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Nursing Exam
| Question | Answer |
|---|---|
| what is shock | The state where widespread reduction of tissue perfusion leads to reversible, and then if prolonged, irreversible cellular injury |
| potential causes of shock | -trauma -anesthetic or surgical complications -anaphylaxis -colic -gastrointestinal obstruction -sepsis |
| 4 types of shock | 1. cardiogenic 2. hypovolemic 3. distributive 4. obstructive |
| what is cardiogenic shock | failure of the heart to pump |
| what is hypovolemic shock | decreased intravascular volume |
| what is distributive shock | loss of peripheral resistance causing flow maldistribution |
| what is obstructive shock | impaired diastolic filling or impaired systolic contraction from a cause originating outside of the heart |
| 4 major ways body responds to shock | 1. sympathetic nervous system is activated and releases epinephrine 2. shunting of blood from unnecessary to necessary organs 3. renal shut-down 4. splenic contraction |
| order of where the blood vessels contract first to last | 1st. Skin, fat, muscles 2nd. liver and GI tract 3rd. Kidney |
| when is shock irreversible | -blood volume is inadequate to perfuse brain and heart -when cells are too damaged by hypoxia and acidosis |
| what is DIC | Disseminated Intravascular Coagulation |
| what happens during DIC | massive vasodilation occurs along with excessive activation of the clotting mechanism and fibrin clots form throughout the body's smallest vessels |
| why is DIC also known as death is coming | very hard to treat |
| clinical signs of shock | -prolonged CRT -weak pulse -tachycardia -pale MM -cold extremities |
| how fast do patients die when not treated for shock | within 12 hours |
| what is the ultimate goal in treating shock | optimize tissue oxygen delivery |
| how to treat shock in hospital | 1. ABC 2. Crystalloid fluids 3. Colloids (use when not responding to crystalloids 4. Treat blood loss 5. Good nursing care |
| when do we treat blood loss in canines and felines | -PCV <20% in canine -PCV <15% in feline |
| what drugs can be used to treat shock | -dopamine/dobutamine -sodium bicarbonate -bactericidal antibiotics -doxapram -epinephrine -lidocaine -furosemide -analgesics -corticosteroids |
| what is the normal urine output | 1-2ml/kg/hr |
| what is normal blood pressure | >90 mmHg systolic |
| 7 first steps when seeing a patient during triage | 1. identify yourself 2. assess the owner 3. thorough history and examination 4. classify emergency 5. contact veterinarian 6. watch what you tell owner 7. seperate before treatment if needed |
| levels of triage | -Class I (critical), needed within sec to mins -Class II(urgent), min to an hour -Class III (pressing), within a few hours -Class IV(non-pressing), within 24 hours |
| examples of class I triage | -cardiac/resp arrest -GDV -anaphylaxis |
| examples of class II triage | -shock -dystocia -seizures |
| examples of class III triage | -lacerations -burns -fractures |
| examples of class IV triage | -lameness -anorexia |
| 5 most common causes of critical emergencies | -resp failure -severe dyspnea -cardiac arrest -anaphylaxis -GDV |
| 3 possible causes of resp failure | -trauma -anaphylaxis -anesthetic emergencies |
| 3 possible causes of dyspnea | -pleural effusion -airway obstruction -pulmonary edema |
| how long does a seizure need to be for it to be status epilepticus | seizure lasting more than 10 minutes |
| 3 causes of status epilepticus | -epilepsy -head trauma -toxicity |
| a few treatments for heat stroke | -large bore IV catheter and cool IV fluids -NO ICING -Oxygen and corticosteroids |
| when should we stop cooling after heat stroke occurs | @ 39 degrees celcius |
| when does gastric dilation +/- volvulus usually occur | -in large deep chested dogs who exercised after a meal or who gulp air during eating |
| 6 steps in treating GDV | 1. place stomach tube 2. gastric lavage 3. trocarization PRN 4. IV catheter and fluids 5. surgery PRN 6. monitor heart for PVC's |
| 4 other gastrointestinal emergencies | 1. intussusceptions, part of the bowel telescopes on itself 2. foreign bodies 3. string gut 4. obstructive tumours |
| 3 causes of acute pre-renal failure | -dehydration -shock -heart failure |
| 4 reasons for acute renal failure | -infection -ischemia -immune-mediated damage -nephrotoxins |
| reasons for acute post-renal failure | -obstruction or rupture of urinary tract |
| clinical signs of acute renal failure | -dehydration -anorexia -oral ulcers |
| what happens in acute renal failure to cause PU/PD | azotemia= increased BUN and CREA and 3/4 of the nephrons are damaged and/or function is lost |
| what is isothenuric urine | specific gravity between 1.008-1.012. kidneys are unable to concentrate |
| is acute renal failure reversible | potentially, it is best to catch early |
| treatment for acute pre-renal failure | -address primary problem -rehydrate, control heart |
| treatment for acute renal failure | -correct fluid and electrolyte imbalances, decrease BUN/CREA, give antiemetics, treat cause |
| treatment for acute post-renal failure | -relieve obstruction/repair rupture |
| who is chronic renal failure more common in | older animals, especially cats |
| what is the goal of treating chronic renal failure | palliative and aimed at improving quality of life while slowing disease progression |
| what treatments can we provide during palliative care for chronic renal failure | -increase fluid intake to decrease azotemia -food nutrition, sometimes less protein and higher quality food -decrease stress |
| how often should we monitor a patient with CKD | every 3-6 months |
| explain the difference between CKD and AKD | AKD: -patient history is healthy -good body condition but depressed -normal or large sized kidney possibly painful CKD: -history is weeks to months of PU/PD -could have weight loss and vomitng -small and non-painful kidney |
| 4 factors IRIS looks at to stage renal failure | -Creatinine -SDMA -urine specific gravity -UPC ratio |
| what is prostatic disease | -when the prostate gland is enlarged due to infection, cysts, benign hypertrophy, neoplasia |
| clinical signs of prostatic disease | -difficulty urinating -blood in urine -tenesmus -difficulty walking |
| treatment of prostatic disease | -castration for all forms |
| what is a pyometra | pus filled uterus |
| what species does a pyometra normally affect | intact females |
| what is the difference between an open and closed pyometra | -open is presented with vaginal discharge -closed is presented with PU/PD, anorexia, no discharge |
| what is the best treatment for a pyometra | -ovariohysterectomy |
| what does IMHA stand for | Immune-mediated Hemolytic Anemia |
| what happens in IMHA | body destroys its on RBC's because it recognizes them as foreign and develops autoantibodies against them |
| clinical signs of IMHA | -lethargy -pale or icteric MM -prolonged CRT -Tachycardia, Tachypenia |
| how to diagnose IMHA | -CBC -Microscopic analysis -Slide agglutination test -Coombs test |
| what is a classic finding of IMHA | agglutination |
| what percentage of animals survive IMHA to be discharged from hospital | 50-80% |
| what are some treatment options for IMHA | -volume resuscitation -O2 -blood transfusion -immunosuppressive drugs -anticoagulants to prevent thromboembolism |
| what are 7 most common types of cancer in dogs | -skin -mammary -testicular -bone -lymph node -splenic -lipomas |
| what are mammary tumours | lumps over mammary glands on abdomen or thorax |
| what is the percentage that mammary tumours are malignant in dogs | 50% |
| what should we always check for before doing surgical removal of mammary tumours | radiograph thorax to determine if metastasis has occurred to lungs |
| a ______ greatly reduces chances of mammary tumours by ______ if done before _______ of age | OVH, 80%, 2 years |
| what percentage of mammary tumours are malignant in cats | 80-90% |
| neutering is 100% effective at preventing what type of cancer | testicular |
| what is bone cancer also known as what | osteosarcoma |
| what species is bone cancer most common in and where is the cancer normally found anatomically | -large breed dogs -usually found at distal ends of the long bones |
| what are splenic tumours also known as | hemangiosarcoma |
| what is a splenic tumour | cancer of the lining of the blood vessels |
| where is the primary splenic tumour most common | primary tumour is in the right atrium of the heart |
| what clinical signs does splenic tumours create | causes signs of hypovolemic shock |
| what are the 3 stages of splenic tumours/hemangiosarcomas | stage 1: non-ruptured stage 2: ruptured with hemoabdomen stage 3: ruptured or non with metastasis to lungs, liver, omentum, etc |
| treatments for splenic tumours | -treat shock -surgical removal (splenectomy) -possibly chemotherapy |
| what is a lipoma | benign tumours of subcutaneous fat |
| when are lipomas most common | older overweight dogs |
| what is a surgical excision of a lipoma necessary | if it interferes with locomotion |
| what is the most common skin tumours in cats | squamous cell carcinoma |
| 7 cancer treatment options | 1. surgery 2. chemotherapy 3. immunotherapy 4. radiation 5. no treatment 6. palliative care 7. euthanasia |
| what is debulking when doing a surgical treatment | partially remove a neoplasm in order to make other therapies more effective |
| what is marginal surgical treatment | used for locally aggressive tumours |
| what is wide margin surgical treatment | complete excision |
| what is radical surgical treatment | removal of a body part |
| common side effects of chemotherapy | -lethargy -decreased appetite -vomiting/diarrhea -hair loss or slow hair growth |
| what are the 3 primary symptoms of GI disease | -vomiting -diarrhea -anorexia |
| when is vomiting and diarrhea a concern | -young patient -occur longer than 24hrs -not eating -weak -dehydrated -abdominal pain -presence of blood in a significant amount |
| vomiting vs regurgitation | Vomiting -retching occurs -occurs variable time after eating -has a variable appearance -pH is acidic Regurgitation -no retching -occurs immediately after eating -looks like food/saliva -pH is the same as food |
| 4 treatments for vomiting | 1. NPO (for 12-24 hours) 2. Fluid therapy 3. Drug therapy 4. Bland Diet (once V stopped) |
| 4 mechanisms of diarrhea and explain | 1. osmotic (something in intestinal lumen draws in water to intestine) 2. secretory (excess fluids and electrolytes are excreted) 3. permeability (leakage of plasma proteins/blood due to increase pore size 4. motility (any change in normal motility) |
| common causes of diarrhea | -toxins and poisons -viral or bacterial infections -parasites |
| small intestine VS large intestine diarrhea | Small: -liquid -no mucous -commonly has fat -melena (black) colour -no straining -weight loss is common Large: -firm -often mucus -rarely fat present -frank red colour -straining (tenesmus) -weight loss is rare |
| what id the definition of anorexia | lack of appetite |
| what are some options for providing nutrition to an anorexic animal | -tempt appetite -force feed -tube feed -administer drugs |
| what is gastritis | inflammation of the lining of the stomach |
| why are dogs more prone to gastritis | because they are most likely to have an unusual meal or overeat |
| what is maldigestion | incomplete digestion, primarly seen in dogs often due to EPI |
| what is EPI | exocrine pancreatic insufficiency -unable to produce pancreatic enzymes to digest food |
| explain the attitude and appearance of a dog with EPI | -emaciates and voracious appetite -greasy, clay coloured stool with rancid odour |
| what is malabsorption | able to digest food but unable to absorb the nutrients from it |
| what is IBD | inflammatory bowel disease |
| what happens during IBD | -inflammatory response in GIT results in thickening of mucosa of stomach |
| how to diagnose IBD | -endoscopic biopsy -laparoscopic biopsy |
| clinical signs of IBD | -V/D -anorexia -weight loss |
| how to treat IBD | treatment is palliative only |
| what are the common symptoms of liver disease | -icterus/jaundice -ascites -weakness -weight loss |
| diagnostic tests to diagnose liver disease | -CBC chemistries (ALT, AST) -bile acids |
| 4 most common diseases of the pancreas | 1. diabetes mellitus 2. exocrine pancreatic insufficiency 3. pancreatitis 4. pancreatic tumour |
| what are common clinical signs of pancreatitis | -abdominal pain -V/D -diarrhea -anorexia -fever |
| why do clinical signs start to occur during pancreatitis | begin when digestive enzymes leak into tissues of abdomen and into circulation |
| what animal is more prone to pancreatitis | dogs |
| how is pancreatitis diagnosed | -increased serum amylase and lipase -snap/spec cPLi and fPLi tests |
| how to treat pancreatitis | -analgesia -fluid therapy -antiemetics -mucosal protectants |
| what can obesity predispose an animal to | -cardiovascular problems -musculoskeletal problems -liver disease -diabetes mellitus -increased risk during anesthesia and surgery |
| why is obesity so common | -decreased exercise -increased age. but decreased metabolic rate -table scraps -genetic predisposition -boredom (beg for treats) |
| 5 strategies for weight loss | -recognize problem -select an appropriate weight loss diet -calculate amount to be fed safe for weight loss -weekly weigh ins -adjust caloric intake down as needed |
| top 5 endocrine disorders most commonly seen in dogs and cats | -diabetes mellitus -hypothyroidism -hyperthyroidism -cushings disease -addisons disease |
| what does insulin do | the key that allows glucose to enter cells to be used for energy |
| clinical signs of animals with diabetes | -PU/PD -polyphagia -weight loss -cataracts -UTI's |
| what is the new treatment for diabetes mellitus and how does it work | Senvelgo -once daily oral solution |
| which is life-threatening hypoglycemia or hyperglycemia | hypoglycemia is the one that is life-threatening because it is an overdose of insulin |
| when is insulin normally administered | twice daily AFTER eating |
| Why is client education and compliance so important for successful management of diabetes? | -the owner must be able to mix insulin correctly, give SQ injections, record clinical signs, ensure food is offered regularly ,recognize insulin shock and keep animal on a schedule |
| what is insulin shock also known as | hypoglycemia |
| what happens during insulin shock | -overdose of insulin, animal is not eating and the regular amound of insulin is given or too much. |
| signs of insulin shock | -weakness/confusion -trembling -seizures |
| how to treat insulin shot | -apply corn syrup to gums -bring in to vet for IV dextrose |
| how is hyperglycemia caused | occurs if too little insulin is administered |
| what do the thyroid glands do | produce T4 and T3 which control the level of metabolism |
| which species is most common for hyperthyroidism and hypothyroidism | -hypothyroidism dogs -hyperthyroidism cats |
| what is hyperthyroidism | a tumour or a disease affecting the thyroids ability to work |
| clinical signs of hypothyroidism | -overweight -lethargic -thickened skin -seeks skin -infertility |
| treatment for hyperthyroidism | life long administration of thyroid hormone |
| what is hypothyroidism | thyroid produces too much thyroxine, resulting in a increased metabolic rate |
| hypothyroidism clinical signs | -thin -voracious appetite -unkempt coat |
| treatment for hyperthyroidism | -lifetime meds that inhibit T4 production -surgical removal of thyroid glands -radioactive iodine - |
| what is cushings disease (hyperadrenocorticism) | increased levels of glucocorticoids and mineralocorticoids |
| clinical signs of cushings disease | -overweight -pot-bellied -thin skin -bilateral hair loss |
| treatment for cushings disease | -surgical removal of adrenal or pituitary gland |
| what is addisons disease | -decreased production of glucocorticoids and mineralocorticoids |
| 2 types of addisons disease | -primary and iatrogenic |
| what does ACTH do | stimulates cortex of adrenal glands to produce glucocorticoids and mineralocorticoids |
| where does Otitis externa start | in the pinna |
| common causes of otitis externa | -bacteria -parasites -yeast -allergies |
| clinical signs of otitis externa | -red/painful pinna -itchy or smelly -discharge -if chronic pinna may be thickened |
| how to diagnose otitis externa | -swab -otoscopic exam -culture and sensitivity |
| what to do if there is suspected mites when a patient has otitis externa | -place sample onto slide with a drop of mineral oil |
| how to treat otitis media | -antibiotics -surgery is severe -sometimes total ear canal ablation is performed to prevent further infection |
| why do aural hematomas develop | -often secondary to otitis externa and due to head shaking which ruptured blood vessels in the pinna |
| how to treat aural hematomas | -oral steroids possibly with a bandage -minor surgery to open hematoma and remove clots -must stabilize ear to prevent shaking -may use a drain |
| if surgery is performed to treat an aural hematoma what is used to prevent re-filling | sutures pass through pinna |
| what species is deafness most common in | Dalmatians and white cats with blue eyes |
| what is entropion | eye rolls inward |
| how to treat entropion and what can it cause | -causes ulcerations and irritation -surgical correction is necessary |
| what is ectropion | when the eyelid turns away from the eye |
| how to treat ectropion and what does it cause | -causes dryness and irritation -surgically corrected or eye drops to maintain moisture |
| what is conjunctivitis | inflammation of the membrane that lines the eyeball |
| signs of conjunctivitis | -often blepharospasm (squinting) due to pain -pink/red |
| how to treat conjunctivitis | -eye exam needed including fluorescein dye -give topical antibiotics -sometimes steroids given |
| what is KCS | inadequate tear production causing dry cornea |
| how to diagose KCS (keratoconjunctivitis sicca) | Schirmer tear test |
| what is cherry eye | Third eyelid gland prolapse |
| how to treat cherry eye | surgery to tack down gland |
| when is cherry eye common | in certain breeds before age 2 |
| what is a corneal ulcer | loss of the corneal epithelium due to trauma |
| how to treat corneal ulcers | -drops -support via third eyelid flap -cross-hatching to stimulate healing -install patients own serum into eye to speed healing |
| what is the new treatment for corneal ulcers | -Optixcare -can be used on horses, birds, and exotics -administer one drop every 2 days for 10 days |
| what is pannus | granulation tissue gradually grows over the cornea |
| what is anisocoria | pupils of unequal size |
| what can cause anisocoria | -trauma -eye disease -neurological disease |
| what are cataracts | opacity of the lens |
| how to treat cataracts | only Tx is surgical removal |
| what is glaucoma | excessive intraocular pressure because there it too much fluid in the eye |
| why do we not want to use atropine when a patient has a glaucoma | atropine increases pressure in eye |
| what does atropine do for ocular treatments | relaxes pupils, decreases pain |
| what do antibiotics do for ocular treatments | treat bacterial infections |
| what do steroids do for ocular treatments | decrease inflammation and scarring |
| 5 main categories of skin problems | 1. alopecia 2. pruritis 3. blistering and ulceration 4. scaling and crusting 5. skin masses |
| name one endocrine disease that could result in bilateral alopecia | cushings disease |
| what is an elimination diet | short term eating plan that eliminates certain food that may be causing allergies. then reintroduces them one at a time to determine which are and well and not-well tolerated |
| a few diagnostic tests to test for allergies | -skin biopsies -blood tests -elimination diet -intradermal skin tests |
| how to determine if alopecia is from a physiological cause | examine the hairs under the microscope to see of they are broken off |
| what is seborrhea | condition where flakes of dead skin are shed |
| True of False? seborrhea be dry and oily | True |
| what is pyoderma | bacterial infection of the skin |
| blistering and ulceration conditions are often ________ mediated diseases | immune |
| how is blistering and ulceration characterized by | raised papules or pustules that rupture and form ulcerative lesions |
| scaling and crusting are what kind of disorders | keritainization |
| 6 types of specific dermatoses | 1. acanthosis nigricans 2. acral lick granuloma 3. acute moist dermatitis 4. miliary dermatitis 5. feline acne 6. solar dermatitis |
| what is a acral lick granuloma | -obsessive licking of anterior surface of carpus and metatarsus until hair and/or layers of skin are worn off |
| treatment of acral lick granuloma | -place-e-collar -address underlying problem -consult behaviourist |
| what is miliary dermatitis | -multiple small, dry scabs, often pruritic with open sores |
| what species is miliary dermatitis common in | cats |
| what are the causes for miliary dermatitis | -allergies -parasites -bacterial infection |
| what is another name for acute moist dermatitis | hot spot |
| how does acute moist dermatitis happen | -rapid onset of excessive biting and licking at an area leading to a hairless, red, weeping lesion |
| what is acanthosis nigricans | hyperpigmentation in axilla or inguinal area (usually due to inflammation from friction) |
| what is solar dermatitis | burn from excessive exposure to U/V radiation |
| what is feline acne | chin and skin next to lower lips have blackheads which progress to pimples and inflamed/red skin |
| what material should a cat be fed from if the have feline acne | ceramic or stainless steel plate |
| what is the cause of feline acne | blockage of pored by excess sebum or keratin |
| what is tracheal collapse | respiratory disorder when there is partial airway obstruction |
| how is tracheal collapse presented | loud, honking, non-productive cough |
| what is congestive heart disease | fluid accumulates in the body, resulting in edema |
| signs of left-sided heart failure | -coughing -exercise intolerance -pulmonary edema |
| signs of right-sided heart failure | -generalized edema -ascites |
| is there a breed-predisposition to congenital heart diseases | yes |
| how do puppies present when they have heart failure | -weak, smaller than normal -heart murmur -possibly cyanosis |
| what is patent ductus arteriosus (PDA) | -if the pulmonary artery remains open 2-3 after birth there might be blood flowing from aorta to lungs (left to right shunt) |
| what is reverse PDA | unoxygenated blood will bypass the lungs and enter the aorta and systemic circulation (right to left shunt) |
| is surgery contradicted in PDA or reverse PDA | reverse PDA |
| what is aortic stenosis | narrowing of aortic outflow, can lead to ventricular arrhythmias |
| what is pulmonic stenosis | abnormal valve leads to R ventricle hypertrophy from increased pressure, then atrial dilation, possibly tricuspid valve regurgitation |
| what is a ventricular septal defect | hole between the ventricles |
| what is tetralogy of fallot | polygenic genetically transmitted malformation of the heart |
| what 4 defects does the tetralogy of the fallot consist of | 1. pulmonic stenosis 2. ventricular septal defect 3. overriding aorta 4. hypertrophy of right ventricle |
| how does phlebotomy work as a treatment | stimulated RBC production |
| what happens if right aortic arch persists | -the esophagus is trapped in the arch and megaesophagus results |
| what is megaesophagus | esophagus dilates proximal to structure, resulting in frequent regurgitation of food |
| what is congestive heart failure | from impaired pumping ability of heart |
| what age of animals is CHF most common in | older animals |
| 5 treatment options for CHF | -diuretics -oxygen -bronchodilators -other meds -low sodium diet |
| 3 types of cardiomyopathy in cats | 1. hypertrophic cardiomyopathy 2. dilated cardiomyopathy 3. restrictive cardiomyopathy |
| what is the most common type of cardiomyopathy in cats | hypertrophic cardiomyopathy |
| what is saddle thrombus | clot on heart valve dislodges, enters aorta. then lodges at the iliac artery obstructing blood flow to one or both legs |
Created by:
jscott41
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