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148 Cards in this Set
- Front
- Back
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What are the uses for a jugular catheter?
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Central line
Total Parenteral Nutrition (TPN) Blood Sampling Large volumes (of fluids, blood) Hypertonic saline Central Venous Pressure (CVP) |
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What are some crystalloids and what are some facts about them?
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LRS, Norm-R, 0.9%NaCl For mild to severe deyhydration
7% NaCl for rapid vol. expansion in hypovolemic shock D5W not good for shock- for cardiac cases |
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What are some colloids?
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Hetastarch For hypovolemic/septic shock
Fresh frozen plasma, RBC When blood is needed |
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When is hypertonic saline used?
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extreme cases
Only once, and not continuously |
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What are some important things to assess for triage?
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Signalment
CV system/MM color/pulse/hemorrhage Respiratory/ airway/breathing Urogenital Neuro ABCs LOC |
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What are some emergency cases?
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Resp. distress
Pale MM Neuro Protracted vomiting Severe coughing Bleeding from orifices Weakness Rapid abd distension Inability to pee Ingestion of toxins |
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What should be included in a crash cart?
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Suction
Defibrilator/ECG IV fluids and supplies Etubes... IVC/ venous access supplies Ambu bags O2 tank |
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Patients that need immediate care
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HBC
Blocked cats Toxicity Trouble breathing Diabetic Seizures Eye problems Weak/collapsing Can't vomit Allergic rxn Profuse V/D Dystocia |
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How do you evaluate the ABCs?
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Airway: quiet/noisy, without stethescope
Breathing: rate/effort, lung sounds Circulation: HR, MM, CRT, pulse rate/quality |
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What is a full inital assesment?
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ABC
Mental Palpate belly Bleeding, Profuse V/D Painful Owner hysterical? Wt/Temp |
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Normal temp
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Dog: 99-102,5
Cat: 99-102.5 |
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Normal pulse
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Dog: 80-120 (pup: 160-200)
Cat: 160-200 |
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Normal resp
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Dog: 35-50/panting
Cat: 40-60 |
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Define shock
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failure of the circulatory system to maintain adequate blood flow/oxygenation to vital organs
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What are the clinical signs of shock?
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Depression
Pale mm Tachycardia Weak pulse Cool extremeties Dec. urine output Low temp |
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What is the difference b/t shock and dehydration?
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Dehydration is loss of water anywhere in the body
Shock is failed 02 delivery to tissues |
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What are the 4 types of shock?
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1. Hypovolemic: inadequate blood vol
2. Cardiogenic: inadequate cardiac function 3. Septic/distributive: maldistribution of blood 4. Obstructive: obstruction of blood flow |
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What are the 3 stages of hypovolemic/septic shock?
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1. Compensated: drop in BP leads to tachycardia
2. Middle or early decompensation: Fluid loss and depression and tachycardia 3. Irreversible/decomp/terminal: Dec. blood flow, bradycardia |
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How do we treat shock?
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Re-establish effective circulation and oxygenation of tissues and organs ASAP
Fluids, colloids, blood products, 02 |
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What do we monitor for shock?
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TPR...
BP PCV/TP pH, blood gases Lactate |
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What is stored whole blood (SWB)?
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After 24hrs of storage, FWB loses pltlt function
RBC Stable coag factors Plasma proteins |
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What is Cryoprecipitate?
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Insoluble portion of plasma
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How long can pltlts live?
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~1 week
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What is DEA?
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Dog Erythrocyte Antigens
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What are alloantibodies?
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Result of antigenicity
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What can alloantibodies cause in cats?
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Transfusion rxns
Neonatal isoerythrolysis |
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What is crossmatching?
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testing if two blood types match
recipient's plasma mixed with donor blood to look for agglutination |
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What is the shock fluid rate for a patient?
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Dog: 60-90ml/kg/hr
Cat: 40-60ml/kg/hr |
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What are some causes of dehydration?
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Insensible loss: panting, feces
Sensible loss: urine Hemorrhage not eating or drinking V/D Redistribution of fluids in shock |
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What are the clinical signs of dehydration %?
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<5%: not detectable
5%: Subtle loss of skin elasticity 6-8%: tent stays, slightly sunken eyes, slt.prolonged CRT, dry/tacky mm 10-12%: tent stays, prolonged CRT, sunken eyes, dry mm, shock signs 12-15%: shock signs, collapse, sev depression, death |
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What are 4 routes of fluid admin w/ ex.?
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SQ: mild dehydration, chronic admin
IV: shock, sever dehydration, anesthesia IO: neonates, exotics IP: dialysis |
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What is the maintenance fluid rate?
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20-30ml/#/hr
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What is the dehydration fluid rate?
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(% dehydration x kg) / 100
=Liters |
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What is the normal CVP?
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4-10 cmH20
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What are the blood types for cats and dogs?
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Cats: A, B, AB
Dogs: Antigen DEA 1.1 |
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Why must you always type a cat before a transfusion?
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Wrong type can be fatal
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What are the components of whole blood (FWB) and what is it used for?
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RBC, WBC, Pltlts,Coag factors, plasma
Anemic patients who also need clotting factors or blood proteins |
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What are the components of pRBC and what is it used for?
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RBC
Anemic patients- blood loss from trauma, bleeding masses, hemolytic anemia, 02 carrying support, SHOCK |
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What are the components of plasma and what is it used for?
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no RBCs or pltlts, proteins(alb/glob), clotting factors, H20, Lytes
Coagulopathies-rodenticide, Liver dz |
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What is needed to perfuse tissue (circulation)?
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BP: intravascular volume, integrity of vessels
Pumping heart RBC |
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How are fluids kept in the BV?
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Hydrostatic Pressure
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What do oncotic pressure and osmality maintain?
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Oncotic: proteins
Osmality: ion concentrations |
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In regards to DEA 1.1, who can receive what?
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+ can get +/-
- can get - |
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What are some transfusion rxns?
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Fever
Hemolysis Vomiting Facial Swelling Itching |
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What are the main things to evaluate in a trauma patient?
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Respiratory
CV Neuro Abdominal Musculoskeletal Pain |
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What is a pneumothorax?
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free air in pleural space
Lungs can't expand dull sounds |
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What is a diaphragmatic hernia?
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force of trauma causes diaphragm to rupture and abdominal contents enter into chest cavity
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What is flail chest?
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broken rib peices don't move with breaths
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What are pulmonary contusions?
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Lung bruising
dull sounds |
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What do we look for in a neuro eval for a trauma patient?
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Head trauma: dull mentation, increase cranial pressure
Spinal trauma: shiff-sherrington, vert. fx |
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What do we look for in an abdominal eval for a trauma patient?
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bleeds: splenic, liver
Bladder/urethral rupture: pelvic trauma |
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What do we look for in a respiratory eval for a trauma patient?
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pneumothorax
diaphragmatic hernia flail chest pulmonary contusions |
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What do we look for in a musculoskeletal eval for a trauma patient?
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Broken legs, hip/pelvis, jaw, ribs
Degloving |
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What pain meds are good for trauma patients?
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Opioids
NSAIDS Fentanyl MLK |
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What is the MDB for trauma patients?
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Blood gas/chem
PCV/TP 2 view chest xrays |
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What do we set up for a trauma patient?
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IV
Doppler Blood tubes 02 Xray machine |
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Define arrest
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Abrupt cessation of spontaneous ventilation and systemic perfusion which leads to inadequate 02 delivery to tissues
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What is external vs internal resuscitation?
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Ext: CPR compressions
Int: open chest and manually compress |
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What is the goal of CPR?
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Provide artificial support of ventilation and circulation until spontaneous breathing and circulation can be restored and maintained
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What are the 3 phases of CPR?
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Basic life support: ABCs
Adv. life support: drugs, countershock Prolonged life support: treating underlyng problem |
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How can we catch arrest early?
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agonal breathing
arryth, persistant tachycardia difficulty breathing life threatening problem |
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What are the breaths per min during CPR?
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12-20
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What are the compressions per min during CPR?
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100
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What is cardiac vs thoracic pump?
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Cardiac: small pets, one handed, squeezing heart
Thoracic: lrg pets, compression of thoracic wall pushes blood around |
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What are some EKG findings during CPR?
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Asystole: flat line
Electromechanical dissociation: EKG signs but no pulse Vfib: may need countershock |
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What are some commonly used drugs during CPR?
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IV fluids
Epi (IV, trachea) |
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What is stertor and stridor?
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Stertor: congestion in nose
Stridor: congestion in trachea/back of throat |
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What are the problems that occur within spaces of the airway?
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upper: larpar
Pleural space: lung expansion Lower: 02 absorption |
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What are some common resp. problems in dogs upper airway?
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Larpar
Collapsing trachea Brachycephalic syndrome |
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What are some common resp. problems in cats upper airway?
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Nasopharyngeal polyp
Masses |
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What are some common resp problems in dogs pleural space?
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Pneumothorax
Pyothorax Transudates |
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What are some common resp problems in cats pleural space?
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Pneumothorax
Chylothorax |
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What are some common resp problems in dogs lower airway?
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Bronchitis
Heart failure- edema Cancer |
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What are some common resp problems in cats lower airway?
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Heart Failure- edema
Asthma Cancer |
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What are the main points to resp emergencies?
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Triage to back
02 Stress Quick dx Underlying issue Xrays caution |
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What are some things during auscultation that may alert to possible heart dz?
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crackles/harsh lung sounds
Dull lung sounds Irregular beat/pulse Rapid HR poor pulse Low body temp |
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What is heart failure?
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Pump fails so fluid backs up or can't maintain adequate pressure
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What is pericardial effusion?
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prevents right side of heart from filling properly
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What is Feline Aortic Throboembolism and what are the clinical signs?
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Saddle thrombus
Painful Cold hind paws Lack of femoral pulses Blue paw pads Lameness May present in heart failure |
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Define ataxia
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Don't know where feet are, stumbling
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Define loss of concious proprioception
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Don't know if paw is turned down
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What are the clinical signs of head trauma and what is the maine goal of treatment?
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Dully sleepy mentation...
Goal is to decrease cerebral swelling, maintain BP and perfusion |
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What are generalized or focal seizures vs grand mal?
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Strange chewing behavior...
vs falling down flopping.... |
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In regards to seizures does the pet need to be seen?
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Having several a day or lasting more than 2 minutes long
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What nursing care is used post op Intervertebral Disc Dz (IVDD) dogs?
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Seizure watch post myelogram
PT Expressing bladder Pain mngmt |
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What is vestibular disease?
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Head tilt, nystagmus..
Caused by idiopathic, otitis media/interna, thyroid dz, or CNS dz |
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What is the difference between vomiting and regurgitation?
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V: heaving, contents from stomach
R: not actively heaving, contents from esophagus |
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Define melena
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dark, tarry stool
digested blood from upper GI bleed |
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What are 5 common non-specific tx for V/D?
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Fluids
Gastroprotectants Antiemetics Abx NPO |
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How does a patient with an esophageal foreign body present?
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Drooling
Difficulty swallowing Gagging Regurg. Coughing |
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How does a patient with a stomach/small intestine foreign body present?
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Vomiting
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What are some clinical signs of a dog with GDV?
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Distended stomach
Retching (can't vomit) |
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What position is an Xray taken for GDV and what does it look like?
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R lat abd
Looks like popeye sign |
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How do we test for parvo?
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SNAP test (fecal)
CBC |
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What does a parvo puppy CBC look like?
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low WBC
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How do we treat a parvo puppy?
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Fluids
ABx Hetastarch/plasma Supportive care Gastroprotectants |
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What PE findings identify a blocked cat?
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Howling
Angry Lemon-sized hard painful bladder Slow HR |
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What lab values need to be checked in a blocked cat?
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K+
BUN CREA |
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Why is hyperkalemia life threatening (in a blocked cat)?
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leads to abnormal cardiac function and death
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How do you check if a ucath is flowing properly?
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Measure ins and outs
Palpate bladder |
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What do you do if ucath is not flowing well?
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Flush it and try to empty bladder completely
Record output |
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If there is less urine output than fluid input, this may mean....
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Ucath blocked
Dehydration |
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What are some causes of acute renal failure?
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Toxins (antifreeze, grapes....)
Lepto Infxn Obstruction |
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How can you resuscitate a newborn?
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Stimulation
Clear airways 02 Epi Dextrose |
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Which insulin goes with U-100 syringes?
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NPH (dogs and cats)
Humulin R-regular Glargine/Lantus (cats) |
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Which insulin goes with U-40 syringes?
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Vetsulin (dogs)
(PZI) |
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What 2 values are we checking when we dip the urine of a diabetic patient?
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Glucose
Ketones |
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What is the MDB for a sick diabetic?
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BG
Blood gas Urine dipstick for ketones |
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What is the MDB for a DKA?
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CBC/Chem
Blood Gas BP Urine dipstick (imaging) |
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Why do we give dextrose IV to DKA patients?
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For the insulin to bind to
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Define demulcent
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soothing, bland, lubricating, coating, protectant
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Define adsorb
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a substance that attracts other materials or particles to its surface
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Define GI adsorbent
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a substance, usually a powder, administered to adsorb gases, toxins, and bacteria in the stomach and intestines
ex: Kaolin, activated charcoal |
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Define cathartic
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causing bowel evacuation
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What is anemia and what causes it?
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Decreased circulating RBC
1. RBC loss (bleeding...) 2.RBC destruction (IMHA) 3.Dec. RBC production (bone marrow dz...) |
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What is thrombocytopenia and what are the clinical signs?
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Decreased circulating platelets
Clinical signs: inc. bleeding, petechia, ecchymois |
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Why do we never do jug sticks in a thrombocytopenic patient?
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large hematomas
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What in-house tests can confirm low platelets?
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Platelet count
Buccal Mucosal Bleeding Time |
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What are the tests for clotting times?
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PT/PTT
ACT Coag test All test for clotting factors not platelets |
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What info should you get from a client who's pet has eaten something toxic?
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What
When How much |
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What are some common ways of decontaminating the GI of toxicities?
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Emesis
Gastric lavage Activated charcoal Fluid diuresis and ion trapping |
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What drugs are commonly used for emesis?
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Apomorphine
H202 Xylazine |
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What are the clinical signs of chocolate toxicity?
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Restlessness
Anxiety Vomiting Arrythmias Trembling Seizure Coma Death |
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What are the clinical signs of snail bait toxicity? What is the tx?
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Shake and Bake
Hypersalivation Incoordination Muscle fasiculations Hyperesthesia Tachycardia Seizures Hyperthemia Acidosis Tx: Muscle relaxants, emesis, fluids, valium |
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What are the clinical signs of tylenol toxicity? What is the tx?
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Vomiting
Salivation Facial and paw edema Depression Inc. RR Dyspnea Tx: emesis, charcoal, mucomyst |
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What are the clinical signs of NSAID toxicity? What is the tx?
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V/D
Hematemesis Melena Lethargy Anemia PU/PD Tx: supportive care, IVF, gastric protectants |
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What are the clinical signs of anticoag rodenticides? What is the tx?
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Bleeding into GI, lungs, CNS
Tx: emesis, gastric lavage, vit.K PCV-whole blood, SQ vit.K, coag profiles |
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What is the tx for antifreeze toxicity?
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emesis, charcoal, cathartic
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What are the clinical signs for organophosphate toxicity? What are the tx?
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SLUDE
Tx: atropine is antidote |
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Define Clean wound
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no microorganisms present
sx wound |
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Define clean-contaminated wound
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minor contamination
sx wounds with technique break |
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Define contaminated wound
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Mod. contamination
fresh open fracture |
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Define dirty wound
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Grossly contaminated/infected
Traumatic old wound, foreign material |
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Define abrasion
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superficial break in the surface from blunt trauma...
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Define laceration
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caused by tearing
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Define avulsion
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tearing leads to detachment of tissues from the attachment (jaw skin from mandible)
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Define degloving
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Avulsion wound on limb with extensive skin loss
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What are some factors that could delay wound healing?
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Host: age, malnourished, renal/hepatic compromise, dz
Wound: foreign material, necrotic tissue, infxn, poor blood supply, improper bandaging, location Other: drugs, radiation, NSAIDS |
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Define second intention healing
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wound is allowed to heal without sx closure
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Why use dry to dry bandages?
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for moist wounds with necrotic tissue that will be removed when changing bandage
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Why use wet to dry bandages?
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if dry material or viscous is present
for contaminated wounds |
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Why use non-adherent bandages?
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for repair stages of healing
over granulation tissue no trauma to injury |
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What is the Schirmer Tear Test for?
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Measure tear production
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What is the Fluorescein Stain for?
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find any break in the corneal epithelial
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What is the Tononometry test for?
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Measure intraocular pressure
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How do you treat an uncomplicated corneal ulcer?
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Topical abx
Pain control Atropine NSAIDS E-collar |
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What is cherry eye?
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Prolapse of the gland of the 3rd eyelid- not an emergency
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Why do we not use steroids in an eye where there is ulceration or feline viral conjunctivitis?
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Can lead to infxn which can go deep and cause the eye to pop
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