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The nursing process
311.2 Vet nursing The nursing process and clinical exams
| Question | Answer |
|---|---|
| How is the medical model orientated? | Disease orientated |
| How is the nursing process orientated? | Patient orientated |
| What are the steps of the nursing process | Assessment->Nursing diagnosis->Planning->Implementation->Evaluation |
| What is assessment in the nursing process? | Establish individual needs of patient, find out info on normal behaviour |
| What is nursing diagnosis in the nursing process? | Find out what the patient needs for the best nursing care |
| What is planning in the nursing process? | Make plans to overcome the nursing problems identified and set goals |
| What is implementation in the nursing process? | Follow the set plan, making sure to record steps on patient sheets |
| What is evaluation in the nursing process? | Make sure the plan is working, that goals are met and the problems have been solved |
| What are the 3 nursing models? | The ability model, The Orem model and The Roper, Logan and Tierney model |
| Which nursing model has the 10 abilities? | The Orpet and Jeffery ability model |
| What are the 10 abilities? | Eat, drink, pee, poo, breathe, body temp, groom, move, sleep and express normal behaviour |
| Which nursing models take lifespan as a continuous factor? | The ability model and the Roper, Logan and Tierney model |
| Which nursing model includes conception? | The Orem model |
| Which nursing model includes the 8 universal self-care requisites? | The Orem model |
| What are the 8 universal self-care requisites? | Breathe, drink, eat, eliminate waste, balance activity and rest, balance social interaction, prevent hazards, behave normally |
| Which nursing model includes the 12 activities of living? | The Roper, Logan and Tierney model |
| What are the 12 activities of living? | Stay safe, communicate, eat and drink, eliminate waste, breathe, groom, body temp, move, work and play, express sexuality, sleep, die |
| Which nursing model looks at the dependence/independence continuum? | The Roper, Logan and Tierney model |
| What are the 5 factors influencing the activities of living? | Biological, Psychological, Sociocultural, Environmental, Politicoeconomic |
| What are the 5 components of the Roper, Logan and Tierney model? | Activities of living, Lifespan, Factors affecting activities, Dependence/independence, Individuality of living |
| What is one of the most important jobs of the veterinary nurse? | Careful observation and assessment of patients |
| What must vet nurses be able to do? | Recognise normal and abnormal appearance and behaviour patterns of those in their care |
| What does a nursing model provide the nurse with, particularly at the assessment stage? | Information on the normal or ideal state of the patient |
| How does carrying out an assessment impact on the nursing care of the patient? | More specific to the patient and ability to not miss out on important info |
| What is the SOAP method? | Subjective, Objective, Assessment, Planning |
| How should the patient be observed at first? | From afar and immediately on their entrance to the surgery |
| How can we promote normal patient behaviour in practice? | Pheromones, animals in best kennels for purpose, nurse consults for socialisation, towels to cover cages, sedation, home visits |
| What is meant by assessment of patient mentation? | How the patient might be feeling, their mental state such as scared, tired, etc. |
| What are 3 important measures of the body's function? | Temperature, pulse and respiration |
| What are TPR also know as? | Clinical parameters |
| What is useful about TPR? | Easy to measure and monitor throughout treatment |
| Normal temperature range of the dog? | 38.3-39.2oC |
| Normal temperature range of the cat? | 38.2-38.6oC |
| Normal temperature range of the horse? | 37.2-38.9oC |
| Normal temperature range of the rabbit? | 38.5-40oC |
| What is another word for fever? | Pyrexia |
| What might cause pyrexia? | Drug reaction, Infection, Neoplasia |
| What might cause hyperthermia? | Hot room, Heat stroke, Stress, Exercise, Seizure activity |
| What might cause hypothermia? | Anaesthesia, Drug reactions, Environment, Illness |
| What is a diphasic temperature? | One which is fluctuating |
| What colour should the mucus membranes be? | Pink, paler in cats |
| What might a pale MM signify? | Poor perfusion, circulatory collapse, haemorrhage, anaemia |
| What might blue/purple MM signify? | Insufficient transport of oxygen to the body tissues. Respiratory obstruction or dyspnoea |
| What is blue/purple tinged MM also called? | Cyanotic |
| What might yellow MM signify? | May be due to liver disease, bile flow obstruction or an increase in RBC destruction. In foals can be due to neonatal isoerytholysis |
| What is yellow tinged MM also called? | Icterus/jaundiced |
| What might a dark MM signify? | Sepsis, fever, congestion, extensive tissue damage or excitement |
| What might cherry red MM signify? | Carbon-monoxide poisoning |
| What might orange MM signify? | Administration of synthetic haemoglobin products |
| What might chocolate brown MM signify? | Paracetamol poisoning in dogs and cats |
| What is neonatal isoerythrolysis? | Incompatibility of blood types between the mare and foal |
| What are petechiae? | Pinpoint red haemorrhages on the mucosa. |
| What might petechiae signify? | Blood clotting disorders such as von Willibrand's or animals poisoned with anti-coagulant rodenticides |
| What is the CRT? | Capillary refill time. The time it takes for full colour to return to the mucosa |
| What is a normal CRT? | 1-2 seconds |
| What may an increased CRT indicate? | Dehydration, Heart failure, Shock, Hypovolaemia |
| What might a decreased CRT indicate? | Severe sepsis or fever |
| What are the 5 common pulse points in dogs and cats? | Sub-lingual, carpal, coccygeal, femoral and dorsal metatarsal |
| Where is the sub-lingual pulse found? | Ventral aspect of the tongue |
| Where is the carpal pulse found? | Palmar aspect of the carpus |
| Where is the coccygeal pulse found? | Proximal ventral aspect of the tail |
| Where is the femoral pulse found? | Medial aspect of the femur |
| Where is the dorsal metatarsal pulse found? | Medial aspect of the tarsus |
| 4 common pulse points in the horse? | Ventral ramus of the mandible, Transverse facial artery, Palmar digital arteries, Radial artery |
| 3 important factors to consider when taking the pulse? | Pace, rhythm, character |
| 7 reasons for a tachycardia? | fever, fear, exercise, pain, hypoxia, hypovolaemia, drug reaction |
| 4 reasons for bradycardia? | Unconsciousness, sleep, anaesthesia, very fit |
| 2 reasons for a weak pulse? | hypovolaemia, diminished cardiac output |
| 2 reasons for a strong, jerky pulse? | Valvular insufficiency, congenital heart defects (patent ductus arteriosus) |
| On double sided stethoscopes the flat diaphragm is for what? | High-frequency sounds such as the heartbeat |
| On double sided stethoscopes the curved diaphragm is for what? | Lower-frequency sounds such as the lungs |
| Single sided stethoscopes rely on what to change pitch detection? | Pressure |
| Light pressure on a single sided stethoscope will detect what? | Low pitched sounds |
| Firm pressure on a single sided stethoscope will detect what? | High pitched sounds |
| Where should you listen for the optimum heart sounds? | Between the 3rd and 6th ribs on the left side |
| What should the heart rate be for a dog? | 70-140bpm |
| What should the heart rate be for a cat? | 100-200bpm |
| What should the heart rate be for a horse? | 30-40bpm |
| What should the heart rate be for a rabbit? | 130-325bpm |
| Why should respiration be measured first when doing TPR? | If patient is not breathing intervention is required. Temp is measured last to stress patient less |
| What is dyspnoea? | Difficulty breathing |
| What is apnoea? | Stop breathing |
| What is tachypnoea? | Fast breathing |
| What is hypopnoea? | Shallow breathing, reduced lung filling |
| What is bradypnoea? | Slow breathing |
| What is orthopnoea? | Dyspnoea that is relieved by adopting an upright position. Extends the head and neck and pushes out the shoulders to give the most space to breath. |
| What is Cheyne-Sokes respiration? | Deep convulsive breaths at infrequent intervals, also called agonal breathing. At death. |
| What is stridor/stertor? | Loud/noisy breathing |
| What is the normal resp rate for a dog? | 10-30rpm |
| What is the normal resp rate for a cat? | 20-30rpm |
| What is the normal resp rate for a horse? | 12-20rpm |
| What is the normal resp rate for a rabbit? | 30-60rpm |
| What does a blood pressure measurement provide? | Info about cardiovascular function. Indirect measurement of cardiac output and tissue blood flow |
| What is hypotension? | Low blood pressure |
| Why is hypotension bad? | Increased glucose demand, O2 demand and cardiac work which leads to tissue and organ damage. |
| What is systolic BP? | Peak pressure. Towards the end of the cardiac cycle when ventricles are contracting. |
| Normal systolic BP? | 90-120 mmHg |
| What is diastolic BP? | Minimum pressure. Beginning of the cardiac cycle as ventricles fill with blood. |
| Normal diastolic BP? | 55-90 mmHg |
| What is the gold standard method of measuring BP? | Direct arterial blood pressure measurement (arterial catheter) |
| How can the wrong size BP cuff affect the results? | Loose cuff- lower readings, Tight cuff- higher readings |