Fundamentals Test 3 Review

Front 1

10 appointment types

Back 1

1. Scheduled routine appointments

2. Vaccination

3. Post operative checks

4. Rechecks

5. Emergency

6. New puppy/kitten

7. Miscellaneous procedures (nails, anal glands)

8. SPCA health check

9. Euthanasia

10. Discharge appointments

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1. Scheduled routine appointment purpose + time taken

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Check ears for example, but also may see major illness booked as routine. 15-20 minutes.

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Vaccine appointments must include (4)

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1. Head to toe exam

2. History

3. Vaccination

4. Explore any routine health concerns

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Thing that deem vaccine unsafe to perform

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General health (ex fever, questionable mass)

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Vaccine appointments may also include

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Additional services, ie nail trim

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Cost for this appointment type usually included in surgery fee

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Post OP checks

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Post operative checks can include (3)

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1. Suture removal

2. Bandage change

3. Incision check

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This appointment type usually not full exam fee

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Recheck appointments

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Recheck appointments are usually for

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Ongoing medical problems (ie medical treatment for infection not working)

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Recheck appointments are a way for vets

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To look at an animal at predetermined intervals

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Clinics are legally bound to accommodate

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Emergency appointments

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Receptionists role in emergency appointments

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Must know what constitutes emergency and have the ability to recognize patient in distress (cyanosis, seizures, cardiac issues, etc)

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Puppy/kitten appointments are a good time to stress

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Preventative medicine (good weights, dental care, spay/neuter)

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This type of appointment is usually booked as longer

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New puppy/kitten or new client

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Misc/tech appointment consists of things like (

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1. Nail trims

2. Anal glands

3. Tick removal

4. Booster vaccine

5. Recheck/blood collection

6. Explaining/counselling clients on upcoming surgeries

7. Laser treatment

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This type of appointment usually booked by VT (why?)

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Misc/tech appointments. To make vet available for next appointment

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Usually charge for procedure only

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Misc/tech appointment

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With the SPCA, new adoption owners have

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48 hours to have animal examined by vet

Front 19

SPCA health checks are a chance to (4)

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1. Talk to new owner/address concerns

2. Review animals health

3. Make vaccine plans

4. Spay/neuter

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Euthanasia appointments are often booked

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As extended appointments at the end of the day

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What is necessary to go through with a euthanasia appointment

Back 21

A signed consent form

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Some routine appointments can turn into what type

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Euthanasia

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For euthanasia appointments, can the owner be absent?

Back 23

The owner can be present or absent

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Discharge appointments are for

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Clients picking up pet from extended stay/surgery

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Discharge appointments are usually booked anytime there is

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Specific lengthy instructions post-stay

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VT sometimes conducts this appointment type

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Discharge

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Some clinics do what with discharge instructions

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Have client sign a copy, which is kept on file

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It's best to avoid booking a patient that needs

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A work up, for end of day or on saturday (time consuming)

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Appointments are in what time blocks

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15, 2p and 30 minute blocks

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It is important to ensure client knows what, when booking an appointment for them

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Which vet they are booked with (preferences)

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Outpatient

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Animal is only in clinic for appointment or quick treatment/procedure (blood, SQ fluids for chronically ill, etc)

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Inpatient

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Animal admitted to hospital for set or undetermined amount of time (rads, bloodwork, urinalysis vs. Treatment of illness/injury)

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Even a short estimated stay at a clinic requires

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Signed estimate and consent form

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Outpatient traffic flow pathway

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Reception -> exam room -> back to reception. +/- taken to treatment room (blood collection, radiographs, nail trims)

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Why can clients not wander to treatment area? (2)

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1. May see/hear things that upset them

2. Protecting privacy of clients that own animals being worked on

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Clients may be brought out back if

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Their animal is an inpatient and cannot be moved to exam room for visitation

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Steps that must be taken when bringing a client out back (3)

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1. Give staff heads up

2. Clean pet + bedding beforehand

3. Offer client a chair, blanket, pillow

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During consults/exams, it is important to ensure 2 things

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1. Exam room doors are closed

2. Dont discuss delicate subjects in reception/presence of other clients

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Steps to an appointment (7)

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1. Files pulled ahead of time (usually day before)

2. Greet client and pet, introduce self

3. Weight patient + record in file

4. Show clients to exam room, offer to assist with carriers

5. Confirm reason for appointment, ask history, get vitals

6. Prepare TGH meds + explain

7. Book follow up

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What to check before bringing client into exam room (3)

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1. Room is clean and stocked (no smell***)

2. Make sure last appointments supplies are cleaned up

3. Confirm room is empty (knock, peephole)

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Exam room maintenance (general, 3)

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1. Clean all surfaces (end of day + between appointments)

2. Air freshener, sometimes need to remove garbage few times daily

3. Supplies must be replenished (usually at end of day)

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Exam room supplies (just try to get like 10 of them, theres 21)

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1. Stethoscope

2. Paper towel

3. Suture scissors

4. Bandage scissors

5. Hemostats

6. Swabs

7. 2x2 gauze

8. Resource material/models

9. Needles/syringes

10. Thermometer

11. Sterile lubricant

12. Routine eye meds, skin creams, ear cleaner

13. Otoscope + ear tips

14. Opthalmoscope

15. Cotton

16. Bandage material

17. Sample containers

18. Garbage containers

19. Sharps container

20. Cold sterile

21. Scalpel blade

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EOD: Exam room (7)

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1. Should have daily EOD maintenance checklist

2. Full turnover + mop

3. Look for sharps not properly disposed of

4. Garbage + sharps not overflowing

5. Paper towel stocked

6. Otoscope/opthalmoscope ready + charged

7. Clean cold sterile

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The SOAP format is used when

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Seeking + considering cause of illness

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SOAP acronym + vet or VT role

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Subjective — VT/V

Objective — VT/V

Assessment — Vet

Plan — Vet

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This part of SOAP may be performed more frequently as part of complex case if requested by vet

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Morning SOAP

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SOAP — Subjective

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Statement about patient with no numbers/measurements. May be performed by vet or vt. Formatted as S: entry.

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SOAP — Objective

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Objective measurements, which are the same between people, unlike Subjective. Where we can incorporate new diagnostics. Done by vet or vt.

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SOAP — Assessment

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Summary/overall view on case, thoughts on diagnosis and analysis of info. Day to day assessment may evolve and eventually diagnosis may be made. Vet only.

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3 types of diagnosis

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1. Differential (list)

2. Working diagnosis (treating as if it is that, failure narrows down list whereas success confirms)

3. Final diagnosis

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Priority of patient evaluations based on hierarchy of patient needs (9)

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1. Oxygen

2. Critical safety/severe pain (ie electrolyte imbalance)

3. Hydration

4. Elimination

5. Nutrition

6. Non critical safety (infection risk)

7. Chronic pain

8. Activity

9. Utility (anxiety)

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MAOR acronym

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Medication Administration/Order Record

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MAOR contains

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When, by whom and which treatments were completed

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MAOR is also called

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Ward treatment sheet

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When preparing a MOAR

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Must be exactly as vet told you, include full drug name + dosage.

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What must be initialed in a MOAR and by whom

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Each treatment when given, by the person giving it.

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With MOAR, when a treatment is as not per order... (2)

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1. Vet must be notified

2. Write NG for Not Given

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With MAOR, when a dose is ordered for a specific time, you must

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Place an X where medication is not to be given

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With MAOR, if a vet has discontinued a medication

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Write the word "discontinued". Do not erase/whiteout anything.

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With MAOR, if there are treatments not given because patient is discharged

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Leave those spaces blank on the form

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Why is it important to initial entries you make in a medical record, legally?

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In a court of law, handwriting alone may be inadequate in identifying an author

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Hypothyroidism is more common in

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Middle aged dogs of medium to large size + neutered males/females

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Hypothyroidism diagnosis + treatment

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A series of blood tests. Dog takes oral medication daily for the rest of their life (usually levothyroxine)

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Hypothyroidism clinical signs in dogs (8)

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1. Hair loss

2. Thin, dull coat

3. Flaky skin

4. Weight gain

5. Muscle loss

6. Toenail/ear infections

7. Cold intolerance

8. Black patches on skin (sometimes)

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Hypothyroidism clinical signs cats (8)

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1. Weight gain

2. Energy loss

3. Mental dullness

4. Decreased body temp

5. Hair loss

6. Constipation

7. Matting

8. Flaky coat

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Hypothyroidism in cats is usually caused by (3)

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1. Treatment for hypothyroidism

2. Cancer

3. Iodine deficiency

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Glaucoma cause (like what it is literally, not the things that make it happen so much)

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Inadequate drainage of aqueous fluid

Front 68

Glaucoma causes (5)

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1. Uveitis

2. Anterior dislocation of lens

3. Tumors

4. Intraocular bleeding

5. Damage to lens

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Primary glaucoma

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Due to inherited biological abnormalities in the drainage angle. Results in increased IOP in healthy eye

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Secondary glaucoma

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Results in increased IOP due to disease/injury to eye

Front 71

Glaucoma clinical signs (7)

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1. Eye pain

2. Ocular discharge

3. Lethargy/loss of appetite

4. Unresponsiveness

5. Physical swelling/bulging of eyeball

6. Cloudy/bluish cornea

7. Blindness

Front 72

Glaucoma treatment (6)

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1. Reduce IOP

2. Analgesics

3. Medications to decrease fluid production + promote drainage

4. Long term medical therapy

5. Surgery

6. Removal of eye

Front 73

Legg-Calve-Perthes disease is found in dogs

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20 lbs or less

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Legg-Calve-Perthes cause

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Unknown. Some studies suggest it's due to disruption of blood flow to hip possibly due to blood clots in vessel. The bone weakens and fractures develop, leads to arthritis

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Legg-Calve-Perthes affects

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Coxofemoral joint. Avascular or aseptic necrosis of femoral head (spontaneous degeneration) which results in collapse of hip joint and severe arthritis

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Legg-Calve-Perthes Clinical signs (5)

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1. Limping on affected leg for several weeks

2. Leads to no weight on leg

3. Usually only affects one

4. Discomfort in manipulating hip joint

5. Loss of muscle mass

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Legg-Calve-Perthes Diagnosis (+ appearance over time)

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Radiograph. Early stage = femoral head slightly flattened. Leads to moth eaten appearance. Finally head becomes obviously deformed with significant evidence of arthritis.

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Legg-Calve-Perthes Treatment (mild vs severe)

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Mild cases: rest, analgesics and ice pack

Severe cases: surgery to excise affected femur head and neck (FHO — femoral head and neck osteotomy). Physiotherapy