)

Selection of Proper Tube Size 29(1)

Supplies 29(2)

Tube Placement 31(3)

Patient Preparation 34(5)

Hair Removal 35(3)

Urination 38(1)

Surgical Site Preparation 39(10)

Scrubbed Personnel 49(17)

Proper Attire in Surgical Area 49(2)

Scrub Suit 50(1)

Head Covers 50(1)

Masks 50(1)

Shoes and Shoe Covers 51(1)

Jewelry 51(1)

General Guidelines for Personal Hygiene 51(1)

Fingernails 51(1)

Surgical Hand Scrub and Hand Rub 52(3)

Prescrubbing Guidelines 52(1)

Surgical Hand Scrub Using Antimicrobial Scrub Agent 53(1)

Surgical Hand Rub Using Antimicrobial Rub Agent 54(1)

Types of Scrub Solutions 55(2)

Gowning and Gloving 57(9)

Drying the Hands 57(1)

Gowning 58(1)

Gloving 59(4)

Contaminated Gown 63(3)

The Operating Room and Asepsis 66(8)

Cleaning the Surgical Area 66(1)

Daily Terminal Cleaning 66(1)

Routine Cleaning after Each Surgical Case 67(1)

Cleaning Protocols 67(1)

Asepsis 67(3)

Surgical Conscience 67(1)

Maintaining Asepsis 67(3)

Opening Sterile Packs 70(4)

Opening Peel-Away Pouches 70(1)

Opening Wrapped Packs with One Hand 71(1)

Opening Large Packs 71(3)

Surgical Supplies and Equipment 74(51)

Surgical Instruments 74(13)

Manufacturing 74(1)

Components 75(1)

General Surgery Instruments 76(5)

Orthopedic Surgery Instruments 81(4)

Ophthalmic Surgery Instruments 85(2)

Anesthesia Machine 87(12)

Components 87(9)

Leak Testing 96(1)

Breathing Circuits 97(1)

Oxygen Flow Rates 98(1)

Surgical Needles 99(2)

Needle Point 99(1)

Needle Body 100(1)

Suture Attachment End 101(1)

Suture Material 101(3)

Characteristics 101(2)

Sizing 103(1)

Packaging 103(1)

Staples 104(1)

Perioperative Equipment 104(8)

Patient Warming Devices 106(1)

Surgical Lights 106(1)

Surgery Table 107(1)

Electrosurgery 108(1)

Suction 109(2)

Clippers 111(1)

Anesthesia Monitoring Devices 112(5)

Pulse Oximeter 112(2)

Capnometer or Capnograph 114(2)

Blood Pressure Monitor 116(1)

Electrocardiograph 117(1)

Surgical ``Power Tools'' 117(8)

PART II INTRAOPERATIVE CONSIDERATIONS

The Intraoperative Patient 125(31)

Techniques for Maintaining Body Temperature 126(1)

Initial Preparations and Positioning 127(6)

Finishing Preparation of Surgical Site 127(1)

Securing Patient in Position on Surgery Table 127(1)

Positioning for Specific Procedures 128(3)

Preparation in the Operating Room 131(1)

Maintaining Sterile Field 132(1)

Patient Monitoring 133(15)

Role of Veterinary Technician Anesthetist 133(4)

Heart Rate and Rhythm 137(1)

Tissue Perfusion 138(1)

Respiratory Rate and Rhythm 139(2)

Neurologic Parameters 141(2)

Anesthesia Form 143(5)

Role of Scrubbed-in Surgical Assistant 148(1)

Intraoperative Analgesia 148(1)

Options for Delivery 148(1)

Specific Analgesics 148(1)

Surgical Wound Classification 149(2)

Clean Wound 150(1)

Clean Contaminated Wound 150(1)

Contaminated Wound 150(1)

Infected Wound 151(1)

Perioperative Antibiotics 151(5)

Surgical Assisting 156(8)

Nutrition, Hygiene, and Appearance 156(1)

Surgical Attire 157(1)

Responsibilities 157(7)

Instrument Count 157(1)

Sponge Count 157(1)

Instrument Handling and Passing 158(2)

Tissue Handling 160(1)

Maintaining Hemostasis 161(3)

Specific Procedures 164(123)

Responsibilities of Surgical Technician 164(1)

Abdominal Procedures 165(31)

Ovariohysterectomy 165(3)

Cesarean Section 168(6)

Abdominal Exploratory Surgery 174(2)

Gastric Foreign Bodies and Gastrotomy 176(3)

Intestinal Foreign Bodies and Enterotomy 179(4)

Intestinal Resection and Anastomosis 183(4)

Gastric Dilatation and Volvulus 187(5)

Cystotomy 192(4)

Orthopedics 196(19)

Technician's Responsibilities 196(3)

Orthopedic Terms and Abbreviations 199(1)

Preoperative Considerations for Fractures 199(1)

Fracture Assessment 200(2)

Surgical Options for Fracture Repair 202(7)

Amputation 209(2)

Cranial Cruciate Repair 211(4)

Biopsy and Mass Removal 215(4)

Fine-Needle Aspiration Biopsy 215(2)

Impression Smears 217(1)

Needle Punch Biopsy 217(1)

Punch Biopsy 217(1)

Bone Biopsy 217(2)

Incisional Biopsy 219(1)

Excisional Biopsy 219(1)

Biopsy Sample Handling and Fixation 219(1)

Ear Procedures 219(6)

Aural Hematoma Repair 219(4)

Lateral Ear Canal Resection 223(2)

Ophthalmic Procedures 225(11)

Entropion Repair 225(5)

Eyelid Mass (Neoplasm) Removal 230(2)

Protrusion (Prolapse) of Gland of Third Eyelid 232(4)

Minimally Invasive Surgery 236(35)

Laser Surgery 236(5)

Laparoscopy 241(6)

Endoscopy 247(24)

Canine and Feline Castration 271(16)

Routine Feline Castration 271(3)

Routine Canine Castration 274(13)

PART III POSTOPERATIVE CONSIDERATIONS

The Postoperative Patient 287(23)

Recovery from Anesthesia and Extubation 287(2)

Postoperative Monitoring 289(1)

Complications Related to Anesthesia 290(3)

Hypothermia 290(1)

Emergence Delirium 291(1)

Prolonged Recovery 292(1)

Complications Related to Surgery 293(4)

Hemorrhage 293(2)

Seroma 295(1)

Dehiscence 295(1)

Self-Trauma 295(2)

Infection 297(1)

Postoperative Nursing Care 297(7)

Wound Cleansing 297(2)

Bandages, Splints, Casts, and Slings 299(1)

Drains 299(2)

Intravenous Catheter Maintenance 301(1)

Urinary Catheter Maintenance 302(1)

Physical Therapy 302(1)

Nutritional Support 303(1)

Postoperative Analgesia 304(6)

Common Analgesic Classes 305(1)

``Wind-Up'' 305(1)

``Take-Home'' Analgesia 305(5)

The Surgery Room 310(12)

Layout of the Surgery Suite 310(2)

Preparation Area 310(1)

Scrub Area 310(1)

Surgery Room 311(1)

Equipment Cleaning 312(2)

Nonmovable (Permanent) Equipment 312(1)

Movable Equipment 312(1)

General Cleaning Instructions 313(1)

Cleaning of Surgery Room 314(1)

Disinfectants 315(2)

Definitions 315(1)

Effectiveness 315(1)

Types of Disinfectants 316(1)

Rotating and Restocking Supplies 317(5)

Disposable Supplies 317(1)

Reusable Supplies 317(5)

Instrument Cleaning and Sterilization 322(15)

Basic Cleaning Procedures 322(3)

Presoaking of Instruments 322(1)

Decontamination of Instruments 322(1)

Ultrasonic Cleaning of Instruments 323(2)

Pack Wrapping 325(2)

Recipes 325(1)

Wrapping Material 325(1)

Sealing of Pack 325(1)

Expiration Dating 326(1)

Sterilization 327(5)

Gravity Air-Displacement Sterilizer 329(1)

High-Vacuum Sterilizer 330(1)

Preparation and Loading 331(1)

``Flash'' Sterilization 331(1)

Ethylene Oxide (Gas) Sterilization 331(1)

Plasma Sterilization 331(1)

Sterilization Indicators 332(1)

Specialty Instrument Cleaning 332(5)

High-Level Disinfection 332(1)

Drill Cleaning 333(1)

Endoscope Cleaning 334(3)

Client Education for Postoperative Care 337(14)

Discharge Instructions 337(1)

General Postanesthesia Instructions 338(1)

General Postsurgical Instructions 338(3)

Postoperative Care of Patients with Drains 340(1)

Postoperative Care of Patients with a Bandage, Splint, or Cast 340(1)

Postoperative Instructions for Common Procedures 341(10)

Dental Extraction 341(1)

Feeding Tube Placement 341(1)

Gastrointestinal Enterotomy or Anastomosis 342(1)

Perianal Surgery 342(1)

Cystotomy 343(1)

Feline Declaw (Onychectomy) Orthopedic Procedures 343(1)

Aural Hematoma 344(1)

Lateral Ear Canal Resection or Ablation 344(1)

Cesarean Section 345(6)

PART IV HIGH-VOLUME SPAY/NEUTER CLINICS

Spay/Neuter Clinics: The Patients, Facilities, Need, and Process 351(13)

Defining the Patient 351(2)

Feral Cats 351(1)

Shelter Animals 352(1)

Animals of Financially Fragile People 352(1)

Animals Belonging to Collectors and Hoarders 352(1)

Juvenile Patients 353(1)

Types of Facilities 353(2)

Stationary Facilities 353(1)

Mobile Surgical Vans 353(2)

Multi-Site ``Clinics'' 355(1)

General Practice Versus High-Volume Sterilization Surgery 355(1)

Stationary High-Volume Facilities 355(1)

Mobile Sterilization Facilities 355(1)

Multi-Site ``Clinic'' Facilities 356(1)

The Need for High-Volume Spay/Neuter Facilities 356(1)

Anesthesia Concerns 356(1)

Disease Concerns 357(1)

Feline Diseases 357(1)

Canine Diseases 358(1)

Vaccinations 358(1)

Diagnostic Blood Tests 358(1)

Surgical Concerns 358(1)

Patient Selection 358(1)

Surgeon Prerogatives 359(1)

Juvenile Patients 359(1)

Postoperative Concerns 359(1)

Special Concerns 360(4)

Management and Planning 360(1)

Return or Release of Feral Cats 360(1)

Fees and Services Provided 360(1)

General Impact on the Involved Parties 361(1)

Volunteerism 361(3)
Appendix A Quick Reference for Common Perioperative Intravenous Infusions 364(15)
Appendix B Selected Product and Manufacturer Contact Information 379