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Chapter 3 Nursing

Chapter 3 Diagnos Sampling and Therapeutic Techniques

Question	Answer
For periheral venipuncture, how far should the needle be introduced into the occluded vein?	As far distal as possible.
What color tube contains anticoagulant?	Red top tube.
When performing abdominocentesis, what approach is taken in order to avoid the spleen?	Right paramedian.
To perform venipuncture from the right lateral saphenous vein, the animal is placed in what recumbancy?	Left lateral recumbancy.
What needle size is commonly used to perform venipuncture on the medial saphenous vein?	22 to 25 gauge needle.
Venipuncture of the marginal ear vein provides a sample from what type of vein?	Capillary.
What method of urine collection is needed in order to collect urine that is free of contamination from the distal urethra and gential tract?	Cystocentesis.
A normotensive, normovolemic animal with intact renal function should produce urine at what rate?	1 to 2 mg/kg of body weight.
Where in the intercostal space is thoracocentesis performed in dogs?	The cranial aspect of the intercostal space.
Normal joint fluid appears viscous, clear and pale what?	Yellow.
What is the route of choice for administering medications if a rapid onset of action is required?	Intravenous/ Intraosseous.
What is the time frame that a intravenous and intraarterial catheters should be in the vessel?	No longer than 12 hours.
What area should be avoided when injecting vaccines and insulin?	Intrascapular.
When giving an intramuscular injection into the semitendinosus or semimembranosus muscles, what nerve should be avoided?	The sciatic vein.
How much blood may be collected fromt the auricular vein of swine?	5 mL.
Blood is commonly collected from this side of the neck in pigs to avoid what nerve?	The Phrenic nerve.
Peritonitis in what animals is often highly compartmentalized?	Ruminants.
The intercostal vessels and nerves run along what border of the ribs?	Caudal.
List the steps to obtaining a blood sample?	Venipuncture is performed with either a needle/syringe or a Vacutainer system. All supplies should be out before the animal is put on the table. The hair and skin should be wiped with 70% alcohol.
What are the most common sites for venipuncture in both the dog and cat?	For dogs it includes the cephalic, jugular, and lateral saphenous veins. For cats it includes the cephalic, jugular, femoral, medial saphenous veins.
Explain the difference between obtaining a sample for a CBC versus obtaining a sample for blood cultures?	Blood that is being collected for a CBC is usually placed in a purple top tube and only a few mL of blood is needed. For a blood culture the skin must be perpared aspectically and the blood must not touch anything that will contaminate it.
Decsribe reasons why blood may stop flowing into the syringe during venipuncture and how to remedy the problem?	Moved the needle and it is outside of the vein, need to redirect the needle carefully back into the vein. If the vein collapse than a different vein should be used. Application of excessive negative pressure may also cause the vein to collapse.
Explain what to do if a hematoma forms during venipuncture?	When a hematoma forms you must remove the needle and apply digital pressure. You can also put a wrap over it as well until it has stopped bleeding.
Explain when it might be appropriate to use a Vacutainer collection device and how it differs from venipuncture with a needle and syringe?	Use of Vacutainers may make jugular blood collection easier. Can be used on large animals. Good for getting large amounts of blood quickly. Sometimes easier all around than needles and syringes.
List reasons to collect a blood sample from the marginal ear vein and name two other sites from which a peripheral capillary sample may be obtained?	To check for erthroparasitic organisms, check pet blood glucose and monitor their diabeties. To obtain blood one can clip quick of toenail, lacerate the buccal mucosa.
List sites from which arterial blood samples may be taken and the reasons for their collecion?	An arterial blood sample is used to evalute the acid base and blood gas status of an animal. The sites for arterial blood draw are the femoral artery and the dorsal metatarsal artery.
Describe indications for manual expression, cystocentesis, and catheterization for urine sample collections?	Routine urinalysis by manual expression of the bladder. Catheterization performed to relieve urethral obstruction or empty bladder. Cystocentesis, collect specimens for urinalysis or bacterial culture.
Decsribe indications for and methods of collecting a fecal sample?	Samples for fecals can be obtained by simply picking them up from the ground. Feces can also be maunally retrieved from the rectum with a gloved ro sleeved hand.
Describe indications for performing thoracocentesis?	Thoracocentesis is the process of removing accumulated air or fluid from within the pleural space. When air and fluid accumulate in the pleural space the lungs are unable to completely expand.
Method for performing thoracocentesis?	A 22 gauge needle with a 60 ml syringe attached and needle is placed directly into the 7 or 8 intercostal space, after the space is penetrated, the needle is directed caudoventrally. Suction is applied and fluid or air flows out of the space.
Describe indications for performing abdominocentesis?	It is the process of drawing fluid from the abdominal cavity. It can help critical cases which include abdominal trauma and when peritonitis is suspected.
Methods for performing abdominocentesis?	The ventral abdomen between the umbilicus and bladder is clipped, a needle is inserted to the right of the ventral midline, fluid is collected as it drips from the needle, or aspirated with a syringe.
Describe indications for performing a transtracheal wash with a percutaneous tube and endotracheal tube technique?	A transtracheal wash is performed to obtain fluid samples from the lower respiratory tract for culture or cytology.
The percutaneous technique:	The catheter goes through the skin and enters the trachea, nonbacteriostatic sterile saline solution is warmed and placed into a syringe. Animals coughs, syringe plumger is retracted several times to collect a sample.
Endotracheal tube technique:	The animal is anesthetized, and a sterile endotracheal tube is placed. A sterile polyproylene urinary catheter longer than the endotracheal tube is threaded down the tube to just above the tracheal bifunction and the sample is collected.
Describe the indications for obtaining synovial fluid in various joints?	Synovial fluid is collected for cytologic bacterial, and biochemical analyses. Places that synovial fluid can be collected from the shoulder, elbow, carpus, stifle or the tarsal joints.
For the shoulder, the needle is inserted into the lateral aspect and directed medially.	The elbow, the lateral or caudual aspect the fluid can be removed.
The carpus is tapped from its dorsal surface.	The stife is approached from the craniodorsal surface just below the patella. For the tarsal joints, they are tapped caudolateral. When it is performed, the animal is sedated, and the skin is shaved aseptically prepared.
14. Describe the indications for and methods of performing bone marrow aspirates in various joints.	Bone marrow aspiration is performed to evaluate the cells in the bone marrow. It is most commonly performed in patients with nonregenerative anemia, persistent thromboeytopenia or neoplasia.
14 continued:	The most frequently aspirated sites include the iliac wing, humerus, and femur.
14 continued:	For iliac aspiration,the widest portion of the iliac crest is clipped and aseptically prepared. A sterile bone marrow needle is flushed with and anticoagulant. Bone marrow needle is introduced into an incision and introduced into the bone.
14 continued:	The needle is advanced with pressure. An anticoagulant
15. Describe the indications for and methods of collecting vaginal cytologic samples?	Performed to determine the patients present stage in the estrous cycle or to collect samples to determine disease. Wiped with warm water. A gloved hand is used to seperate the labia so that a cotton swab can be inserted and rolled in the vaginal wall.
Describe the indications and methods of collecting a fine needle aspirate?	It is performed to collect a sample of fluid or tissue cells from a dermal or visceral mass or a lymph node. The needle is embedded in the mass, and suction is applied to aspirate cells into the needle.
17. Describe the indications for and method of placing a central catheter?	Shave and aseptically prepare the skin over the distal portion of the vein. Occlude the vein. Aligh the catheter parallel to the vein. Insert the catheter into the skin and vein with the bevel facing up.
17 continued:	When blood enters the hub of the catheter, advance an additonal few mm. Hold the stylet in place and slide the catheter into the vein. Remove the digital pressure as the catheter is advanced.
17 continued:	Immediately place a catheter cap into the hub of the catheter. Secure the catheter in place with adhesive tape.
List the advantages of placing a through the needle catheter?	An through the needle catheter is used when the catheter must be indwelling. It also is one of the perferred catheters in a vet clinic.
19.List signs that an injected drug (particularly a chemotherapeutic agent) has extravasated. Explain what action should be taken?	The drug can be very irritiating. It can cause major tissue damage like tissue scuffing. If extravasation occurs, as much of the drug should be removed from the site as possible by aspirating 5 ml of blood back through the catheter.
19 Continued:	The tissue surrounding the site should be infused with saline solution, cortiscosteroids, or 2% lidocaine; either warm or cold compresses should be applied.
Explain the route and method of vaccine administration?	When vaccines are administrated, especially to feline patients, the intrascapular region should be avoided because of the incidence of vaccine induced tumors.
Feline vaccinations should be administered in as distal a portion of an extremity as possible. The following sites are recommended for feline vaccinations:	Rhinotracheitis/calici/panleukopenia in the right front leg. Rabies in the right rear leg. Feline leukemia in the left rear leg.
20.Explain indications and contraindications of intraosseous fluid administration?	Medications and fluids quickly enter the central circulations via the intramedullary vessels in the marrow cavity. Intraosseous placement of a needle ro catheter allows rapid fluid delivery to neonates, small animals, animals cirulatory collapse.
20 coninued:	Placement of an intraosseous needle or catheter is contraindication in patients with sepsis. Catheters are not placed in bones that are fractured/infected. Skin around catheter should be kept very clean.
22. List indications for intraperitoneal administration of fluids and medications?	The intraperitoneal route involves placement of substances directly into the abdominal cavity. Used to administer noncaustic fluids, blood products, or medications.
22 Continued:	Substances injected into the peritoneal cavity are absorbed more rapidly than those administered SQ but more slowly than those given by the intravascular or intraosseous route.
23. Demonstrate skill at administering medications of fluids and medications?	Administration of oral medications can be administered as liquid, tablet, or capsule. Tablets and capsules may be placed in the back of the animals oral cavity just by grasping the animals top and bottom jaw and prying open.
23 continued:	Liquid medications can be administratered by using a syringe and placing it on the side of the mouth in the cheek pocket, and pushing the teeth apart and opening the jaw and getting it in the back of the throat.
24. Discuss indications and contraindications for usage of various forms of feeding tubes.	Critically ill animals may not be able to normally consume enough calories for proper nutrition and therefore require nutritional support.
24 contined:	If the gastrointestinal tract is capable of digestion and absorption, then slurries or medications can be administered through tubes placed directly into the pharynx, esophagus, stomach. Most feeding tubes should be replaced after so many days.
25. List the most common sites used for venipuctuntcure as well as other possible sites in cattle, horses, swine, sheep, and goats?	Bovine Venipucture includes the jugular, coccygeal, and subcutaneous abdominal venipuncture.
25 continued: Porcrine venipuncture includes cranial vena cava, external juglular, auricular vein, orbital sinus, tail vein. Ovine and Caprine venipuncture includes the jugular. Equine venipuncture includes jugular and transverse facial vein.
26. Compare abdominocentesis techniques in ruminants when each of the following is suspected: Traumatic reticuloperitonitis, uterine rupture, small bowel rupture, urinary tract obstruction, urinary bladder rupture. List potential complications?	Traumatic reticuloperitonitis: the centesis site is the ruminoreticular recess. This recess is in the left cranial guadrant of the abdomen approximately 5 cm caudal to the xiphoid process and 5 cm to the left of the midline.
26 continued:	Small bowel rupture: centesis is performed 5 cm cranial to the udder and medial to the right flank fold.
26 continued:	Urinary tract obstruction and bladder rupture: The needle is inserted approximately 3 cm to the right midline in the most dependent part of the ventral abdomen.
26 continued:	Complications of abdoinocentesis include, bowel laceration, introduction of bacteria at the site, resulting in peritonitis or cellutitis, and damage to the xiphoid process of the centesis site is top cranial.
28. List signs of inflammation or infections around a catheter site and explain what is commonly done if any of these signs are present?	The catheter site and the surrounding tissue should be checked regularly for pain, redness, swelling, and discharge, if any of these signs are noted, the catheter should be removed and a new one should be placed in a different vein.
28 continued:	If the catheter inducing bactermia or specticemia is suspected, the tip of the catheter is submitted for bacterial culture. If the catheter becomes extravascular, SQ swelling occurs, the catheter should be removed and placed in a different vein.
29. Compare commonly used sites for medication administration (intramuscularly and subsutaneously) in large animals, sites to avoid, and maxium amounts that may be injected at each site?	In cattle the only muscle that should be used for intramuscular administration should be in the neck. In horses the neck and rear legs are. The lower half of the semimembraneous/semitendinosus muscules are great places in the rear leg.
29 continued:	For SQ injections the neck is the site recommended in horses and any region on the lateral aspect of the neck or trunk can be used for SQ injections on cattle.
29 continued:	The areas that should be avoided on both horses and cattle is the gluteal area because it is more prone to abscessation. The pectrol muscles in horses can be used but there may be some inflammation.
30. Discuss steps to follow when performing an intramammary infusion of antibotics?	The udder is milked out, cleaned with a dip and dried with a seperate cloth. The teat is wiped down with 70% alcohol, air dried. The syringe is partially inserted into the teat. The teat is grasped and occluded as the antibotic is massaged into the teat.

Created by: BananaGirl05

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