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Unit 3 cp 19

Small Animal Medical Nursing Objectives 7-10

chronic kidney disease is characterized by an irreversible, progressive loss of functioning renal tissue
serum elevations of the protein metabolites creatinine and blood urea nitrogen azotemia
what does urine specific gravity test for it measures the concentration of urine and is a reflection of patient hydration status and of kidney function. Low USG is indicative of impaired kidney function
medical management of chronic kidney disease focuses on several key steps they are slowing progression of the disease, treating concurrent disease, correcting electrolyte imbalances, ameliorating clinical signs and providing nutritional support
what is a urolithiasis a pathologic stone formed from mineral salts found in the urinary tract and is dependent on urine pH, concentration and saturation
clinical signs of a urolith depend on location, number, size and shape, and whether concurrent urinary tract infection is present
naming urolith depend on the location of urolith include nephrolith, ureterolith, urocystolith and urethrolith
straining to urinate is called stranguria
abnormally frequent urination pollakiuria
painful urination dysuria
the most common form of bacteria to cause a UTI in small animals is Escherichia coli
UTI is a common secondary infection for pets with diabetes, CKD or hyperadrenocorticism and patients with indwelling catheters
diagnosing a UTI is made based on the presence of white blood cells, red blood cells and bacteria found during microscopic examination of urine
FLUTD stands for feline lower urinary tract disease
FLUTD is a term used to describe the constellation of signs indicating irritation of the bladder and urethra in the cat with signs of stranguria, dysuria, hematuria, pollakiuria and inappropriate urination
FLUTD can be either one of two types they are obstructive and nonobstructive
the underlying cause of patients with nonobstructive FLUTD is feline idiopathic cystitis or the presence of uroliths
a thorough diagnostic approach for FLUTD includes but is not limited to complete urinalysis, urine c&S, x-ray, US, contrast studies
If uroliths, UTI, neoplasia or any other causative disease process is ruled out the diagnoses is then FIC - feline idiopathis cystitis
FIC is a multifactorial disease with a complex pathogenesis that involves disorders of the hypthalmic pituitary adrenal axis, nervous system and the bladder itself
other factors that play a role in FIC are environmental stressors, behavioral disturbances and dietary factors
Endocrine Disease a disease that affects cats in which the thyroid gland is overactive, producing abnormally large amounts of T4 and T3 resulting in an increased basal metabolic rate is called hyperthyroidism
Clinical signs of hyperthyroidism include weight loss, anorexia, vomiting, depression, tachycardia, heart murmur, enlarged thyroid gland and hypertension. also elevated serum T4, T3
treatment of hyperthyroidism falls into two categories curative and palliative
palliative treatment consists of antithyroid medication, given once or twice a day which blocks thyroid hormone synthesis, decreasing the levels of circulating thyroid hormones
Curative treatment consists of surgical removal of the thyroid gland either one or both lobes
disease that primarily affects dogs, although a rare congenital form can be seen in kittens hypothyroidism
underactive tyroid, resulting in subnormal circulation levels of thyroid hormones causing a decreased metabolic rate hypothyroidism
clinical signs of hypothyroidism include weight gain, exercise intolerance, altered mentation, lethargy
diagnostic conformation of hypothyroidism includes low serum T4 and T3 levels and elevated TSH
disease that results from insufficient production of insulin by pancreatic beta cells, or from insulin resistance diabetes mellitus
high blood glucose hyperglycemia
glucose in the urine glucosuria
clinical signs of diabetes mellitus include PU/PD, weight loss and increased appetite, cats have plantigrade stance, dogs have cataracts
cats with diabetes should eat a diet of high-protein/low-carbohydrate
dogs with diabetes should eat a diet of high fiber
DKA-diabetic ketoacidosis develops in patients that go a long time with out treatment of diabetes
the toxic metabolite found in patients with DKA is ketones in the urine
ketones develope in the urine over time because the body is unable to use glucose an alternate pathway for carbohydrate metabolism is formed. Ketones are the by product of that pathway
disease that primarily affects dogs and is characterized by elevated circulating levels of cortisol produced by the adrenal cortex Hyperadrenocorticism or Cushings syndrome
the cause of HAC can be a anterior pituitary tumor secretes ACTH or adrenal tumor secretes cortisol or pharmacologic intervention aidmed at decreasing the amount to cortisol produced by the adrenal glands
The treatment of choice for adrenal-dependant HAC is the removal of the adrenal tumor
disease caused by adrenal glad atrophy or destruction, resultin in inadequate secretion of glucocorticoids and mineralocorticoids hypoadrenocorticism or Addisons disease
clinical abnormalities include anemia, azotemia, hypoglycemia, elevated serum K and decreased Na
Reproductive diseases inflammation of one or more mammary glands mastitis
decreased flow of milk in the mammary glands, resulting in enlarged painful mammary glands galactostasis
a bacterial infection of the uterus metritis or pyometra??
disorder occurs usually 2-3 weeks after birth and patients present with trembling, convulsions and low Ca serum levels Eclampsia or hypocalcemia
a condition that occurs in old intact male dogs who present with trouble urinating, blood in urine, and trouble defecatating prostatic disease
those diseases in which the immune system has lost tolerance of self and perpetuates damage to the bodys organs immune-mediated disease
the most common cause of immune-mediate hemolytic anemia in dogs is immune-mediated, the RBC's,
the most commmon type of IMHA in dogs is primary where the immune system targets the RBC as foreign or an antigen and makes antibodies against RBC tissue
IHMA in cats is different it is secondary to blood parasite infection of the RBC, where the immune system attacks the parasite but kills the RBC in the process
a disorder of neuromuscular transmission that causes muscle weskness acquired IM) Myasthenia Gravis
myasthenia gravis is caused by an immune system dysfunction that produces autoantibodies against acetylcholine receptors in the postsynaptic membrane
a chronic progressive deterioration of the articular cartilage of the joint caused by joint laxity and/or abnormal load bearing of the joint joint disease osteoarthritis
prevention of OA is ideal and entails early detection
administration of chondroprotective medications and supplements promotes synovial joint health
diseases caused by pathogenic microorganisms that invade and colonize within the tissues and fluids of an individual animal are called infectious diseases
Infectious diseases involve many different pathogens such as viruses, bacteria, fungi and rickettsiae
A Transmissible disease (Infectious Disease) must be able to avoid host defense systems, reproduce in the host and cause disease The pathogen
can be an animal, insect or fomite (inanimate object) in which he pathogen can survive The reservoir
Where/how the pathogen leaves the reservoir, often related to clinical signs of the disease process Portal of exit
how the pathogen travels to the next host mode of transmission
direct transmission immediate and requires direct contact of skin or mucous membranes with infected animal or its secretions or excresions
Indirect transmission delayed and requires contact with a contaminated fomite (inanimate object or insect)
Transplacental transmission passed from mother to neonate
where/how the pathogen gains entry into the new host portal of entry
exposure to a pathogen does not guarantee infection and disease Host susceptibility
infectious diseases that are transmitted directly between animals or indirectly through fomites contaminated with animal secretions are considered contagious
infectious diseases that require a biological vector are called vector borne
infectious diseases that are transmitted directly from animals to human are called zoonotic
Infectious agents that can infect a human or animal via a common vector are called shared vector zoonoses
infectious diseases that are transmitted from humans to animals are called reverse zoonoses
control of transmissible infectious diseases involves 1.Kill the pathogen while it is in the host 2. Kill the pathogen while it is living on a fomite 3. kill pathogen while it is living in a vector 4. strengthen host defense systems 5. decrease host exposure
the most effective management approach against contracting a zoonotic disease is called barrier nursing - a method that creates a "barrier" between a contagious patient and the nurse in an effort to reduce transmission of an infectious pathogen to other patients
the study of cancer oncology
cancer is a disease of uncontrolled growth of abnormal cells
the process of uncontrolled cell growth and subsequent formation of a tissue mass is called neoplasia
a multifactorial process by which normal cells are transformed into tumors carcinogenesis
three events must take place before malignant transformation can occur initiation, promotion and progression
initiation the cell is exposed to a factor that rapidly and irreversibly alter its DNA
further mutatuions of the initiated cell by an agent or event that stimulate proliferation of the cell to grow into neoplasm is called promotion
factors with carcinogenic potential include inherited genetic defects, hormones, viruses, diet, immune system dysfunction, trauma, chronic inflammation, radiation, variety of chemicals
tumors can be benign or malignant
tumors that do not invade or destroy surrounding normal tissues or spread to a new site are considered benign tumors
tumors capable of invasion and destruction of local tissue and of metastasis are considered malignant tumors
the process by which cancer cells spread ffrom a primary tumor to secondary locations such as lungs,lymph nodes. metastasis
steps in the metastatic process 1. cancer cells of the primary tumor must detach from the mass and invade other tissue 2. cells are transported to distant tissues where they reach metastatic site 3. a metastatic tumor is established when cells can survive and grow at the new site
carcinomas spread through both the lymphatic system and the blood stream. lymph node and lung metastases is common
sarcomas arise from mesenchymal tissues like cartilage, so not usually seen in the lymph system, spread through the blood stream and are more prevalent in pulmonary tissue
"oma" usually refers to a benign tumor
"sarcoma" or "carcinoma" malignant tumor
tumor grading is done by the veterinarian according to features of the tumor at the primary site (T), whether lymph nodes are involved (N), and whether the tumor has metastasized (M)
hormones or other substances synthesized by the tumor that circulate systemically and affect multiple organ systems or tissues parneoplastic syndrome
syndrome characterized by weight loss and muscle wasting caused by the presence of the tumor and by the secondary problems ie nausea, vomiting anorexia is called cancer cachexia
three primary treatment options are available for both dogs and cats with cancer diagnosis surgery, chemotherapy and radiotherapy
surgical approach resection should be performed in the normal tissues surrounding the mass so that a generous margin of normal tissue is removed along with the tumor
limitations of surgery include potential for damage to surrounding normal structures and its inability to address systemic spread of tumor, if long term disease control is not possibel
a cold source is used to freeze superficial cancers that are smaller in diameter cryosurgery
cryosurgery should not be performed in patients with very large tumors, in which definitive distologic diagnosis has not yet been made
radiotherapy is most appropriately prescribed for the treatment of localized cancers and does not address systemic cancers.It is used alone or in conmbination with surgery or chemotherapy
because radiation targets DNA it is most effective against tumor cells with rapid rates of proliferation
potential side effects of radiation are divided into two phases late phase and acute phase
late phase effects of radiotherapy develope over a course of months to years and usually involve permanent changes such as necrosis or fibrosis of normal tissues
acute effects usually seen during the latter stages of radiotherapy and and require nursing care but are temporary, vomiting, nausea
preferred method of treatment for local cancers is surgery and radiotherapy
preferred treatment for systemic cancers chemotherapy
the treatment of cancer with chemical agents chemotherapy
indications for chemotherapy include 1. primary treatment for known chemotherapy sensitive tumors to "shrink" them for better resection 2. palliative vs. curative treatment for temporary relief of clinical signs caused by cancer and quality of life
if a chemotherapy agent a potent vesicant is given perivascularly do not remove the iv catheter, but irrigate the area with sterile saline both through the catheter and SQ to dilute the drug. Giving dexamethasone in the area is often recommended, cold compressesd
some administration of chemotherapy drugs may elicit an allergic reaction so a premed of antihistamines and glucocorticoids is recommended
the most clinically relevant blood line affected after administration of chemotherapy is bone marrow suppression, myelosuppression
other reactions include GI upset, loss of hair
Created by: tnewhouse