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86 Cards in this Set

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primary survey
60 seconds
Level of conscousness(AVPU=alert, visual acuity, pain level, unconscious)
ABC
Gross exam-initiate life saving procedures if needed
Attach monitors
Vital signs
HR
Pulse rate, strength
RR
mm color
CRT
Temp
BP
jugular vein distension, fill time
Base line data in emergency/triage
2 lead EKG, PCV/TP, BUN, BG, blood smear
Frequency of monitoring
continually during crisis
every 10-15 min when stable for at least 30 min
decrease to no less than every 4 hrs for 1st 24 hrs
Equipment
ECG-heart
Pulse ox-O@ saturation
Doppler-BP
Urinary cath-output
CVP-CO, blood volume
Therm- temp
IVAC-fluid therapy
Length of time for cephalic catheter to stay in
3 days
ACRASHPLAN
Airway
Circulation-mm CRT pulse temp
Respiratory
Abdomen
Spine
Head
Pelvis
Limbs
Arteries and veins'
Nerves
epiphera
blood around the eye
After primary survey
Vitals, decision for tx
Puncture wound
clip and clean, may enlarge for drainage. Flush. If abcessed may place penrose drain.
Abs, hot pack twice daily
comps= abcess, sloughing, systemic infection
Contusion
Bruise. Painfull
Ice within 2-4 hrs. >12 hrs alternate ice and heat
Look for other injuries
could signal internal injuries, coag problem
Abrasion
Scrape, oozing fluid, painful at first.
Sedate w/ analgesic. Clip, clean, flush. Place KY in wound. apply Ab. Wrap lightly
Comp=pyoderma
Laceration
Rip or tear
Ligate vessels if bleeding. Apply pressure, Protect, control infection, pain mgt
Comp= hemmorage
How are breaks describes
Where on bone- distal or proximal.
Type of fx
Which bone orleg
Open reduction
Surgical repair of broken limb
closed reduction
cast or splint of fx
reduction of fx
putting ends in opposition
Initial tx of fx
Assess for other damage
control bleeding
stabilize wound
sx if indicated
1st degree burn
sunburn- only epidermis.
PAINFUL, red. Heals repidly
cool w/ water
2nd degree burn
superficial involving all layers of dermis. Tan crust, reddened skin. Blisters +/- after several hrs.Painful
Abs. +/- pain meds.
Observe for shock, hypovolemia
3rd degree burn
full thickness- all layers of dermis. May not be painful. Pearly white w/ charred grey edges. Leathery, firm and depressed. Susceptivle to pseudomonis
IV cath, fluids, ABs, cool packs
If >50% may euth
4th degree burn
skin plus SQ fat and muscle
eschar
thick crust - scab caused by burning. Requires multiple debridements
types of burns (not classes)
heat
chemical
electrical
First aid for burns
Ice pack, cold H2O,
chemical- PPE- watch for splashing of chemical
electrical-check mouth, may not be able to eat. Watch for heart arryhthmias
ID of poisonous snakes
triangular head, rattles, raised eyes.
Red and yellow-dangerous fellow.
types of snake venom
Lyses, necrosis-western diamondback
Neurotoxins- green mohave
snake bite symptoms
may take hours
puncture wound, severe pain
edeme, petechiae, ecchymosis, sloughing
hypotension, hypovolemic shock
lethargy, tremors, neuro signs, collapse
snake bite treatment
Keep quiet.
Tx< 30 min inc survival
Constrictor band if peripheral.
Anti-venin
Prevent shock: benadryl, fluids, pain meds, +/- steroids, IV abs
Snake bite tx in order
1. IV pain meds
2. fluids
3. locate bite
4. anti-venin
5. IV Abs
6. clip and clean
7. baseline blood
bee stings
symptoms-nothing--anaphylactic shock
hives, edema
care-benadryl im, O2 if needed
if rx- Epi, steroids, fluid
comp=gagging, trembling-collapse usu w/i 20-30 min
spiders
black widow, violin/brown recluse- bulls-eye lesion. neuro damage. May need to excise
hyperthermia
common- brachycephalic, rabbits
symptoms=panting, salivation, V/D,dry mm, brt red-grey,seizures,coma dehydration.oliguria, anuria
care-ASAP ice packs in towels between legs, on head. when temp 103 stop, rub ice chips on mm, cool IV lines
comp=coma, death, blindness
hypothermia
from external factors,not anesthesia
symptoms-cold skin, extremitites, mm cold, pale. shivering then sluggish
tx-rewarm slowly in swirling warm water 102-105. warm blankets, circulating hot water pad, hair dryer, warm iv fluids
frostbite
usu extremities.
symptoms=pale, red, scaly during warming. painful at first, hurts when warming
tx= heat gently- use own body heat with warm towels. no rubbing, Ab ointments
comp=amputation, sloughing
#1 cause of cardiopulmonary arrest
prescribed drugs or anesthetics
causes of cardiopulmonary arrest
seizures, stress w/ pre-existing condition, loss of fluids/tissue,drugs, anesthesia, old age, airway obstruction, kidney or liver disease
premonitory signs of cardiopulmonary arrest
dark unoxygenated blood, cyanosis, respiration change in rate and effort, dilated pupils, cold clammy skin, tacky mm, fast uneven HR
Team approach for cardiopulmonary arrest
1. Airway mgt
2. Cardo mgt
3. Venous access
4. Monnitoring
5. Drugs
6. Practice drills
7. Evaluation
CPR drugs
Central venous or IT
Fluids-LRS
Atropine-Inc HR
Epi-vasoconstrictor-Inc BP
Lidocaine-antiarrhythmia-for PVC, ventricular tachycardia
Dopram-respiratory stimulant
chemical defibrillation
10% Ca Chloride at 1mEq/Kg/ or 0.2ml/KG
ABCs of CPR
Airway
Breathing
Cardiac
Drugs
Ecg
Follow up
Hypovolemic shock
decreased intravascular volume
causes-blood loss, dehydration, malnourishment, protein losing disease
cardiogenic shock
decreased cardiac output from pump insufficiency
vasogenic shock
bloodflow is poorly distributed
causes-toxicity, anesthetic, organ malfunction, septic shock (pyo)
obstructive shock
physical obstruction
aneuryism, embolism, tumor
shock stage 1
1. compensatory/early= Inc HR, bounding pulse, norm to high BP, mm normal to very pink,CRT<1
shock stage 2
decompensatory/middle and late- pale, cold, slow CRT HR slow, BP decreased. edema, kidney and GI at risk. septicemia can occur
shock stage 3
terminal/irrevversible
heart failure, severe hypotension, pulmonary edema, abnormal breathing
treatment for shock
Airway, oxygen
Rapid IV fluids-60-90ml/Kg for stage 2. Crystalloid or colloids
Corticosteroids-Solu Delta or Dex Na Phos
Vasoactive drugs-dobutamine, dopamine
Monitor
anaphylactic shock tx
shock can be local or systemic
tx for systemic
establish airway, oxygen if needed.
IV LRS
Epi
Corticosteroids-sodium prednisolone succinate IV
Dex Sp IV if only local
Benadryl IV slowly
Recovery within 5-10 minutes is good prognosis
bloat
distention of the stomach caused by food, secretions, gas w/ possible malpositioned stomach.
dx-retching, abd distention,diff breathing
xray, abd percussion
tx=-basic life support
decompression via gastrocentesis'
passing of stomach tube
sx-gastropexy
info needed for poison control hotline
name and spelling of poison, type of product
route, amt of exposure
size, species of animal
how long ago
tx for poison
slow rate of absorption
emesis-hydrogen peroxide-1-2 tsp per 10Kg up to 3 X at 5min intervals.
Apomorphine-6mg tab/6ml saline- 1ml/10Kg IV
Activated charcoal by gavage or nasogastric tube(If powder make slurry of 1 g activated charcoal in 5-10 ml H2O)
Remove toxin from skin and fur
IV fluids, diuresis(mannitol and furosemide), cathartics(sodium sulfate) to increase excretion
antidotes for poisons
warfarin-vitamin K
ethylene glycol-ethanol
tylanol-mocomyst
nursing card/supportive care for toxicity, poisoning
prevent aspiration pneumonia
anticonvulsants
muscle relaxers
treat/prevent shock
keep loud noises down- some poisons and apomorphine cause hypersensitivity
emergency protocol for seizures
1. control seizures'
2. airway
3 check vitals
4. keep head lowered
5 IV cath
6 specific poison tx
7 treat for shock
aminophylline
bronchodilator-feline asthma
dexamethasone
corticosteroid.
anti-inflammatory
treats shock
digoxin
CHF-increases force decreases rate
pharmacology
the science of dealing with the preparation, use and effects of drugs
pharmacotherapeutics
plan of tx which utilizes drugs-
Treatment regimen-Name of drug, route, dose, frequency, duration
Choice made by vet
Vet-client-pet relationship must exist
legend
rx only
pharmacokinetics
sequence of events that occurs from time drug is administered till excretion
drug absorption
Determined by:
1.method of cellular transport- passive active or ionization
2. PH and ionization state of the drug
3. absorptive surface of the site
4. blood supply at the site
5. solubility of the drug
6. formulation of the drug
7. condition of GI tract
drug distribution
process by which drug is carried from site of administration to site of action
Factors effecting drug distribution
1. proteins in plasma may bind/store drug
2. certain tissues (fat) store drug
3. tissue barriers-blood/brain
4. disease
biotransformation
metabolism-bodys ability to transform a drug to a form that can be eliminated
occurs primarily in liver
factors effecting biotransformation
species, age, nutritional status
drug excretion
process by which drug is eliminated- usu kidney
half-life
amt of time it takes to reduce amt of drug in body to 1/2
LD50
the dose of drug lethal to 50% of animals in trial
pharmacodynamics
study by which drugs produce physiological changes in body
1. affinity/attraction
2. efficacy
3.antagonist
4. stimulation, replacement
5.adverse drug reactions
types of topical products
lotion-usu large area
ointment-small local area
cream-more liquid than oint
powder- for drying
aerosols and sprays
parts of rx label
date
owner and pet name
name of drug
strength
number, amt
instructions
vets name/hospital name
exp date
warnings
Optional-initials, childproof, other instructions ie shake
not to mix parenteral IV
acidic with alkaline
vitamins and abs
diff abs
antifungals with anything
steroids and abs
Flush catheter with NaCl between incompatible drugs
Purpose of hormone drugs
to correct a deficiency
to obtain a desired effect
estrogen
female hormone produced in the ovaries
to induce abortion
to treat urinary incontinence in spayed females
spayed ferrets-prevent cystic ovaries
IM. oral-DES
adverse-anemia, bone marrow supression
progestins
similar to progesterone-prolong, maintain repro environment for fetus to plant
Ovaban, Megace-controls estrus, prevent false preg,control male behavior, treat dermatoses
adverse-hyperglycemia, adrenal suppression, endometrial hyperplasia
Depo Medrol-skin, suppress estrus
Androgens
testosterone=rarely used
treats urinary incontinence in un-neutered male dogs. Increases libido
Inj only
Anabolic steroids
produced in adrenal
stimulates appetite
cancer support
Winstrol-V
Pituitary hormones
FSH-stimulates follicle to produce ova
LH-helps thicken endometrium
oxytoxin-expels eggs, fetus
phenobarbital
can be used in cats
dilantin
dogs only-seizure control. draws sodium out of cell
sodium bromide-
seizure control
crystal-mix with water, can be toxic
gabapentin-neurontin
dogs only-anti convulsant
hard on liver,kidney