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Nursing Lab Exam
| Question | Answer |
|---|---|
| 4 goals of physical therapy | 1. prevent complications from injury or secondary to inactivity 2. maintain body condition 3. improve patient comfort 4. speed recovery |
| what are needs of a recumbent patient | -clean dry, well padded bedding -rotate sides -propped up -massage -heat therapy |
| what is stroking? | massage technique: head to tail, proximal to distal |
| what is Effleurage? | massage technique: distal to proximal, towards heart |
| what is PROM | passive range of motion -full motion through joint (flexion and extension) -don't go past resistance |
| benefits of PROM | -done after a massage to warm up -maintains mobility -improves circulation -decreases edema and stress -improves rate of recovery |
| what is Active Range of Motion | -during exercise, weight bearing, stretching -hold slighter longer at point of resistance |
| 5 weight bearing and weight shifting benefits | 1. improve muscle strength and joint stability 2. improve joint mobility 3. proprioception training 4. increase endurance 5. maximize function |
| 4 suggested weight bearing/shifting exercises | 1. assisted standing 2. weight shifting 3. limb-lifting 4. slow leash walking on short leash |
| what is cryotherapy | cold therapy, best immediately post-trauma and post-exercise |
| When is heat therapy preferred | before exercise and post trauma |
| what is hypoxia | lack of O2 to tissues/cells |
| what is the primary reason for O2 therapy | Hypoxia |
| what happens to tissues when there is hypoxia | body starts anaerobic metabolism, lactic acid builds up, metabolic acidosis occurs and results in cellular dysfunction or death |
| 3 things that causes of hypoxia | 1. decrease in blood flow 2. reduction in oxygen content of the blood 3. inability of cells to use oxygen |
| what is the goal of O2 Supplementation | to provide adequate oxygen at the tissue level |
| what does Pulse Oximetry measure | measures arterial hemoglobin-oxygen saturation (amount of SpO2 in the blood) |
| what is the normal SpO2 level | 95-98% and over |
| what does the capnometer measure | measures carbon dioxide concentration of expired air) |
| what can Capnography help ensure | the proper ET tube placement |
| 5 clinical signs of Hypoxemia | 1. open mouth breathing 2. dyspnea 3. cold extremities 4. cyanosis 5. Tachypnea |
| 9 indications for oxygen therapy | 1. hypoxemia 2. airway obstruction 3. pulmonary neoplasia 4. thoracic pain 5. anesthetic accident 6. abdominal distension 7. pneumonia 8. pulmonary contusion 9. anaphylaxis |
| why can O2 supplementation sometimes be bad | -can suppress body's drive to breath, suppress RBC formation, and can cause pulmonary vasodilation and systemic vasoconstriction |
| 6 steps to monitoring patients on Oxygen | 1. First OBSERVE 2. Then LISTEN 3. Check MM 4. Use monitoring equipment 5. Check blood values 6. Reassess often! |
| what is the goal of oxygen therapy | increase the amount of oxygen bound to hemoglobin arterial blood |
| how can we tell if oxygen therapy is helping. a patient | 1. improved MM colour 2. decreased anxiety 3. decreased breathing 4. improvement in PaO2 or SPO2 |
| what 3 conditions have decreased oxygen demand | 1. anemia 2. CHF 3. Cardiovascular Shock |
| what 4 conditions have increased oxygen demand | 1. Heat Stroke 2. Fever 3. Heath Trauma 4. Sepsis |
| 8 oxygen administration techniques | 1. Face mask and nasal prongs 2. Flow-by 3. Crowe collar 4. Oxygen hood 5. Nasal catheter 6. Intratracheal 7. O2 cage 8. Mechanical ventilation |
| when is a face mask and nasal prongs used for O2 delivery | short term in emergency cases |
| benefit and disadvantage to the face mask and nasal prongs for O2 delivery | -benefit is quick delivery -disadvantage is there is a lot of waste gas and patients might not tolerate it |
| benefit and disadvantage to the flow by O2 administration | - benefit is that is it easy, immediate and well tolerated - disadvantage is that it is wasteful |
| benefits and disadvantages to a crowe collar | benefits: better tolerates than a mask disadvantages: O2 leakage, high humidity and CO2 retention |
| when is an oxygen hood used | used on recumbent animals that are unable to rise |
| when is a nasal catheter used for O2 therapy | long term use of O2 therapy |
| advantages to nasal catheter | allows access to patient, effective, well tolerated |
| when is Intratracheal O2 therapy used | emergency delivery when intubation is needed but not possible |
| when is an O2 cage a good idea | patients who are fractious and hard to handle |
| disadvantages of O2 cage | expensive, O2 waste |
| when would you use mechanical ventilation for O2 therapy | -when patient is holding breath or not breathing well -difficulty reaching a good plane of anesthesia -thoracic surgery |
| what is the goal of mechanical ventilation | optimize lung exchange, ensuring that the breath is delivered in a physiologically appropriate manner |
| 3 risks to mechanical ventilation | 1. ruptured alveoli 2. decreased cardiac output 3. respiratory alkalosis or acidosis |
| 3 types of mechanical ventilators | 1. pressure cycle 2. volume cycle 3. time cycle |
| 3 things pain can cause | 1. altered cardiac output 2. increased oxygen consumption 3. immunological impairment |
| what can relieving pain do for the patient | allow patients to regain normal function faster and improve both surgical recovery and speed healing |
| dispelling 3 pain management myths | 1. analgesics dont mask physiological signsof pain and should not be withheld 2. neonates have a stronger experience of pain than adults because their nervous system is unable to dampen the pain signals 3. opioids dont impair ventilation but improve it |
| pain definition | disagreeable sensory and emotion occurrence associated with actual or potential tissue harm |
| what are nociceptors | receptors that specifically detect injury to body tissues |
| 4 phases of the pain pathway | 1. Transduction 2. Transmission 3. Modulation 4. Perception |
| describe the flow of the pain pathway | on paper.... |
| nociception vs perception | difference is the consciousness. Nociception occurs even when patient is unconscious; perception does NOT occur when unconscious, |
| what part of the pain pathway does Opioids affect and name 2 drugs | Affects perception -hydromorphone, methadone |
| what part of the pain pathway do NSAIDS affect and name 2 drugs | affects transduction -meloxicam, carprofen |
| what part of the pain pathway do Alpha 2 Agonists affect and name 2 drugs | affects transmission -dexedetomidine, xylazine |
| what part of the pain pathway do NMDA antagonists affect and name 2 drugs | affects Modulation -ketamine, amantadine |
| what part of the pain pathway do Local anesthetic effects and name 2 drugs | affects transduction an transmission -lidocaine, bupivacaine |
| what part of the pain pathway do anticonvulsants affect and name 2 drugs | affects perception -gabapentin, diazepam |
| what part of the pain pathway do antidepressants effect and name 1 drug | affects perception -amitriptyline |
| what is windup pain | if pain is left untreated, the CNS becomes overwhelmed causing the neurons to become progressively and increasingly excitable |
| what is hyperalgesia | a state where less and less stimulation is required to incite a pain response |
| what is allodynia | where a normally non-painful stimulus (light/sound) are interpreted as painful |
| in general what are the 5 concepts used when developing a good pain management protocol | 1. pre-emptive analgesia 2. multimodal analgesia 3. matching analgesics 4. maintain an analgesic plane 5. dont quit until the pain quits |
| 3 behavioural characteristics of pain | 1. hiding 2. head pressing 3. screaming |
| 3 physiological characteristics of pain | 1. dilated pupils 2. panting 3. tachycardia |
| how do local anesthetics work | blocks the transmission of nerve impulses. |
| what technique do you need to use to provide effective local anesthesia | place the drug immediately beside the target nerve |
| what are the 12 methods to administer local anesthetic | 1. topical 2. splash block 3. regional nerve block 4. head/dental 5. intracoastal 6. inter-pleural 7. brachial plexus block 8. intravenous/CRI 9. Paw block 10. Intra articular 11. ring block 12. epidural |
| what are topical local anesthetics used for | desensitize the nose, mouth, eyes, esophagus, and urogenital tract, as well as what we use Emla for |
| what is an inter-pleural block | alternative to an intra-costal block, distribution of the block is affected by gravity and the patient is positioned incision side down, the patient should remain in this position for 20 mins while the drug takes effect |
| when should a brachial plexus block be performed | performing a toe amputation, fractures of the ulna or radius, and surgery of the foot |
| 5 nerves effected in a brachial plexus nerve block | 1. radial 2. median 3. ulnar 4. musculocutaneous 5. axillary |
| when is a ring block normally used | on a digit or a teat and completely encircles the effected area |
| what is an epidural | the injection of an anesthetic agent into the epidural space in order to affect sensation and or movement of the body |
| where is the anesthetic agent injected into for an epidural | lumbosacral verterbral junction |
| 5 surgeries that would benefit from an epidural | 1. abdominal surgery 2. rectal surgery 3. C-section 4. Vulva surgery 5. Surgery of the tail |
| 2 classes of patients that would benefit from an epidural | 1. debilitated patients: high risk during anesthesia 2. painful orthopedic surgery: intra-op and post-op analgesia |
| 5 contradictions of an epidural | 1. patients with septicemia or infections 2. spinal trauma 3. bleeding disorders 4. pre-exsiting neuro disease of spinal cord or peripheral nerves 5. spinal deformities |
| 4 ways to check the placement of an epidural | 1. "pop": of the ligamentum flavum 2. hanging drop: as needle is removed saline should be sucked in 3. Inject air: hear a whoosh in thoracic cavity with stethoscope 4. Injection of saline: you should not feel resistance |
| how are canine and feline blood groups determined | by the presence of species-specific antigens on the surface of rbc membranes |
| for canines how many major blood group antigens are they and what is the name | 8, DEA |
| what is the universal donor for a dog | a dog that is negative for all DEA group except DEA 4. |
| why do cats not have a universal donor | the have the presence of naturally occurring alloantibodies |
| what are the 3 blood types of cats and which is the most common | type A, B, and AB -A is the most common (90%) |
| what is the cat universal recipient | have type AB blood so can receive any feline blood |
| why is the most common type of canine blood typing kit test for DEA 1.1 | it is the most antigenic blood type, causing the most clinically noteworthy transfusion reaction |
| what criteria must a dog have to be eligible for blood donation | - > 25kg - 1-7 yrs - PCV at least 40% - UTD on all core vaccines - Do heart-worm test and be on prevention - free of blood parasites and Rickettsial diseases |
| what criteria must a cat have to be eligible for blood donation | - > 4.5kg - 1-7 yrs - PCV at least 30% - UTD on all core vaccines - Tested for FeLV, FIV - Free of blood parasites |
| weight restrictions allow _________ of blood to be collected from a canine and ______ from a feline | 450mls/g, 60/gmls |
| how often can a patient donate | every 4-6 weeks but clinics often just do it 4 times a year |
| what is the preferred method of blood collection for donors | jugular vein |
| which species requires sedation for blood collection for transfusions | cats |
| why is a single venipuncture preferred for blood transfusions | prevent damage to RBC's and activation of the clotting process |
| blood drawn in heparin or sodium citrate has to be used within ______ hrs to _______ hrs | 24-48 |
| procedure of blood collection for donor in dogs | 1. insert 16g needle into jugular 2. closed collection system placed on floor 3. scale placed under bag to measure how much is taken 4. no more than 13-17ml/kg taken from a patient at one time 5. Replacement crystalloid fluids = 3X vol blood taken |
| no more than ____ to _____ ml/kg should be taken from a feline patient at one time during blood donor collection | 11-15 |
| what is the shelf life of whole blood | 14-45 days |
| what is the shelf life of frozen plasma | 1-5 years |
| what consideration may prompt transfusion | a hematocrit of less than 20% |
| what is the transfusion calculation | anti-coagulated blood (mls) needed = kg x 70 x (PCV desired - PCV recipient) all divided by PCV donor |
| what is the normal rate of transfusion | 5-10 ml/kg/hour to a maximum of 22ml/kg/24 hrs |
| 3 non-immunological reactions to blood transfusion | 1. bacterial contamination 2. circulatory overload 3. improper administration |
| 3 immunological reactions to blood transfusion | 1. hives or edema 2. acute haemolytic reactions 3. delayed haemolytic reactions |
| what do blood crossmatching tests detect | will detect performed antibodies to forgien cells |
| IMHA patients show incompatibility with ______ donors | ALL |
| 4 examples of adverse reactions to blood transfusions | 1. tachypnea 2. fever 3. lethargy 4. vomiting |
| when whole blood is separated which products arise | plasma and packed red blood cells |
| what does frozen plasma contain | all clotting factors, albumin, and globulin proteins for 1 year |
| what is cryoprecipitate | specialized plasma product that is full of clotting factors and can be stored for up to 5 years |
| what type of blood product is best for animals with anemia | whole blood |
| why might it be better to give a smaller component of blood instead of whole blood | it has a short shelf life of 14-45 days . separated whole blood also causes less transfusion reactions because it contains less reactive substances |
| full cross match method | look on sheet |
| crossmatch slide mthod | look on sheet |
| what makes the full cross match better than the slide method | we washed the cells which breaks apart the rouleux, and it is thinner because we diluted it. Slide method also has a lot of false positives |
| 5 indications of stomach tubing | 1. mandible fractures 2. large oral tumours 3. megaesophagus 4. inappetance 5. weakness, etc |
| what is megaesophagus | the muscles of the esophagus fail and it cannot propel food or water into the stomach |
| how does supportive therapy with feeding help a patient. 3 ways. | 1. facilitates healing 2. shortens recovery period 3. maintains normal bowel function till patient can eat on its own |
| what is very important to remove when removing a naso or oro gastric tube | kink the tube! failure to do so can cause stomach contents to be drawn up into the pharynx and be inhaled |
| why might a nasogastric or nasoesophageal tube be placed | short term nutritional support, usually less than 10 days . diet must be liquid or almost liquid |
| where does the nasogastric tube end | in the stomach |
| where does the nasoesophageal tube end | distal esophagus |
| what is an esophagostomy tube | tube that enters the esophagus through an incision in the lateral neck and ends in the distal esophagus for a longer term (weeks/months) done under anesthesia |
| what is a gastrostomy tube | a tube that enters the stomach through an incision in the abdominal wall and is for long term use (months/year) done under anesthesia |
| what is a orogastric tube | tube that passes through the mouth through esophagus into the stomach. used for one time use for distention relief or delivery of contrast medium |
| what is gastric lavage | performed under general anesthesia to empty stomach of toxin and dilute contents with repeated flushing of water |
| how fast can nutrients be fed through a nasogastric tube | 20ml/kg at any one time |
| what does RER stand for | Resting energy requirement |
| RER calculation | RER (kcal/day)= (kg x 30) +70 |
| once RER is established how do you determine the amount needed to full fill caloric requirement | by dividing kcal/day by kcal/can. then further divide the amount into as many meals as makes sense for your patients needs |
| normal horse behaviour | -ears perked forwards -extended head and neck to sniff person -nuzzle, rub with head, calm and quiet eyes |
| nervous equine behaviour | -pulls back -shy -body tense, dilated pupils or buldgy eyes |
| aggressive equine behaviour | -bare teeth -ears laid flat back -kicking -lunging forwards |
| what kind of vision do horses have | monocular |
| where is a common place to find the pulse of a horse | maxillary artery (facial artery) |
| 3 common equine injection sites | 1. IV: jugular 2. IM: brachiocephalic, smst, hamstring, gluteal 3. SQ: scapula, brachiocephalic |
| 3 reasons to bandage horses legs | -protect legs from injury during shipping or fracture support -support after strenuous exercise and work -protection of wounds |
| 7 principles of equine bandaging | look on paper |
| what is cording | cutting off circulation in an area distal to where the bandage may have been drawn too tightly |
| how can you detect cording | excessive heat and swelling |
| how can you prevent cording | avoid too much tension, wrap in a coil pattern, leave 1inch visible of the 2nd layer |
| when might a equine tail wrap used | -used when horse is shipped - protection from urine, feces -during medical and surgical reproductive surgeries to prevent contamination |
| what do you have to be careful about with the tail wrap | • Tail has coccygeal artery in the upper portion • Careful not to cut off circulation • Could lead to tail sloughing |
| what does passive cattle look like | -chewing cud -licking themselves -rubbing themselves |
| what does nervous cattle look like | -try to run away -excited going back and forth |
| what does aggressive cattle look like | -raised erect head -snorting -pawing |
| what are the 2 defence mechanisms of a cow | 1. kicking (most common) 2. charging (most dangerous) |
| what is a cattle chute used for | restraint mechanisms, it decreases stress to animal and increases handler safety |
| what is a tail jack used for | lessens the effectiveness and strength of a kick |
| what is a tail jack | grasp base of tail firmly with both hands and bend it in a dorsal direction |
| 3 common places for blood collection in a cow | 1. jugular vein 2. tail vein 3. mammary veins |
| where is the point of balance in a cow | at the shoulders |
| what is the herding instinct | where the cow likes to be a group so it is harder to more one cow alone rather than a group |
| look over how to get a heart rate on an ECG | on assignment |
Created by:
jscott41
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