Medical Nursing Ii - Emergency Care

Front 1

What is critical care?

Back 1

Critical care is the care of a patient in an unstable condition.

Front 2

What is triage?

Back 2

Triage is the act of sorting cases according to status.

Front 3

What should be communicated to a distraught owner who calls the clinic with an emergency situation?

Back 3

In an emergency situation, the owner should be counselled to bring in animal immediately, advised that animal may bite if in pain, to not use muzzle if in respiratory distress, to bring in suspected toxins if probable poisoning, or keep cool if heat stroke.

Front 4

What is the most important first step to take upon arrival of an emergency case at the clinic?

Back 4

Upon arrival of an emergency case, the first determination needs to be made as to how and to what level of restraint needs to be accomplished to keep pet, handler, and treatment team safe without overly stressing animal.

Front 5

What are the 8 initial patient assessments performed upon an emergency patient?

Back 5

Patient assessments performed are: mental state, mucous membranes, CRT, palpebral reflex, pupils, heart rate, respiratory rate, and pulse.

Front 6

What are the 7 steps to be initiated immediately if the animal crashes?

Back 6

If an animal crashes, the following steps must be taken: call for help, assess airway,assess rate and condition of breathing or supplement, assess HR and pulse and MM and CRT, administer drugs for resuscitation, monitor on EKG, then handle fractures.

Front 7

What should be assessed in the airway before moving on to the next step of emergency care?

Back 7

The airway should be checked to ensure that it is free of obstructions, then establish a supplemented airway which is usually done using an endotracheal tube.

Front 8

What is done when assessing breathing status?

Back 8

Breathing status must be assessed by rate and condition, then supplemented if breathing is not occurring.

Front 9

How is breathing initially supplemented in an emergency?

Back 9

Breathing is initially supplemented in an emergency with 20 breaths per minute using bagging or anesthesia machine.

Front 10

What is the next step to take if the heart is not beating?

Back 10

If heart is not beating, chest compressions should be initiated at a rate of 80 to 100 compressions per minute.

Front 11

What is the difference in chest compression rate between small and large dogs?

Back 11

Chest compression rate should be higher for small dogs as they have a normally higher heart rate.

Front 12

What is a possible issue if heart beat is normal but pulse is thready?

Back 12

If heart beat is normal but pulse is thready, it could be an indicator of internal bleeding.

Front 13

What is the major reason for administering fluids to an emergency patient?

Back 13

The most important reason for administering fluids to an emergency patient is to keep blood pressure up in order to maintain periphery circulation and avoid damage to tissues.

Front 14

What are 4 body systems that are critical to assess post resuscitation?

Back 14

Post resuscitation assessments are: brain, kidneys, heart, and lungs.

Front 15

What are some of the more frequently seen emergencies?

Back 15

Frequently seen emergencies are: cardiac, shock, seizures, trauma, respiratory, central nervous system, abdominal, musculoskeletal injuries, soft tissue injuries, firm tissue injuries, ear, ocular, and poisonings.

Front 16

What are 5 steps to take to ensure preparedness for cardiac emergencies?

Back 16

Preparedness for cardiac emergencies includes: maintaining crash cart, maintaining adequate and maintained supplies, ability to administer external cardiac massage, ability to read and record EKG monitor, and team practice drills for efficiency.

Front 17

How soon does irreversible brain damage occur after cardiac arrest?

Back 17

Irreversible brain damage occurs 3.5 to 4 minutes after cardiac arrest.

Front 18

What are the characteristics of acute congestive heart failure?

Back 18

Acute congestive heart failure is sudden in onset in which heart is not pumping enough blood to supply body with enough oxygen.

Front 19

What is the treatment for acute congestive heart failure?

Back 19

Treatment for ACHF is use of oxygen cage to help supplement low levels and drug support, keeping in mind that intubation should not be performed because it requires sedation which would further reduce heart rate.

Front 20

What are two critical factors in providing the best chance of recovery from shock?

Back 20

To help an animal recover from shock, it is vital that it is carefully monitored and provided fluid therapy.

Front 21

What are 2 common types of shock?

Back 21

Two common types of shock are hypovolemic and anaphylactic.

Front 22

What is hypovolemic shock?

Back 22

Hypovolemic shock results in low blood pressure caused by low blood volume, and is associated with traumas but not main reason for presentation of case.

Front 23

What is anaphylactic shock?

Back 23

Anaphylactic shock results from a sever hypersensitivity, and due to the amount of cardiac and respiratory distress it causes to animal, death can occur rapidly.

Front 24

What are the characteristics of seizures?

Back 24

Seizures are a disturbance of brain function causing convulsions which are acute and spontaneous in nature, and they must be diagnosed correctly before any treatment can commence.

Front 25

What is trauma?

Back 25

Trauma is a physical injury caused by extreme force or violence, in which it is important to treat life threatening occurrences first and then secondary issues.

Front 26

What are typical traumas seen?

Back 26

Typical traumas are hit-by-car, dog fights, gunshots, and knife wounds.

Front 27

What are 3 common respiratory emergencies?

Back 27

Common respiratory emergencies are pneumothorax, hemothorax, diaphragmatic hernia, and flail chest.

Front 28

What does "pneumo" mean?

Back 28

"Pneumo" means air or lungs.

Front 29

What is a pneumothorax?

Back 29

Pneumothorax is air in chest cavity typically caused by trauma to chest, and the air in chest inhibits the expansion and contraction of lungs and heart.

Front 30

What is the treatment for pneumothorax?

Back 30

To provide normal negative pressure in thorax so that lungs and heart can expand and contract normally, a barrier or closure must be made over hole in chest.

Front 31

What does "hemo" mean?

Back 31

"Hemo" means blood.

Front 32

What is a hemothorax?

Back 32

Hemothorax is blood in chest.

Front 33

What is the immediate treatment for hemothorax?

Back 33

The first concern in treating hemothorax is to determine where blood is occurring, then to stop bleeding, removing excess blood, followed by fluid therapy.

Front 34

What is a flail chest?

Back 34

A flail chest injury caused by a broken rib, most of which are internal, and exhalation and inhalation causes intense pain.

Front 35

What is a diaphragmatic hernia?

Back 35

A diaphragmatic hernia is a protrusion of abdominal viscera through diaphragm usually caused by trauma that creates a hole in the diaphragm.

Front 36

What is the treatment for a diaphragmatic hernia?

Back 36

Treatment for a diaphragmatic hernia requires surgery, as well as breathing support, along with elevation of head to alleviate pressure on organs and chest.

Front 37

What are 3 common central nervous system emergencies?

Back 37

Common central nervous system emergencies are brain trauma, spinal cord injury, and peripheral nervous injuries.

Front 38

What is a common cause of brain trauma?

Back 38

Brain trauma is common in HBC occurrences or if animal is hit with extreme blunt froce to head.

Front 39

What are the clinical signs for brain trauma?

Back 39

Clinical signs for brain trauma vary from unconsciousness to coma or depression to seizures, delayed responses, and extremely dilated pupils.

Front 40

What are the common causes of spinal cord injury?

Back 40

Spinal cord injuries are usually associated with rupture of disks, fractures, or dislocations, and are more prevalent in long-bodied short-legged animals.

Front 41

How should an animal with spinal cord injury be transported?

Back 41

An animal with spinal cord injury should be transported on a board or blanket, or picked up with one arm under chest and one arm under rump while trying to keep spine in alignment.

Front 42

What are characteristics of peripheral nervous injuries?

Back 42

Peripheral nervous injuries result in loss of movement which causes atrophy of muscles.

Front 43

What is an important part of nursing care for central nervous system patients?

Back 43

It is important to reposition animals with central nervous system issues because of their lack of mobility which can cause decubital ulcers.

Front 44

What are the characteristics of abdominal emergencies?

Back 44

Many times patients will show no signs with abdominal emergencies and must be diagnosed by using bloodwork to check for problems, or by observing blood in urine for urinary traumas.

Front 45

What are the 2 types of musculoskeletal injuries?

Back 45

Two types of musculoskeletal injuries are soft tissue or firm tissue.

Front 46

What are the 5 terms used to classify soft tissue injuries?

Back 46

Soft tissue injuries are described as being open, closed, abrasions, punctures, or lacerations.

Front 47

What is a closed soft tissue injury?

Back 47

A closed soft tissue injury has no break in skin but is severe enough in impact to cause extensive bruising.

Front 48

What is the outcome for untreated closed soft tissue injuries?

Back 48

If supportive care is not provided adequately for closed soft tissue injuries, it can result in necrosis and sloughing of tissues due to damage of cell membranes.

Front 49

What is an abrasion?

Back 49

An abrasion, also called "road rash" is an injury where typically the first few layers of skin have been scraped off.

Front 50

What is a puncture injury?

Back 50

A puncture injury is caused by an object sharp enough to penetrate skin.

Front 51

How are lacerations different than punctures?

Back 51

Lacerations are different than punctures as they cause deeper damage to tissues, muscles, and arteries.

Front 52

How are lacerations classified?

Back 52

Lacerations are classified by cleanliness.

Front 53

What is a clean wound laceration?

Back 53

A clean wound laceration is an opening created surgically.

Front 54

What is a contaminated wound laceration?

Back 54

A contaminated wound laceration is one in which bacterial growth is in place.

Front 55

What is a clean/contaminated wound laceration?

Back 55

A clean/contaminated wound laceration is one which was contaminated and then surgically cleaned up.

Front 56

What is debridement?

Back 56

Debridement is to surgically clean up a wound.

Front 57

What is a dirty laceration?

Back 57

A dirty laceration is infected.

Front 58

What is the basic treatment of a laceration?

Back 58

Basic treatment of a laceration starts with the hair being clipped from wound site, area cleaned, wound lavaged with sterile saline, and then application of bandages.

Front 59

What is the most common firm tissue injury?

Back 59

The most common firm tissue injury involve bones.

Front 60

What is an important factor in treating firm tissue injuries?

Back 60

An important factor in treating firm tissue injuries is to immobilize joint above and below fracture site.

Front 61

What is the most common reason for ear emergencies?

Back 61

The most common reason for ear emergencies is foreign bodies.

Front 62

What is one of the most common foreign bodies in ear emergencies?

Back 62

The most common foreign body in ear emergencies is the grassawn.

Front 63

What is the outcome if a grassawn is not removed?

Back 63

If not remedied, a grassawn will work thru drum into middle ear, which causes pressure on tissues around it resulting in inflammation and eventual necrosis.

Front 64

What is a critical factor in treatment of ocular emergencies?

Back 64

Ocular emergencies need to be treated within an hour to reduce extensive damage resulting in loss of vision.

Front 65

What are the 2 most common ocular emergencies?

Back 65

The most common ocular emergencies are due to foreign bodies or proptosis.

Front 66

What is proptosis?

Back 66

Proptosis is a condition in which the eyeball pops out of the socket, which is common in brachycephalic breeds.

Front 67

What are 5 keys to communicating with a client about an emergency arising from a suspected poisoning?

Back 67

Clients should be instructed to bring in suspected ingested or contacted substance or container, try to determine type and amount of toxin, induce vomiting if not caustic, bathe with mild detergent for dermal isues, and bring animal in as soon as possible.

Front 68

What are the 3 main steps to properly evaluating a patient presenting with suspected poisoning?

Back 68

Evaluation of a patient with suspected poisoning starts with evaluation of patient, followed by physical exam, and then toxin elimination.

Front 69

What are the 5 most immediate questions to ask about patient history in a poison case?

Back 69

The history to be obtained from a patient with suspected poisoning includes determining possible poisons, rate of onset, duration of signs, progression of symptoms, and status of eliminations.

Front 70

What are the 5 steps of a physical exam for a poison case?

Back 70

The physical exam that should be performed initially on a poison case should be assessment of appearance, TPR, skin exam, oral odor, and abdominal palpation.

Front 71

How should skin be treated that has been in contact with a toxin?

Back 71

Skin contact with a toxin should be washed with a mild detergent within 20 to 30 minutes of contact, preferrably shaved to remove hair retaining toxins and to provide for easier monitoring.

Front 72

What are 5 drugs used as emetics?

Back 72

Drugs used as emetics are apomorphine, xylazine, 3% hydrogen peroxide, table salt, and syrup of ipecac.

Front 73

What is the dosage of hydrogen peroxide to use as an emetic in poison cases?

Back 73

Dosage in poison cases is 1 teaspoon per 10 pounds of body weight using hydrogen peroxide.

Front 74

What are supplies needed for gastric lavage?

Back 74

Gastric lavage supplies include endotracheal tube, gauze, gastric tube, lubricant, warm water, funnel, mild suctioning device, dosing syringe, and an absorbent.

Front 75

What are 3 absorbents used for gastric lavage?

Back 75

Absorbents used for gastric lavage are activated charcoal, mineral oil, and antidotes.

Front 76

Which antidote is used to treat organophosphates?

Back 76

Organophosphates or insecticides are treated with atropine.

Front 77

What antidote is used to treat ethylene glycol poisoning?

Back 77

Ethanol is used to treat antifreeze or ethylene glycol poisoning.

Front 78

What antidote is used to treat lead poisoning?

Back 78

Pencillamine and EDTA are used to treat lead poisoning.

Front 79

What antidote is used to treat acetaminophen toxicity?

Back 79

Acetylcysteine and methylene blue are used to treat acetaminopen toxicity.

Front 80

What antidote is used to treat poisoning from rodenticides?

Back 80

Vitamin K is used as an antidote for rodenticide poisonings.

Front 81

What antidote is used to treat heavy metal poisoning?

Back 81

Penicillamine is used to treat heavy metal poisoning.

Front 82

What are some of the supplies and equipment needed for a gastric lavage?

Back 82

Equipment needed for a gastric lavage includes: endotracheal tube, gauze, gastric tubes, funnel, absorbent, suctioning device, and dosing syringe.

Front 83

What are 3 rodenticides?

Back 83

Rodenticides are strychnine, warfarin, and thallium.

Front 84

What are the clinical signs of strychnine poisoning?

Back 84

Clinical signs of strychnine poisoning are blue-green grains in vomit, seizure within minutes of ingestion, nervous and tense behavior, muscle stiffness, and sensitivity to noise.

Front 85

What are the clinical signs of warfarin poisoning?

Back 85

Clinical signs of warfarin poisoning are paleness, weakness, coughing, and hemorrhaging from ears, nose, or anus.

Front 86

What are the clinical signs of thallium poisoning?

Back 86

Clinical signs of thallium poisoning are vomiting, diarrhea, anorexia, hypersalivation, and abdominal pain.

Front 87

What are 3 insecticides most commonly seen in poisonings?

Back 87

Insecticides most commonly seen in poisonings are organophophates, pyrethrins, and d-limonene.

Front 88

What are the typical sources for organophosphate poisonings?

Back 88

Organophophate poisonings usually result from contact with flea powders, bug sprays, and dips.

Front 89

What are the clinical signs of organophosphate poisoning?

Back 89

Clinical signs of organophosphate poisoning are salivation, constricted pupils, muscle tremors, vomiting, and diarrhea, with further progression resulting in coma and death.

Front 90

What is a common source for pyrethrins?

Back 90

Pyrethrins are organic, most commonly coming from chrysanthemums.

Front 91

What are the clinical signs of d-limonene poisoning?

Back 91

Clinical signs of d-limonene poisoning include seizures and coma.

Front 92

What are 3 heavy metal types of poisonings?

Back 92

Heavy metal poisonings include arsenic, lead, and molluscides.

Front 93

What are the common sources for arsenic poisonings?

Back 93

Arsenic is typically found in ant, roach, and weed killers.

Front 94

What are the clinical signs for arsenic poisoning?

Back 94

Clinical signs for arsenic poisoning include vomiting and diarrhea, along with dehydration and pronounced restlessness.

Front 95

What is the common source for molluscide poisonings?

Back 95

Molluscides are found in snail and slug bait.

Front 96

What are the clinical signs for molluscide poisonings?

Back 96

Clinical signs for molluscides are incoordination, muscle tremors, salivation, anxiety, seizures, and diarrhea.

Front 97

What are 4 types of plant poisonings?

Back 97

Types of plant poisonings include cyanide, nitrates, oxalates, and glycosides.

Front 98

What are common sources for cyanide plant poisonings?

Back 98

Cyanide plant poisonings result from ingestion of hydrangea, and cherry, apricot, and peach pits.

Front 99

What are common plant sources for nitrate poisoning?

Back 99

Plant sources that result in nitrate poisoning are nightshade, jimson weed, sweet clover, and pigweed.

Front 100

What are common plant sources for oxalate poisonings?

Back 100

Oxalates are found in rhubarb leaves, calla lilies, easter lilies, and beet greens.

Front 101

What are common plant sources for glycoside poisoning?

Back 101

Glycosides are found in foxglove and oleander.

Front 102

What are clinical signs for methylxanthine poisonings?

Back 102

Clinical signs for methylxanthines are seizures and muscle tremors.

Front 103

What are 5 types of miscellaneous poisonings?

Back 103

Miscellaneous poisons include snake bites, acetylsalicylic, ethylene glycol, acetaminopen, and phenolic compound.

Front 104

What are clinical signs for a snake bites?

Back 104

Snake bites are typically found on face or appendages, and observed with puncture marks, associated pain in area, edema, redness, swelling, vomiting, diarrhea, rapid heartrate, wide pupils, seizures, disorientation, and weakness.

Front 105

What are the clinical signs of ethylene glycol poisoning?

Back 105

Ethylene glycol poisoning causes depression, darrhea, vomiting, colic, and kidney failure, and will result in high levels of blood and protein in urine.

Front 106

What is the most common clinical sign of acetaminophen poisoning?

Back 106

The most common clinical sign of acetaminophen poisoning is brown mucous membranes.

Front 107

Where are phenolic compounds most commonly found?

Back 107

Phenolic compounds are most commonly found in wood preservatives and household disinfectants.