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Veterinary NursingIV
Lecture Review Questions: Neuro
| Question | Answer |
|---|---|
| Signs of Respiratory Distress Animals will assume posture to maximize airway size. Name five postural changes you might see in an animal in respiratory distress. | Flared nostrils. Open-mouth breathing (lips pulled back). Extended neck. Elbows away from the body. Refusal to lay down. |
| Signs of Respiratory Distress True or false: you may also see an animal with muddy or dusky mucous membranes, noisy breathing, or signs of distress such as dilated pupils, tachycardia, tachypnea, or dyspnea. | True |
| Evaluation of Respiratory Health Name six common test for evaluation. | RR/MM and effort. Pulse oximetry. Blood gas analysis. Radiographs. Culture. Cytology. |
| Evaluation of Respiratory Health Name three less common tests. | Bronchoscopy. Ultrasound. Biopsy. |
| Oxygen Therapy Name 4-7 techniques. | Face mask. Nasal catheter. "Flow-by." Oxygen tent. Oxygen cage. Endotracheal or tracheostomy tube. Ventilator. |
| Upper Airway Obstruction What are four clinical signs? | 1. Noisy breathing in throat, coughing, gagging, retching. 2. Extended head posture, slow deep breathing. 3. Hypersalivation. 4. Possible weakness and cyanosis. |
| Upper Airway Obstruction Describe possible etiologies. | Anything in the airway from the larynx to the bronchus: foreign object or tumor. Swelling due to: trauma, anaphylaxis, laryngeal paralysis, collapsing trachea, Brachycephalic Syndrome. |
| Upper Airway Obstruction Describe supportive care. | Keep animal calm, cool, and resting. Oxygen. |
| Tracheostomy Describe three indications. | Upper airway obstruction: Emergency airway access, short term therapy, ventilation on away animal. |
| Tracheostomy Tubes Describe some characteristics of these tubes. | Different sizes. With or without cuff. With or without inner cannula (inner cannula facilitates cleaning). |
| Tracheostomy Name four pieces of equipment needed for this procedure. Positioning of animal for procedure? Prep for procedure? | Surgical prep of ventral neck. Dorsal recumbency. Local or general anesthesia. Small sx pack. Nylon sutures. Tracheostomy tube. |
| Tracheostomy Care Tube cleaning: inner cannula, clean with ____ every __ to __ hours. | Chlorhexidine. Every 2 - 6 hours. |
| Tracheostomy Care True or false: dried exudate obstruction tube is a concern. | True. Maintaining patient and airway humidity is important. Careful respiratory watch. Always keep extra sterile tube near patient for emergency. When in doubt, pull the entire unit out. |
| Tracheostomy Care ___ can occur very near tube with saline to moisten airways. | Nebulization |
| Tracheostomy Care Sterile ___ (dose chosen by DVM) can be directly infused into trachea and immediately suctioned out (aseptic technique). | saline |
| Tracheostomy Care True or false: drugs can be given to patient to encourage fluid airway secretions (mucolytics). | True |
| Suctioning Airways Always needs aseptic technique. Use sterile ___ and ___. | Sterile catheter and gloves. |
| Suctioning Airways Before proceeding be sure to ___ patient for five minutes. Procedure should be atraumatic. | Pre-oxygenate |
| Suctioning Airways True or false: remember the animal can not ventilate if you are removing all the air from the airway. | True. Be rapid and efficient. |
| Feline Asthma What are three clinical signs? | Acute labored breathing. Chronic cough and possible wheeze. Exercise intolerance. May be life threatening. |
| Feline Asthma Describe etiology of this condition. | Allergies or irritants cause severe airway inflammation and narrowing. |
| Feline Asthma Describe four supportive care techniques. | Emergency oxygen. Medications: chronic bronchodilators, antibiotics, corticosteriods. Air purifiers. Minimal handling/stress. |
| Inhaled Therapy: MDI What is it? Hold mask snugly to face for __ to __ breaths or __ seconds for a cat. Immediately give a treat. Be sure to wash equipment with soap and water several times per week and dry thoroughly. | Metered Dose Inhaler. 7-10 breaths. 20 seconds. |
| Pleural Effusion What are four possible clinical signs? | Shallow, rapid breathing with exaggerated abdominal movements. Cough. Fever. Chest pain. |
| Pleural Effusion How can it be diagnosed? (3) | Imaging: radiographs, ultrasound. Thoracocentesis. |
| Pleural Effusion Name four essential supportive care techniques. | Minimize stress. Provide oxygen. Remove pleural fluid ASAP. Treat primary disease. |
| Thoracocentesis True or false: place needle into pleural space to remove air or fluid (diagnostic and therapeutic). Always a sterile procedure. First draw samples evaluated by culture and cytology. | True. Volume of air or fluid collected on each side needs to be measured and carefully recorded. |
| Conditions Requiring Chest Drainage: Pneumothorax True or false: occurs when there is an opening on surface of lung or in airways, in chest wall or both. The opening allows air to enter the pleural space between the pleurae, creating an actual space. | True |
| Conditions Requiring Chest Drainage Air between the pleurae is a ___. | pneumothorax |
| Conditions Requiring Chest Drainage: Hemothorax True or false: it occurs after thoracic surgery and many traumatic injuries. The negative pressure between the pleurae is disrupted and the lung will collapse to some degree depending on amount of blood. | True |
| Conditions Requiring Chest Drainage Blood in the pleural space is called ____. | hemothorax |
| Conditions Requiring Chest Drainage: Pleural Effusion This occurs when fluid is in the pleural space. ___ is a clear fluid that collects in the pleural space when there are fluid shifts in the body: CHF, malnutrition, renal, and liver failure. | Transudate |
| Conditions Requiring Chest Drainage: Pleural Effusion This occurs when fluid is in the pleural space. ___ is a cloudy fluid with cells and proteins that collects when the pleurae are affected by malignancy or diseases such as tuberculosis and pneumonia. | Exudate |
| Conditions Requiring Chest Drainage: Pleural Effusion ___ or ___ in the pleural space is a pleural effusion. | Transudate or exudate |
| ___ ___ is a general term to describe an abnormal accumulation of fluid in the pleural space. It is important as a sign of the primary disease and because large amounts will impair the ability to ventilate. | Pleural effusion |
| There are multiple types of pleural effusion. ___ appears opaque, tan to yellow. | Purulent |
| There are multiple types of pleural effusion. ___ appears opaque, white to pink. | Chylous |
| There are multiple types of pleural effusion. ___ appears clear. | Transudate |
| There are multiple types of pleural effusion. ___ appears red to red-brown. | Hemorrhagic |
| Chest Tube Indications? | Patient needs multiple or continuous evacuation of pleural space for air or fluid. |
| Chest Tube Name five to nine pieces of equipment needed to perform placement. | Surgical prep of lateral thoracic wall (lateral recumbency). Lidocaine local +/- general anesthesia. Chest tube or red rubber tube (fenestrated). Small sx pack. Clamps (preferably plastic). 3-way stopcock. Suture material. Antibiotic ointment. Bandages. |
| Pneumonia How is it diagnosed (2)? | Radiographs. Transtracheal wash (cytology & culture). |
| Pneumonia What are four supportive care techniques? | Treating primary disease. Maintain hydration. Nebulize. Coupage. |
| Pneumonia True or false: it is best treated by encouraging the productive cough. The lungs way of cleaning themselves. | True |
| Pneumonia ___ means to expose animal to ultra fine water droplets to moisten small airways (humidifier is not as effective, water droplets are too large and land in nose. | Nebulize |
| Pneumonia ___ is a technique in which the technician slaps the thorax with cupped hands over consolidated lung to encourage coughing and loosen debris. It is usually performed for 5-10 minutes after 10-15 minutes of nebulization. | Coupage |
| Respiratory System What is the primary function? | To bring O2 into the body and CO2 out of it. It works in conjunction with the cardiovascular system. |
| Respiratory System What are four secondary functions? | Phonation (voice production). Regulation of body temperature. Regulation of acid-base balance. Sense of smell. |
| Alveolar Gas Exchange Simple ___ of gas molecules according to concentration gradient. | diffusion. O2 diffuses from the alveolar air into the blood of the alveolar capillary. CO2 diffuses from the blood into the alveolus. |
| What is partial pressure of gases? | Pressure of each individual gas in a mixture of gases. |
| True or false: partial pressure of O2 and CO2 in the blood of alveolar capillaries is determined by the partial pressure of O2 and CO2 in alveolar air. | True |
| Respiratory Center Area located in the ___ ___. | brain stem |
| Respiratory Center True or false: it controls respiratory muscle contractions. Directs timing and strength of contractions. | True |
| Respiratory Center Name the individual centers (3). | Inspiration. Expiration. Breath holding. |
| Respiratory Center True or false: it can be controlled for brief periods. | True |
| Chemical Control System True or false: it adjusts the normal rhythmic breathing pattern produced by the mechanical control system of the brain. | True |
| Chemical Control System Chemical receptors in the ___ and ___ monitor blood CO2, pH, and O2. | carotid artery. aorta. |
| Chemical Control System What do you call a decrease in blood O2 level. | Hypoxia |
| Chemical Control System True or false: severe hypoxia causes neurons of the respiratory center to become so depressed that adequate nerve impulses cannot be sent to the respiratory muscles. | True. It can cause breathing to decrease or stop completely. |
| Chemical Control System True or false: slight hypoxia triggers respiratory center to increase the rate and depth of breathing. | True |
| Blood pH True or false: pH quantifies the amount of H+ available. | True |
| Blood pH True or false: it is an inverse logarithmic scale. pH of 7 has 10x more H+ available than pH of 8. | True |
| Blood pH True or false: the body tightly regulates blood pH at all times. | True |
| Blood pH Normal values for dogs and cats are: | 7.30 -7.45 (remember 7.4) |
| Blood pH Name three ways that blood pH is regulated in the body. | Serum buffers. Kidneys. Lungs. |
| Blood pH Daily maintenance of blood pH is regulated by the: | Serum buffers |
| Blood pH It is regulated over days (large adjustments) by the: | Kidneys |
| Blood pH It is regulated by the minute (smaller adjustment) by the: | Lungs |
| Blood pH Name two Serum Buffers that help regulate daily values. | HCO3 and Lactate |
| Blood pH True or false: Buffers can either accept or donate H+. | True |
| pH and CO2 CO2 and H2O are by-products of metabolism and therefore must be exhaled off continuously to prevent acid accumulation in the body. Similarly, the ___ excrete large amounts of H+ each day. | kidneys. |
| Acid Base Balance The body produces acids daily. The ___ and ___ attempt to maintain balance. | lungs and kidneys |
| Chemical Control System True or false: Blood level of CO2 and blood pH are usually linked. | True |
| Chemical Control System ___ CO2 in the blood and ___ blood pH triggers respiratory center to increase rate and depth of respiration. | Increased. Decreased. |
| Chemical Control System ___ CO2 in the blood increases blood pH; ___ blood pH level triggers respiratory center to decrease rate and depth of respiration. | Decreased. Increased. |
| Lung Disease True or false: may cause poor oxygen exchange (hypoxia), and poor CO2 exchange which leads to build up of CO2 (respiratory acidosis). | True |
| Pneumonia True or false: fluid and cells affect diffusion resulting in impaired O2 uptake. | True |
| Hyperventilation CO2 is aggressively exhaled resulting in: | respiratory alkalosis |
| Metabolic Disease Excess acid and CO2 produced from disease is a common problem. Name three diseases or conditions that can cause this. | Diabetes mellitus. Liver failure. Muscle trauma. |
| Metabolic Disease What two reasons can explain failure of the body to excrete acid H+? What condition results? | Kidney failure. Dehydration. Metabolic acidosis. |
| Metabolic Disease Excretion of too much acid can be caused by what? What condition results? | Upper GI obstruction causing vomiting of stomach acid only. Metabolic alkalosis. |
| pH Compensation True or false: Blood pH is so important that if part of the system fails, all other parts will attempt to compensate (over compensation never occurs). | True. If a patient has severe metabolic acidosis, respiratory rate will elevate in an attempt to breathe off excess CO2 irregardless of patient oxygen status. |
| pH Compensation If ventilating a patient during anesthesia results in driving the CO2 levels low, the patient will not try to breath in order to conserve CO2. | True |
| Pulse Oximetry "Pulse Ox" True or false: it works by measuring % saturation of hemoglobin with oxygen. The probe is placed over a superficial artery and light of a specific wavelength is passed through the skin. | True. Hemoglobin saturated with oxygen absorbs light differently than unsaturated Hgb. |
| Pulse Oximetry "Pulse Ox" Log scale: Normal values for animals is? What % means severe hypoxia? | Normal: 98 - 100%. Severe hypoxia: 90%. |
| Pulse Oximetry "Pulse Ox" Name four common veterinary sites. | Ear. Tongue. Toe web. Prepuce/Vulva. |
| Pulse Oximetry "Pulse Ox" Name three to six reasons that the probe may not work or be accurate. | Dirty or damaged probe. Poor skin contact. Thick tissue. Low blood pressure. Shivering. Bright overhead light. |
| Capnography True or false: A capnograph measures exhaled CO2 levels when attached to the end of an endotracheal tube. | True. End-tidal CO2 or Capnogram. |
| Capnography What are normal values? | 35 - 40 mm Hg. |
| Capnography True or false: if End-tidal CO2 is high, the patient is not ventilating frequently enough and assistance is required. | True |
| Capnography True or false: if End-tidal CO2 is too low, the patient may not breath spontaneously. | True |
| Blood Gas Analysis How does it work? | Blood is collected from the patient (arterial blood is best) in a manner that does not contaminate sample with room air. Blood is immediately placed in a blood gas analyzer. It measures blood pH, pCO2, and pO2. Evaluates gas exchange in lungs. |
| Blood Gas Analysis What are five reasons a DVM may order a blood gas? | Aids in establishing a diagnosis. Helps guide treatment plan. Aids in ventilator management. Improvement in acid/base management allows for optimal function of medication. Acid/base status may alter electrolyte levels critical to patient status/care. |
| Arterial Blood Gas: Collection What equipment is needed? | 3 mL heparinized syringe. 25 g needle. Blood gas analyzer. |
| Arterial Blood Gas: Collection What are two ways of acquiring heparinized syringes? | Commercially prepared or "rinse" syringe with 1000 u/ml Heparin. |
| Arterial Blood Gas: Collection How is the procedure performed? | Palpate pulse with two fingers on non-dominant hand. "Dart" artery between two fingers. Syringe will self-fill with pulse. Empty bubbles and occlude needle. Hold off artery for 5 minutes (hematoma risk). Immediately run sample. |
| Cardiovascular Disease What are seven clinical signs of cardiovascular disease? | Exercise intolerance or weakness. Tachypnea or Dyspnea. Coughing. Syncope (fainting). Abnormal heart rate and rhythm. Abnormal pulse quality or pulse deficit. Prolonged Capillary Refill Time (CRT). Ascites or pleural effusion. |
| Cardiovascular Disease ___ ___ is a non-specific term referring to any heart disease that leads to very significant "heart pump" insufficiency and compensatory mechanisms of the body cause fluid to accumulate in the tissues. | heart failure |
| Cardiovascular Disease Free fluid accumulates in the pleural and/or abdominal cavity in ___ side heart failure. | right sided heart failure |
| Cardiovascular Disease Fluid accumulates in the lung in ___ sided heart failure. | left sided heart failure |
| Cardiovascular Disease True or false: cats tend to suffer from right sided heart failure. | True (Ascites or Pleural effusion) |
| True or false: dogs tend to suffer from left sided heart failure. | True (pulmonary edema) |
| Cardiovascular Disease When we are administering emergency care of the heart, what are the three immediate nursing care needs of the patient? | Restore oxygenation/ventilation. Restore perfusion. Minimize stress. |
| Emergency Care of the Heart: Dogs What are three ways of administering oxygen therapy under low stress? | Cage. Tent or Hood. Flow-by |
| Emergency Care of the Heart: Dogs ___ (IV or IM) is a diuretic used to treat pulmonary edema. | Furosemide |
| Emergency Care of the Heart: Dogs ___ ointment on the pinna is a vasodilator used to treat pulmonary edema. | Nitroglycerin |
| Emergency Care of the Heart: Dogs True of false: a patient may need to rest and wait for these drugs to work (1-2 hours) before any further evaluation or care is possible. | True |
| Emergency Care of the Heart: Dogs What radiograph is the most safe and effect in these situations? | DV without stretching. May be the only view initially available due to unstable status. |
| Emergency Care of the Heart: Dogs As a patient improves over the first few hours our goals should be to get what five things done? | IV catheter for drugs and emergency use. Pulse ox. ECG. Blood evaluation. Complete set of radiographs. |
| Emergency Care of the Heart: Dogs What four therapies might a patient in this situation receive in the first few days? | Oxygen. Furosemide. Digoxin if there is cardiomyopathy present. Low salt diet. |
| Emergency Care of the Heart: Dogs Other than radiographs, what is a great diagnostic tool available to evaluate the heart? | Echocardiogram (ultrasound) |
| Cardiomyopathy ___ ___ (DCM) is a hereditary disease of dogs. Breeds frequently affected are: Dobermans, Boxers, Cocker Spaniels, St. Bernards. | Dilated Cardiomyopathy |
| Cardiomyopathy Describe three pathology features of Dilated Cardiomyopathy. | Heart muscle becomes thin and flabby. Heart chambers enlarge to compensate. Heart arrhythmias are common. |
| Valve Dysfunction What disease would you suspect if pathology included: nodular thickening of the heart valve causing leaking of the valve during systole and increased work load on the left atrium and the potential for heart failure? | Mitral Valve Insufficiency |
| Valve Dysfunction What are three parameters that might lead to a Mitral Valve Insufficiency diagnosis? (3) | Systolic heart murmur. Cough, especially at night or with exercise. Radiographs/Ultrasound showing left atrial enlargement with or without heart failure (pulmonary edema). |
| What is Cardiac Tamponade? | Pericardium fills with blood (often due to a bleeding tumor). Pressure prevents the right atrium from filling normally. |
| How is Cardiac Tamponade diagnosed? | EKG. Radiographs. Ultrasound of heart |
| What are three treatment options for Cardiac Tamponade? | Emergency Pericardiocentesis. IV fluids to restore preload pressure. May need surgery if the problem keeps occurring. |
| A ___ involves a large catheter being inserted in the pericardium from the right side to remove pericardial fluid and absolute aseptic technique is required. | Pericardiocentesis |
| True or false: when administering a pericardiocentesis, all samples collected should be submitted for cytology to evaluate for cause. | True |
| True or false: Ideally, when performing a pericardiocentesis, an animal is on continuous ECG during the procedure. If the needle touches the heart, arrhythmias usually occur. | True |
| Periocardiocentesis What 10 pieces of equipment are needed to perform a pericardiocentesis/ | Surgical scrub prep. 14 g over-the-needle 8" catheter. 3-way stopcock. Syringe (35 cc). 2% lidocaine. Sterile gloves. Purple and red top vacutainers. Collection bowl. ECG. Ultrasound. |
| Emergency Care of the Heart: Cats Dyspnea due to feline heart disease is usually associated with ____. | pleural effusion/pulmonary edema |
| Emergency Care of the Heart: Cats What are three treatment options for cats suffering from pleural effusion due to heart disease? | Emergency thoracocentesis. Oxygen support. Minimize stress. |
| Thoracocentesis What are six pieces of equipment needed for this procedure? | Surgical scrub prep. 21 g butterfly needle with a 3-way stopcock. Syringe (6cc-35cc) small volume in chest should be collected with low pressure (6 cc). 2% lidocaine (9:1) with sodium bicarbonate. Sterile gloves. Purple and red top vacutainers. |
| Cardiomyopathy True or false: Hypertrophic cardiomyopathy (HCM) is a hereditary disease of cats such as Persians, Maine Coons, and Norwegian Forest Cats. | True |
| Cardiomyopathy Besides hereditary disease, what is another common cause of Hypertrophic Cardiomyopathy (HCM) in cats? | Hyperthyroidism. Reversible if hyperthyroidism is successfully treated. |
| Cardiomyopathy Pathology: ___ heart muscle with very ___ chamber size. | thickened. small. |
| Cardiomyopathy True or false: thromboembolism to caudal aorta, in cats with hypertrophic cardiomyopathy, is a possible fatal complication. | True |
| Cardiomyopathy How is hypertrophic cardiomyopathy diagnosed in cats? | Radiographs and/or ultrasound consistent with heart changes or heart failure. |
| Cardiomyopathy - Feline What treatments are available? | Treat heart failure according to signs. |
| Cardiomyopathy - Feline True or false: saddle thrombus is a complication of hypertrophic cardiomyopathy in cats. | True |
| Cardiomyopathy - Feline If Saddle Thrombus is diagnosed, prognosis is guarded to poor. What are four treatment options? | Dissolve the clot (if <12 hours)(high risk). Pain relief. Dilate arteries. Treat heart disease. |
| True or false: blood pressure is the driving force for blood flow (perfusion). It is required to move blood through resistant capillary beds such as the brain, kidneys, and lungs. | True |
| Blood Pressure ___ Pressure is arterial pressure generated during left ventricular contraction. | Systolic |
| Blood Pressure ___ Pressure is arterial pressure during ventricular relaxation. | Diastolic |
| Blood Pressure True or false: Mean Arterial Pressure is a calculation that evaluates perfusion pressure. | True |
| Mean Arterial Pressure What is the equation? | 1/3 systolic + 2/3 diastolic = MAP |
| Mean Arterial Pressure MAP of ___ mmHg is considered minimum for organ perfusion? | 60 mmHg |
| Hypertension What five clinical signs might we see in an animal suffering from Hypertension for extended periods. | Retinal hemorrhage/detachment. Kidney damage. Increased afterload for heart. Brain damage. Increased risk of emboli. |
| Hypertension > ___mm Hg Systolic | 150 mm Hg |
| Hypertension >___ mm Hg Diastolic | 90 mm Hg |
| Malignant Hypertension What are five clinical signs of this condition? | Sudden blindness. Head pressing/disorientation. Epistaxis. Heart failure. Kidney disease. |
| Malignant Hypertension What are two treatments for this condition? | Emergency drugs to lower blood pressure. Treat underlying issue such as Hyperthyroidism, Cushings, etc. |
| Hypotension Leads to what four clinical signs due to poor perfusion? | Kidney failure. Pancreatitis. Heart arrhythmias. Cognitive dysfunction. MAP < 60 mmHg |
| BP Measurements: Oscillometric (Dinamap) Pros (2): Con: | Pros: Quick, Easy Con: Least accurate |
| BP Measurements: Doppler Pro: | More accurate than oscillometric especially in cats and small dogs. |
| BP Measurements: Central Venous Pressure True or false: needs a jugular catheter in place. | True |
| Blood Pressure Measurements For accurate readings what three parameters must be met? | Correct cuff size. Record cuff size in patient record. Lateral recumbent with leg parallel to heart (front leg is most accurate). Relaxed patient. |
| Blood Pressure Measurements The cuff should be __% of circumference of the leg at measurement location. | 40% |
| Blood Pressure Measurements If the cuff is too small, the results will be artificially too ___. | high |
| Blood Pressure Measurements If the cuff is too large, the results will be artificially too ___. | low |
| Central Venous Pressure (CVP) What are three indications for this type of monitoring device? | Evaluates hypovolemia or hypervolemia in critical patients (shock, heart or renal disease). |
| Central Venous Pressure (CVP) What are normal values in dogs and cats? | 0-10 cm H2O. Trends of rising or falling very important. |
| Central Venous Pressure (CVP) What situations might lead to a high CVP? | Right heart failure. Pleural effusion. Pulmonary hypertension. Over-hydration. |
| Central Venous Pressure (CVP) What six pieces of equipment do you need? | Sterile saline. Fluid set. Extension set. Manometer. 3-way stopcock. Jugular catheter in patient. |
| Central Venous Pressure (CVP) How do you measure it? | Check jugular catheter function. Prime the manometer. Allow manometer to read CVP of patient. |
| Toxicology A ___ is any substance that when introduced into or on the body can interfere with the normal functions of body cells. | Toxin |
| ___ is the study of toxins or poisons. | Toxicology |
| Toxin Exposure Management What does PADS stand for? | Prevention, Assess Status, Decontaminate, Specific Plan (Therapy & Support). |
| Toxicology - Prevention What are two ways to prevent toxic exposure? | Educate Clients. Toxin-proof your own home. |
| Toxicology - Prevention What are four common subject that must be discussed during client education? | Common household toxins. Food toxins. Plant toxins. Medications. |
| Toxicology - Assess Current status of the animal? What six clinical signs might we see in an animal with toxin exposure? | Weak, tremors, altered mentation. Breathing difficulty. Hydration status. Body temperature. |
| Toxicology - Assess What four questions do we need to ask when attempting to determine the type of toxin exposure? | Name of substance (What). Mode of exposure (How). (When) was the exposure. Information on package (ask them to bring it with them if they have it). |
| Toxicology - Assess What four pieces of information can we obtain to provide additional information for the treatment plan? | Weight of the animal. Health hx of the animal. Has the owner begun treatment. Poison control contact? (case number?) |
| What are three options for contacting a poison control center? | ASPCA Poison Control (National Animal Poison Control). Local Poison Control (Washington). Package Emergency #. |
| Toxicology - Decontaminate - External Exposure What are two treatment options? Describe them. | Flush eyes - water or saline for 20-30 minutes. Bathe - Liquid dish soap for hand wash of animal. "Dawn" if oil material in on the animal. Especially important for cats. |
| Toxicology - Decontaminate - Oral Ingestion What is the number one piece of information to determine before proceeding? | Determine if the toxin is corrosive. |
| Toxicology - Decontaminate - Oral Ingestion If corrosive, what can we give? | 1-3 ml/lb of milk to dilute |
| Toxicology - Decontaminate - Oral Ingestion If non-corrosive and the animal is swallowing normally, what should we do? | Induce vomiting with hydrogen peroxide 3%. 1 tsp (5 ml)/5 lb of dog or cat, if the exposure occurred within the last 30 minutes. |
| Toxicology - Decontaminate - Oral Ingestion True or false: never administer syrup of ipecac to induce vomiting in veterinary patients. | True |
| Toxicology - Decontaminate - Oral Ingestion What is the purpose of administering activated charcoal? What is the dose? | To absorb the toxin to prevent further uptake within the animals body. 1-3g/kg by syringe feeding. Not indicated if caustic substance. |
| Toxicology - Decontaminate - Oral Ingestion What is the purpose of administering a cathartic? | They cause rapid bowel movements. Usually added to activated charcoal. Clears toxin from the body. |
| Toxicology - Decontaminate - Oral Ingestion How is an enema helpful in treatment? | May speed toxin removal. Indicated if substance is known to be in the colon. |
| Toxicology - Decontaminate - Oral Ingestion What is Gastric Lavage? How is it performed? Why? | "Pumping the stomach." Performed under anesthesia. Indicated if unable to induce vomiting. |
| Toxicology - Decontaminate - Oral Ingestion If the poisonous substance is an object, such as a penny, zinc, lead object, or a tick collar what can be done? | Endoscopy or Surgery |
| Toxicology - Decontaminate - Supportive Care What is the number one supportive care method we can offer these patients? | Aggressive IV fluid therapy. It treats dehydration and shock, speeds toxin processing by the body, and supports vital organs (especially kidneys and the liver). |
| Toxicology - Decontaminate - Supportive Care What are six possible clinical signs we can treat directly? | Seizures. Muscle tremors. Vomiting. Heart arrhythmia. Hypotension. Hyperthermia or hypothermia. |
| Toxicology - Decontaminate - Supportive Care What are five specific blood findings we can treat directly? | Hypoglycemia. Anemia. Electrolyte abnormalities. Liver failure. Kidney failure. |
| Toxicology - Decontaminate - Supportive Care What are four possible toxin risks we can treat? | Gastric ulcers. Pain. Oxygen depletion. Clotting abnormalities. |
| Toxicology - Decontaminate - Specific Care What three toxin exposures have antidotes? | Antifreeze. Rodenticide. Lead poisoning. |
| Toxicology - Decontaminate - Specific Care True or false: if is important to know a toxins duration of effect. | True. Some therapy needs to be for weeks even if the animal appears normal. |
| Toxicology - Common Poisons - Cleaners Name three Acids (low pH). | Drain openers. Toilet bowel cleaners. Household cleaners. |
| Toxicology - Common Poisons - Cleaners Name three Alkali (high pH). | Bleach. Liquid potpourri. Detergents. |
| Toxicology - Common Poisons - Cleaners True or false: Do not induce vomiting if corrosive agents with high risk of esophagus/stomach damage have been ingested. | True |
| Toxicology - Common Poisons - Objects Pennies are a source of ___ toxicity. They cause severe hemolytic anemia. | zinc toxicity |
| Toxicology - Common Poisons - Objects Batteries contain corrosive ___. Ingestion will cause severe burns to the mouth, tongue, and esophagus. | alkali |
| Toxicology - Common Poisons - Objects True or false: mothballs contain Naphthalene, which causes sever hemolytic anemia and possible liver damage. | True |
| Toxicology - Common Poisons - Foods Name four to eight: | Chocolate. Macadamia Nuts. Grapes & Raisins. Yeast Dough. Xylitol. Onions & Garlic. Moldy food. Contaminated Food (E. coli and Salmonella). |
| Toxicology - Common Poisons - Food Chocolate contains Methylxanthines. What are three clinical signs of toxicity? | Tremors. Heart arrhythmia. Vomiting. |
| Toxicology - Common Poisons - Foods What are two clinical signs of macadamia nut toxicity? | Tremors, hyperthermia. |
| Toxicology - Common Poisons - Foods What is one consequence of grape and raisin ingestion? | Kidney failure |
| Toxicology - Common Poisons - Foods Why is yeast dough dangerous for animals to eat? | It causes organ rupture. |
| Toxicology - Common Poisons - Foods Xylitol causes what two clinical signs? | Hypoglycemia. Liver failure. |
| Toxicology - Common Poisons - Foods What does onion and garlic toxicity cause? | Heinz body anemia |
| Toxicology - Common Poisons - Foods Moldy food - Penicillium causes what two clinical signs? | Tremors. Seizures. |
| Toxicology - Common Poisons - Foods Contaminated food toxicities often contain what two bacteria? | E. coli. Salmonella. |
| Toxicology - Common Poisons - Pesticides Snail & Slug bait contains Metaldehyde. What are three clinical signs of ingestion? | Tremors. Seizures. Liver failure. Shake n Bake. |
| Toxicology - Common Poisons - Pesticides Rodenticides often contain Warfarin or Brodifacoum. What clinical sign will be evident with ingestion? How long is therapy needed? | Bleeding disorder. Therapy is needed for four - eight weeks. |
| Toxicology - Common Poisons - Pesticides Organophosphates are commonly found in what three products? | Flea collars. Powders. Shampoos. |
| Toxicology - Common Poisons - Pesticides True or false: cats are especially sensitive to organophosphates. | True |
| Toxicology - Common Poisons - Pesticides What are six clinical signs of Organophosphate toxicity? | Vomiting. Diarrhea. Drooling. Constricted pupils. Respiratory distress. Bone marrow damage. |
| Toxicology - Common Poisons - Antifreeze What toxic ingredient does it contain? | Ethylene Glycol |
| Toxicology - Common Poisons - Antifreeze What are two clinical signs? | Ataxia occurs in 1-4 hours. Then goes away. Acute kidney failure. Untreated death within 2 days. |
| Toxicology - Common Poisons - Antifreeze How is it diagnosed? | Hx and in hospital test is available. |
| Toxicology - Common Poisons - Antifreeze Is there an antidote? | Yes. Feomepizole. It must be given within 12 hours of ingestion. |
| Toxicology - Common Poisons - Antifreeze What are three possible treatment options? | Feomepizole within 12 hours. Aggressive IV fluids. Dialysis |
| Toxicology - Common Poisons - Plants True or false: cats are especially sensitive to Easter and Day Lily toxicity. | True |
| Toxicology - Common Poisons - Plants True or false: renal failure occurs in 1-3 days after Easter or Day Lily ingestion. | True |
| Toxicology - Common Poisons - Plants What can be done to treat Easter and Day lily toxicity? | GI decontamination. Aggressive care for kidney failure. |
| Toxicology - Common Poisons - Household Drugs True or false: cats are particularly sensitive to Acetaminophen (Tylenol) ingestion. | True. Red cell damage and liver failure |
| Toxicology - Common Poisons - Household Drugs What three clinical signs will be seen after ingestion of aspirin, ibuprofen, or naproxen? | Gastric ulcer. Kidney failure. Seizures. |
| Toxicology - Common Poisons - Household Drugs Calcipotriene (Vitamin D) found in medicated skin cream causes what three clinical signs? | Hypercalcemia. Kidney failure. Heart damage. |
| What are five reasons isolation protocols should be enacted? | Patient may be contagious to other animals. Patient may be contagious to humans. Patient may be dangerous to human (chemotherapy or radiation therapy). The patient may need to be protected from hazards of the facility (immunosuppression.) |
| Universal Precautions True or false: limit the number of staff allowed that come in contact with the infected animal. | True |
| Universal Precautions True or false: practice good personal hygiene after all contact with a sick animal and contaminated surfaces. | True |
| Universal Precautions The use of gown and gloves for any contact with a sick animal or contaminated surfaces provides a physical "barrier." Name two rules to follow for effect use of these PPE. | The items should not leave the isolation unit. The items should be patient specific. |
| Universal Precautions Contain and dispose of contaminated waste properly. ___ bag inside unit and outside unit. | Double |
| Universal Precautions True or false: it is our job to enforce cleaning and disinfecting procedures for contaminated environmental surfaces. | True |
| What constitutes a "good" hand washing? True or false: handwashing should last approximately 1-2 minutes and include each side of hand, between fingers, halfway up arm and under rings. | True |
| What constitutes a "good" hand washing? True or false: if there is debris under fingernails, use a hard plastic pick or stiff brush to remove the material while the soap is still on the hands. | True |
| What constitutes a "good" hand washing? True or false: moisture will attract more microorganisms from the air, so be sure to dry your hands and arms thoroughly. | True |
| Levels of Isolation ___ usually indicates no special precautions aside from normal animal husbandry and good personal hygiene. | Green. This could also indicate that the isolation space has been properly cleaned and disinfected after use and is now ready for the next patient. |
| Levels of Isolation ___ level is used when the condition of the patient warrants segregation from other animals. | Yellow. Usually of the same species. Kennel cough due to canine adenovirus, Feline Upper Respiratory Infections, and Feline Leukemia are some possibilities. |
| Levels of Isolation ___ level is used for patients which are highly contagious to other animals of any species but not considered contagious to the staff or general public. | Orange. Scrapie and Foot and Mouth Disease (FMD) warrant this level of isolation. |
| Levels of Isolation True or false: Isolation Condition Red is the most severe and indicates the animal is both contagious to other animals and humans. | True. Rabies, Leptospirosis, Salmonella, Brucellosis, and Dermatophytes. |
| Levels of Isolation What color indicates a level of precaution for conditions that are hazardous to people, but not necessarily a concern to other animals (chemotherapy or radiation). | Purple |
| Use of Chemical Agents True or false: most will not work on organic debris (esp. bleach). | True |
| Use of Chemical Agents True or false: hard water may inactivate. | True |
| Use of Chemical Agents True or false: fresh solution must be made every few days. | True |
| Use of Chemical Agents True or false: they must have sufficient contact time to work. | True |
| Use of Chemical Agents True or false: do not mix products together. | True |
| Use of Chemical Agents True or false: do not apply directly to the animal. Use with care on equipment. | True |
| Chemical Virus Killers How much contact time is needed to kill Parvo? | 10 minutes |
| Isolation Procedures True or false: they are used for suspected cases of URI, Parvo, Distemper, Ringworm, Salmonella, and Leptospirosis. | True |
| Isolation Procedures True or false: the isolation area should be a separate room with separate air exchange. | True |
| Isolation Procedures True or false: one-way flow of traffic through the hospital is necessary. | True |
| Isolation Procedures True or false: it is essential to use Bleach-in and Bleach-out foot baths. | True |
| Isolation Procedures True or false: all items in the Isolation unit stay in the unit (or are discarded). | True |
| Isolation Procedures True or false: Animals that are suspected of being contagious should not step on any surface people or animals will walk through. | True |
| Isolation Procedures Staff caring for isolated animals must wear ___ and ___ at all times in the unit. Those items stay in the unit. Minimal staff in unit. | gown. gloves. |
| Isolation Procedures True or false: separate supplies for each animal should be supplied within the isolation unit. | True |
| Canine Parvovirus Pathogenesis (CPV-2) Incubation usually takes ___ days with shedding of the virus beginning on the ___ day, before the appearance of clinical signs. Vomiting is usually the first sign. | 3-8 days. 3rd. |
| Canine Parvovirus Pathogenesis (CPV-2) How is this disease transmitted? | Direct contact with infected dog's feces or indirectly through fecal contamination of fomites. |
| Canine Parvovirus Pathogenesis (CPV-2) The virus may be shed up to ___ weeks following infection and may survive up to ___ months in a contaminated area. | 3 weeks. 9 months. |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: once in blood stream, virus seeks rapidly dividing cells such as bone marrow, lymphopoietic, and intestinal epithelium. This leads to viremia and further replication and lysis of these host cells. | True |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: depletion of lyphocytes and compromised gastrointestinal system may lead to bacteremia by normal gut flora (i.e. Escherichia coli, which can be fatal). | True |
| Canine Parvovirus Pathogenesis (CPV-2) What are five initial clinical signs seen in these patients? | depression, fever, anorexia, vomiting, severe diarrhea. Feces may be yellowish gray due to the presence of mucus. The feces may also contain blood due to the onset of hemorrhagic enteritis. |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: dehydration is commonly seen in these patients due to rapid loss of fluids from vomiting and loose stools. | True. Some very unfortunate puppies may experience projectile, bloody diarrhea, and vomiting until their death (48-72 hours following obvious signs). |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: these infections have been misdiagnosed due to the the similarities in symptoms to parasitic infections, stress colitis, or stomach upset due to a dog's last meal. | True. |
| Canine Parvovirus Pathogenesis (CPV-2) What are three means used to diagnose? | Extensive hx based upon clinical signs. Positive fecal ELISA result to confirm. Newest diagnostic tools (PCR, Electron Microscopy). |
| Canine Parvovirus Pathogenesis (CPV-2) How can we prevent infection in the typical puppy? | Vaccinate puppies at 8 weeks and every 3-4 weeks until 16 weeks old. |
| Canine Parvovirus Pathogenesis (CPV-2) What special precautions should be taken with Rottweiler, Doberman, and Pit Bull puppies? | These breeds are at increased risk, so they should be vaccinated every 4 weeks until they are 6 months old then annually. |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: puppies should not go to public places until vaccines are complete. | True |
| Canine Parvovirus Pathogenesis (CPV-2) True or false: positive animals should be quarantined. They will be contagious for 6 weeks, and yard will be contagious for 6-9 months. | True |
| Canine Parvovirus Pathogenesis (CPV-2) The only absolutely effective disinfectant is: | bleach at 1:30 dilution. |
| Canine Parvovirus Pathogenesis (CPV-2) What are some high risk places for dogs to pick up infection (4)? | dog shows, field trials, boarding kennels, public spaces (dog parks). |
| Feline Panleukopenia Is also called? | "feline distemper" |
| Feline Panleukopenia Etiology? | parvo virus (related to canine parvo) |
| Feline Panleukopenia How is it transmitted? | Direct contact: bite wounds, grooming. Indirect contact: environment may be contaminated for years. |
| Feline Panleukopenia True or false: the virus attacks neonatal brain tissue, bone marrow, and GALT. | True |
| Feline Panleukopenia What are five clinical signs? | Fever, vomiting/diarrhea, panleukopenia, abortions, cerebellar gait in surviving neonates. |
| Feline Panleukopenia True or false: these animals must be quarantined. It is a highly contagious, often fatal virus. All body secretions contain the virus. | True |
| Feline Panleukopenia How is it treated? | Aggressive supportive care: IV fluids, Antibiotics, Treat symptoms. |
| Feline Panleukopenia How is it prevented? | Vaccinate all kittens at 8, 12, and 16 weeks of age. |
| Canine Distemper Etiology? | Parmyxovirus that is highly contagious but easily decontaminated. |
| Canine Distemper How is it transmitted? | Aerosol (common in Humane Societies). Fecal/urine oral. Transplacental. |
| Canine Distemper What are five possible clinical signs? | Leukopenia. Vomiting/Diarrhea. Enamel Dysplasia. Neurologic signs. Abdominal skin pustules. |
| Canine Distemper How is it treated? | Supportive care |
| Canine Distemper How is it prevented? | Vaccinate as per other puppy protocols. Quarantine all suspect animals. |
| Rabies The incubation period is __ - __ weeks. It depends on the species and site of viral entry. | 3-8 weeks. |
| Rabies How many stages are typical recognized for this disease? | Three |
| Rabies What are the three stages? | Prodromal stage. Furious stage. Paralytic stage. |
| Rabies What is the Prodromal stage? | There are changes in behavior that are inappropriate for the species. Walking around during the day in people's backyards (nocturnal animals). |
| Rabies What is the Furious stage? | Animals in this stage will be Hyperactive. Some are "Dumb" (stuporous). |
| Rabies What is the Paralytic stage? | Ascending paralysis and death. |
| Rabies: How can we decrease zoonotic risk? True or false: Assume any animal with neurological signs, bite wounds, or unknown vaccination status may be a carrier. | True |
| Rabies: How can we decrease zoonotic risk? Wear ___ when working with these animals. | gloves |
| Rabies: How can we decrease zoonotic risk? True or false: quarantine procedures should be implemented (10 days is not magic). | True |
| Rabies: How can we decrease zoonotic risk? True or false: if working with wildlife or at a zoo, get vaccinated. | True |
| Rabies: How can we decrease zoonotic risk? True or false: if bitten by an animal of unknown vaccine status, report to Public Health. | True |
| Rabies: How can we decrease zoonotic risk? True or false: brain examination of fresh, not frozen, sample is the only means recognized as a definitive test for rabies in a biting animal | True |
| ___ refers to a systemic inflammatory response to infection or bacterial toxins. | Sepsis |
| ___ refers to bacteria in the blood stream. | Bacteremia |
| What is septic shock? | Hypotension secondary to severe sepsis. |
| What is shock? | A life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means cells & organs don't get enough oxygen & nutrients to function properly. Many organs can be damaged as a result. Requires immediate treatment |
| What is SIRS? | Systemic Inflammatory Response Syndrome. Organ failure or immune system collapse due to septic shock. |
| Sepsis What are three clinical signs of a hyperdynamic animal? | brick-red mucous membranes. Tachycardia. Bounding pulse. |
| Sepsis What are three clinical signs of a hypodynamic animal? | Hypotension. Pale mucous membranes. Hypothermia. |
| Sepsis Care: Describe Step 1 | Characterize patient condition and begin instrumentation: monitor with ECG and pulse oximetry. Large-bore peripheral catheter placed. Central venous catheter: consider a double or triple lumen catheter. Collect blood for testing. Oxygen if SPO2 < 90%. |
| Sepsis Care: Describe Step 1 What five things should be collect blood to test? | CBC, chemistry profile, BIG (PCV, TP, Glucose, BUN), Arterial (or central venous) blood gas. Coagulation profile and or a baseline aPTT on the SCA 2000. |
| Sepsis Care: Goals Name four to nine: | Stable oxygenation, perfusion (blood pressure), hydration, electrolytes, pH, glucose. Treat primary cause. Stable organ function. Comfort. Stable clotting status. Nutritional support. |
| Sepsis Care: Describe Step 2 | Identify hypoglycemia, K or Ca++ disorders, and evaluate response to fluid challenge. |
| Sepsis Care: Describe Step 2 True of false: we should run a glucose test immediately. | True |
| Sepsis Care: Describe Step 2 True or false: we should insert a continuous temperature probe and beginning active warming with warm air until normal. | true |
| Sepsis Care: Describe Step 3 | Oxygen, metabolic monitoring, identify source of infection. |
| Sepsis Care What are three ways to get nutrition into these patients? | Hand feeding. Feeding tubes. Parenteral nutrition. |
| Blood Components ___ is the liquid component containing water, proteins, lipids, and electrolytes. | Plasma |
| Blood Components True or false: clotting factors, circulating proteins, are found in plasma. | True |
| Blood Components What three types of cells are found in blood? | Erythrocytes. Leukocytes. Thrombocytes. |
| Blood Components ___ are oxygen-carrying cells due to hemoglobin. | Erythrocytes (Red blood cells- RBC) |
| Blood Components ___ initiate the clotting cascade | Thrombocytes (Platelets). |
| A ___ ___ is a form of fluid replacement that replaces cellular and protein components of blood. | Blood transfusion |
| True or false: blood transfusions can be administered from one animal to another of the same species, from animal to itself (auto-transfusion), and from one animal to another of a different species. | True |
| Blood Transfusion What are four potential dangers? | Allergic and immune-mediated reactions. Thromboemboli. Disease transmission. Volume overload. |
| Blood Transfusion What are two indications? | Severe blood loss and bleeding disorders. |
| Blood Transfusion What are two possible causes of severe blood loss in a patient? | Substantial loss of oxygen carrying. Substantial loss of tissue perfusion. |
| Blood Transfusion What are three possible bleeding disorders requiring a transfusion? | Vitamin K deficiency. VonWillebrand's disease. Hemophilia. |
| Blood Transfusion What are three indications for plasma transfusions? | Need for plasma proteins: Albumin, Antibodies, or Macroglobulin. |
| Blood Transfusion What two functions does albumin have? | Oncotic pressure. Carrier molecule. |
| Blood Transfusion What is oncotic pressure? | It is a form of osmotic pressure induced by proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that displaces water molecules, thus creating a relative water molecule deficit with water molecules moving back into the circulatory system. |
| Blood Transfusion Why would be provide a plasma transfusion for antibodies? | Failure of passive transport |
| Blood Transfusion Why would we provide a plasma transfusion for macroglobulin? | Protective scavenger |
| Blood Transfusion True or false: beneficial effects of transfusion are temporary. Underlying problem must be corrected. Transfusion effectiveness lasts for 1-21 days. | True. Immune system will remove foreign blood. Transfused blood has short life-span, no nutrient available. Collection, storage, and transfusion damages the blood. |
| Blood Donor What are three important factors to keep in mind when selecting a donor? | Healthy individual: can donate blood without injury to donor, and donor does not carry contagious disease transmitted via blood. Blood Type Determination. |
| Blood Donor: Canine A donor is (7): | Negative for DEA 1 (A-) and negative for Von Willebrand. Current on vaccinations and parasite control. Negative for heart worms, Ehrlichia, Babesia, and Mycoplasma canis. Greater than 50#. |
| Blood Donor: Canine What blood type is a universal donor? | DEA 1 - (A-) |
| Blood Donor: Feline A donor is (4): | Blood type A (95% of need). Negative for FeLV, FIV, Mycoplasma hemofelis. Current on vaccinations and parasite control. Greater than 10# in a lean animal. |
| Blood Donor: Feline Can donate every ___ weeks if health is monitored. HCT must be > ___. | 4 weeks. HCT > 35%. |
| Blood Donor: Canine Can donate every ___ weeks if health is monitored. HCT must be > ___. | 4 weeks. HCT > 40%. |
| Blood Type Blood types (or groups) are determined by specific ___ found on the surface of erythrocytes. | antigens |
| Blood Type True or false: knowledge of blood types is important as transfusion of incompatible blood (the donor animal has a different blood type than the recipient) can result in severe hemolytic transfusion reaction, even death. | True |
| Compatible Blood Transfusions What blood type is a universal recipient in cats? | AB |
| Determining Blood Type The RapidVet-H (Canine DEA 1) assay is based on the agglutination reaction that occurs when an erythrocyte which contains a DEA 1 ___ on its surface membrane interacts with a murine monoclonal antibody proven specific to DEA 1. | antigen. |
| Determining Blood Type Which collection tube should be used to collect donor and recipient samples? | EDTA (purple top). Ethylenediaminetetraacetic acid |
| Determining Cross-match True or false: the test determines whether a donor is compatible (or incompatible) with a recipient's blood> | True |
| Determining Cross-match True or false: Cross-matching will pick up incompatibilities between the donor and recipient that will not be evident on blood typing . | True |
| Determining Cross-match ___ cross match is the most important cross-match. It compares a donor's erythrocytes with a recipients serum. This checks for antibodies in recipient serum against donor erythrocytes. | Major |
| Determining Cross-match What are four indications for running a major cross-match test? | The recipient has received a prior transfusion more than 72 hours prior. Has been pregnant. If for a cat and blood typing is not available. If the recipient has AIHA. If emergency canine donation and donor blood typing is not available. |
| Determining Cross-match ___ cross-matching compares a donors serum to the recipient's erythrocytes and checks for preformed antibodies in donor serum that could hemolyse the recipient red cells. | Minor |
| Cross-match Procedure For the major cross-match: __ erythrocytes are washed and incubated with __ serum. | Donor. Recipient. |
| Determining Cross-match For the minor cross-match: ) __ serum is incubated with washed __ erythrocytes. | Donor. Recipient. |
| Determining Cross-match True or false: mixture of erythrocytes & serum are observed visually for hemolysis (especially in horses) & microscopically for agglutination. Any evidence of agglutination or hemolysis indicates an incompatible cross-match. | True |
| Blood Collection If heparin or sodium citrate is used as the anticoagulant blood must be used with ___ hours. | 24-48 hours |
| Blood Collection Why is it extremely important that the correct ratio of anticoagulant to blood collection is used? | Excess anticoagulant may cause bleeding disorders or toxicity in recipient. |
| Blood Collection True or false: sedation is avoided in dogs. | True |
| Blood Collection How much blood can a dog donate? | 16 ml/kg |
| Blood Collection How much blood can a cat donate? | 40-60 ml |
| Blood Collection After collection, venipuncture site should be held off and light pressure wrap applied for ___ minutes. | 10 minutes. |
| Blood Collection True or false: IV or SQ fluids should be given to prevent hypotension and dehydration. | True |
| Blood Collection Collected blood should be ___ until ready to use. | refrigerated |
| Blood Collection Name four to eight supplies needed: | Surgical prep of venipuncture site. Blood line stripper. Clippers. Clamps. Gram scale. Collection bag. Sterile gloves. Hemostats. |
| Blood Components Name three: | Whole Blood. Packed Red Cells. Fresh Frozen Plasma (FFP). |
| Blood Components: Fresh Frozen Plasma (FFP) This is platelet-poor plasma that is separated from red cells within __ hours of blood collection and frozen | 6 hours |
| Blood Components: Fresh Frozen Plasma (FFP) True or false: FFP and fresh plasma contain all coagulation factors and plasma proteins (such as albumin). | True |
| Blood Components Fresh frozen plasma is stable for 1 ___ if maintained in a dedicated freezer. | 1 year |
| Transfusion Procedure Any stored whole blood or packed red cell products that are discolored (brown), bubbly or hemolyzed should be ___. | Discarded |
| Transfusion Procedure True or false: transfusions should not be infused through the same line or catheter as lactated Ringer's solution. | True. This product contains sufficient calcium to overcome the citrate in the transfusion bag and cause clotting. Hypotonic solutions (5% dextrose in water) can cause hemolysis of red cell-containing products. |
| Transfusion Procedure The transfusion should be administered slowly (by gravity). Running these fluids at a fast rate is likely to produce transfusion reactions. Name two. | Circulatory overload. Anaphylaxis. |
| Transfusion Procedure Rapid administration of dog blood by pump or through a small filter ___ red cells. | destroys |
| Transfusion Procedure The transfusion should be completed within __ hours. Why? | 4 hours. In order to prevent bacterial contamination and growth. Blood is an excellent culture medium for bacteria. |
| Transfusion Procedure The animal should be observed carefully for transfusion reactions, especially in the first 15 minutes. TPR should be taken every __ minutes for the first 30 minutes, then every 15 minutes for __ hours. Record in Transfusion Log. | 5 minutes. 2 hours. |
| Blood Transfusion: Adverse Reactions What are five immunological etiologies? | Fever. Vomiting. Facial edema. Intravascular hemolysis. Shock. Tachycardia. Tachypnea. |
| Blood Transfusion: Adverse Reactions What are four to seven non-immunological etiologies? | Volume overload. Bacterial contamination. Hypocalcemia. Hyperammonemia and acidosis. Embolism. Coagulopathy. Disease transmission. |
| Volume Overload What are four common clinical signs? What clinical signs might you see in a severe case? | coughing, tachypnea, dyspnea, tachycardia (cardiovascular). |
| Volume Overload What are two ways we can reduce this reaction? | Slow infusion rate and appropriate component therapy. |
| Volume Overload What should be done if this occurs during a transfusion? | The transfusion should be stopped and furosemide given. |
| What two anatomical structures make up the central nervous system? | Brain and spinal cord |
| Name three important parts of the brain that a vet tech should be familiar with? | Cerebrum. Cerebellum. Brain stem. |
| The ___ is the area of the brain responsible for higher-order behaviors (learning, intelligence, awareness, etc). | Cerebrum. |
| ___ matter makes up the cerebral cortex. It is the outer layer of the brain. | Gray matter |
| ___ matter makes up the cortex and is made up of fibers. | White matter |
| The ___ ___ connects the brain and the spinal cord. | Brain stem |
| The ___ ___ is the area of the brain responsible for basic support functions of the body. | Brain stem |
| True or false: many of the cranial nerves original from the brain stem. | True |
| There are ___ nerve pairs in the PNS that originate directly from the brain. | 12 |
| The ___ is the area of the brain responsible for coordinated movement, balance, and posture. | Cerebellum |
| The function of the ___ ___ is to conduct sensory information and motor instructions between the brain and the peripheral nerves. It also modifies nerve impulses. | Spinal Cord |
| Neurological Signs What will you see if the brain is involved? | Mentation, behavior, seizures, balance |
| Neurological Signs What will you see if the spinal cord is involved? | Gait, pain perception |
| Neurological Signs What will you see if the peripheral nervous system (PNS) is involved? | Weakness, tremors, stiffness |
| True or false: the etiology of primary neurologic issues is within the neurologic system. | True |
| True or false: the etiology of secondary neurologic issues is due to organ or electrolyte dysfunction. | True. Neurologic system simply shows signs. |
| Neurological Signs What are seven ways to evaluate for neurological issues? | Neurological exam. Blood evaluation (CBC, Chemistry-glucose, calcium), Bile acid study (especially neonates), BP, Ophthomalogy exam |
| What are 5 components of the Neurological Exam? | Mentation status. Gait & Posture. Cranial Nerve Exam. Postural Reactions. Spinal Reactions. |
| Mentation Status What does BAR stand for? | Bright, Alert, Responsive |
| Mentation Status What does QAR stand for? | Quiet, Alert, Responsive |
| Mentation Status What does Dull mean? | Aware of environment, but blunted response. |
| Mentation Status What does Disoriented/Stupor? | Aware of environment, but inappropriate response. |
| Mentation Status What does Obtunded? | Will only respond to very strong stimuli. |
| Mentation Status What does Coma? | Will not respond to stimuli. |
| Gait & Posture evaluations test what three things? | Cerebellum and Vestibular centers of the brain. Spinal Cord. Musculoskeletal system. |
| Cranial Nerve Exam evaluations test? | The sensory and motor functions of the 12 cranial nerves. Abnormalities can locate the problem to a very specific portion of the brain. |
| The ___ reflex arc consists of a light tap on the medial canthus of the eye to produce a blink of the eyelids. | Palpebral |
| The ___ light reflex (PLR) is a response to shining light in the eye of a normal animal in which the iris in both eyes will constrict. | Pupillary light reflex (PLR) |
| Postural Reactions Tests of the complex recognition of body location in the environment and appropriate responses to the situation. Name five possible techniques. | Conscious proprioception. Hemiwalking. Hopping. Wheelbarrowing. Postural Thrust. |
| True or false: Spinal reflex tests check function of the spinal cord at a specific site. They do not evaluate if spinal messages are perceived by the brain. | True. Myotatic reflexes (hammer test). Withdrawal reflex. Cross-extensor. |
| Withdrawal Reflex results in contraction or flexing of ____. | muscles. |
| ___ are transitory disturbances in brain function. | Seizures. |
| What are four possible clinical signs of seizure in a veterinary patient? | Loss or change in consciousness. Change in muscle tone or movement. Behavior change. Change of autonomic function. |
| What are the three components of a seizure? | Aura (preictal period). Ictus (seizure activity). Postictal period. |
| True or false: Status Epilepticus is a medical emergency. | True |
| What four clinical signs are often seen with Status Epilepticus? | Seizures lasting continuously > 15 minute. Cerebral edema. Coma. Death. |
| What are three clinical signs of Cerebral Edema (Poor Brain Perfusion)? | Abnormal Mentation. Abnormal Pupils. Abnormal Pupillary Reflex. |
| What are three therapies for perfusion in cases of Cerebral Edema? | IV fluids. Oxygen. Reverse Cerebral Edema. |
| Describe four therapy options for Cerebral Edema. | Elevate head. Stop seizure (seizure medication, treat case). Corticosteroids IV. Mannitol IV over 20 minutes. |
| What are seven "Must Haves" when treating a patient with Status Epilepticus? | Must Have: IV catheter(s), function airway (intubate if necessary), continuous supervision, blood glucose checks, blood pressure checks, temperature checks, excellent nursing care. |
| What are six excellent care techniques for Status Epilepticus? | Lubricate eyes with ointment QID. Roll patient QID. Monitor urinary bladder size q 4-6 hours (express if needed, monitor urine output and consider indwelling urinary catheter), TPR minimum of q 6 hrs, Fluids and medications on schedule, clean and dry. |
| True or false: ICU flow sheets are designed for concise and thorough recording of patient parameters and treatments, designed for 24 hr monitoring/care, highlighters can be used to emphasize treatments, many styles available. | True |
| Neurological Monitoring: Cerebral Disease What are five things to monitor? | Vision. Consciousness. Mentation. Seizures (generalized, partial), for aura (possible indication that seizure is imminent. |
| What are four clinical signs that a seizure is imminent? | Fluttering whiskers. Hyperaesthesia. Anxious behaviors. Partial motor seizure prior to generalized. |
| ___ ___ disease is described as the herniation of one or more intervertebral discs that impinge the spinal cord. | Intervertrebral Disc disease. |
| What are three possible clinical signs of Intervertebral Disc Disease? | Back pain (often severe). Paresis or paralysis of limbs caudal to lesion. Altered pain sensation caudal to the lesion. |
| What are six possible techniques used to diagnose intervertebral disc disease? | Clinical signs. Neurological exam. Plain radiographs (possible calcified disc, narrowed disc space consistent with signs), Myelogram. CT scan. MRI. |
| What are four possible treatment options for intervertebral disc disease? | Pain relief. Corticosteriods (decrease swelling, decrease on-going cord trauma), DMSO, Emergency Sx (remove abnormal disc material, decrease pressure on spinal cord). |
| If a decline in neurological exam is noted, when is emergency surgery indicated for intervertebral disc disease? | Loss or conscious proprioception (CP), Loss of superficial pain. This is the point that sx is warranted -> Loss of Voluntary Mobility. Cross Extensor Pain. Loss of Deep pain (very bad). |
| True or false: conscious proprioception is one of the first test performed in a neurological exam and is a good indicator of spinal cord dysfunction. | True |
| Superficial pain can be tested by: | pinching the webbing between the toes. Withdrawal of limb is only a spinal reflex. |
| The urinary bladder receives nerves from the spinal cord at what site? | L5-7 |
| True or false: if the spinal cord trauma is cranial to L5-7 then an Upper Motor Bladder results in inability to urinate and difficulty in expressing. | True |
| True or false: if the injury occurs at L5 or caudal then a Lower Motor Bladder results in inability to urinate normally (urine may leak out, easily expressed). | True |
| True or false: function of the bladder needs to be closely monitored and cared for with any spinal injury patient. | True |
| Nursing the Spinal Cord Patient Very careful monitoring of neurologic status, immediately report and decline in function at least q 2-6 hours. What are three ways to do this? | Ability to walk. Pain perception in rear legs. Ability to urinate. |
| What are three ways we can prevent pressure sores? | Roll patient (right lateral, sternal, left lateral) q 4 hours. Deeply bedded. Clean and dry at all times. |
| Nursing the Spinal Cord Patient |
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