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Nursing 1111 Wk6
Common Conditions and Treatments
| Question | Answer | |
|---|---|---|
| Small Animal Medical Nursing pp 580 – 589/Conjunctiva Therapeutic Techniques pp 515- 519/ Medical Mgmt of GI Symptoms pp 594 – 597 | The tissue coating the eye and lining the eyelids. Normally moist and glistening w/ tiny blood vessels coursing through the semilucent tissue. Serves as a barrier for the eye by trapping debris & helping prevent invasion of viruses & bacteria. | |
| Conjunctivitis | Definition: Inflammation of the conjunctiva Clinical signs: Redness, discharge, swelling, squinting/excessive blinking pawing/rubbing at eyes | |
| Conjunctivitis Cause | Viral/bacterial infections Parasites of conjunctiva or eyelids Corneal dz Disorders of tear ducts/tear production Eyelid infections/abnormalities Foreign material/chemicals Trauma Allergies Idiopathic Other illness, ie. skin dz | |
| Conjunctivitis Clinical Signs | Redness Eye discharge Swelling of conjunctiva Squinting or excessive blinking Pawing/rubbing eyes | |
| Conjunctivitis Diagnosis | Most common in dogs Usually based on PE findings testing may include: Fluorescein staining for corneal ulcers STT for tear production PE of conjunctiva, external eyelids, and 3rd eyelid | Additioanal tests mayinclude: Bacterial cultures Test for distemper virus Tonometry for IOP (glaucoma) Conjunctival scrapings to eval cells Conjunctival biopsy (rare) Blood test to determine if pt is also ill |
| Conjunctivitis Treatment | -TX involves symptomatic therapy for conjunctivitis and specific therapy for underlying causes -W/o assoc. eye dz, conjunctivitis due to 1° bacterial infection is rare. More often 2° to an underlying problem | Irrigation to remove irritating substance Foreign material removed Tear production abnorms tx Eyelid infection/abnorms tx/sx 2° bacterial infections tx w/ ointments Anti-inflammatory meds rx'd |
| Conjunctivitis Nursing Care | Flush eye Vet care REchecks frequently Medication compliance NO improvement, recheck w/ vet | |
| Conjunctivitis Client Education | Not much in way o f prevention, however Prevent fb by preventing exposure to damaging items Prevent shampoo in eyes during bathing | KCS URI Mechanical Irritation ie entropion FB -sand, plastic, metal, grass Enviro irritants - Cig smoke, dust, exhaust fumes, pollen = follicular conj. Allergic conj. -atopy (inhaled allergies) = red & itchy Parasites - Cuterebra, Thelazia worms |
| Corneal Ulcer Definition /Description | Cornea: clear, outermost surface of the eye Corneal Ulcer: wound or scrape to the surface of the eye Sometimes called corneal erosion | Because outermost layer of the eye it is prone to scrapes and tears |
| Corneal Ulcer Cause | Rough contact w/ plants, thorns, bushes Scratches from another animal Self trauma, rubbing/scratching @ ear/eye Chemical irritation - shampoo Foreign body- plant material that gets stuck | Cat scratch wounds are esp. serious since corneal ulcers heal fast and can seal in infections |
| Corneal Ulcer Clinical Signs | Redness Conjunctiva or Chemosis Squinting Rubbing at face | |
| Corneal Ulcer Diagnosis | Physical Exam Fluorescein staining confirms presence of ulcer or erosion | Positive stain uptake |
| Corneal Ulcer Treatment | Topical abx applied (ideally) 4x daily Atropine drops for pain relief | Atropine drops stops pupil's ability to constrict (pain from pupil spasms from ulcer) |
| Corneal Ulcer Nursing Care | Abx drops, pain relief drops Application of E-collar | |
| Corneal Ulcer Nursing/Client Education | With Atropine: Animal may be sensitive to light - atropine temporarily stops pupil constriction. Has bitter taste - pet may drool a lot (especially cats) Elizabethan collar may be needed | |
| 1. What is atropine used in some patients with a corneal ulcer? | Pain management. Pain is from pupil constriction/spasm. prevents constriction | |
| 2. What would you warn the cat owner about when the patient is prescribed atropine? | May cause hypersalivation due to bitter taste. Tear ducts connected to nose and mouth | |
| 3. Where would you place the eye ointment in a patient’s eye? What would you do after placing the ointment? | -Place the ointment in the pocket formed by pulling down the lower eyelid. -After placing ointment massage the ointment across the eye with the lids closed. -Ointments should be applied to the conjunctiva, drops to sclera | |
| 4. Where would you place eye drops in a patient’s eye? | -Place the drops in the pocket formed by pulling down the lower eyelid -Drops should be applied to sclera, ointment to the conjunctiva | |
| 5. What could you do to prevent transmitting ocular infections to other patients and to prevent additional damage to the eye? | Expel (aseptically as poss.) a sm amt to remove possible contaminants Do not share meds Do not contaminate med tip/applicator Wash hands Steady - do not poke eye w/ med/bottle | |
| Otitis Externa Definition/Description | Inflammation/infection of the external ear Characterized by shaking head/pawing at ear, droopy ear, pain on palpation, odor, and discharge | |
| Otitis Externa Cause | Debris/wax in canal breeds bacteria/yeast Over-production of wax due to irritation → wax = moisture → Allergic skin dz affecting ears aka allergies Foreign bodies, grass, plants, hair Ear mites | |
| Otitis Externa Clinical Signs | shaking head/pawing at ear, scratching at ears droopy ear, pain on palpation, redness, odor, and discharge | If infection reaches middle ear, pts may have head tilt, lack of balance, nystagmus. These are called vestibular signs. Middle ear infections can also cause paralysis of the facial nerve, leading to a slack-jawed appearance on that side of the face. |
| Otitis Externa Diagnosis | PE w/ otoscope, cytology, culture Allergy testing SX if foreign body suspected | |
| Otitis Externa Treatment | Cleaning and medication Meds = abx, antifungl, steroid(pain/inflam) Culture for specific tx for specific growth Further testing for allergies, hormone imbalances Additional oral medications Surgery | |
| Otitis Externa Nursing Care | ||
| Otitis Externa Client Education | Take time to treat Recurrence is typical Regular recheck appts Prevention such as weekly ear washes/disinfection | |
| 1. Describe the outer ear of a dog. | The pinna outer canal = vertical and horizontal canals almost 90° bend that helps keep debris/wax from being able to migrate out | |
| 2. Describe the tympanic membrane. | "Ear drum" thin, fragile membrane that separates the outer ear from the middle ear. Can be damaged by disease and/or cleaning | |
| 3. Describe the middle ear of a dog. | Consists of 3 small bones - turn card An air filled cavity called the bulla Eustachian tube - thin tube leading from the bulla to the back of the mouth | The 3 Middle Ear Bones Malleus aka Hammer attaches directly to ear drum Incus aka Anvil: connects Malleus to Stapes Stapes aka Stirrup: innermost bone rests against the oval window of the inner ear |
| 4. Describe the inner ear of a dog. | Connects to the brain and contains nerves and centers for balance and hearing. | |
| 5. Why do some animals have more ear problems than others? | Physiological differences, some behavior dogs > cats heavy floppy ears >pricked ears Breeds w/ lots of hair> Dogs w/ skin allergies > Dogs in water | |
| 6. When medicating the ear, what should you do prior to instilling the ear medications? Why? | Clean and epilate. If meds are placed on top of wax/debris, they will not be as effective. Similarly, hair impedes meds and air flow | |
| 7. What clinical signs can occur if the infection reaches the middle ear? | If infection reaches middle ear, pts may have head tilt, lack of balance, nystagmus. These are called vestibular signs. Middle ear infections can also cause paralysis of the facial nerve, leading to a slack-jawed appearance on that side of the face. | |
| Bite Wound Abscess Definition /Description | When an infected bite wound heals over on the surface, sealing infection inside. | Fever is generated as infection incubates. Inflammatory cells liquefy into pus forming a pocket of pus which is the abscess Pus breaks thru surface & drains, leading to foul odor, pain, discharge |
| Bite Wound Abscess Cause | Bites wounds usually from other cats | |
| Bite Wound Abscess Clinical Signs | Fluid filled swelling Possible draining pus, non draining pocket of pus that may need lanced Foul-smellilng pus/drainage Fever which leads to appetite loss and listlessness Swollen, tender, painful skin Poss. visible scabs from teeth punctures, hairl | |
| Bite Wound Abscess Diagnosis | Physical Exam, clinical observations Fluid filled swelling Foul smelling, draining sore Abscess may need to be punctured and pus cultured Wound that is not healing Visible puncture wounds X-rays History | |
| Bite Wound Abscess Treatment | Lanced and flushed, may req. sedation Older abscesses may need sx trimming and stitches, drain tube May need flushed at home Antibiotics, oral or inj.of Convenia Text book does not mention pain - NSAIDs injection, Metacam or Onsior Hot compresses | |
| Bite Wound Abscess Nursing Care / | Temp or TPR in general Clip and clean Administration of meds Surgical assistance Warm compresses Medications (abx) | |
| Bite Wound Abscess Client Education | Flushing/water therapy Medication compliance Hot compresses FeLV/FIV education Rabies education | |
| In addition to bite wound abscesses, what are 3 other types of infections that can occur from bite wounds? | FeLV, FIV, and Rabies (staph?) | |
| Anal Sacculitis/Abscess Definition/Description | a painful, pus-filled infection that happens when a pt's anal glands (sacs) become blocked | |
| Anal Sacculitis/Abscess Cause | Ducts become blocked trapping exudate causing blockage, impaction, infection, abscess, then possible rupture Obesity | |
| Anal Sacculitis/Abscess Clinical Signs | Swollen gland, discoloration/purple Licking around anus Bloody stools Strong odor (sm amt of d/c) Swollen anus | |
| Anal Sacculitis/Abscess Diagnosis | PE, obvious signs of abscess | |
| Anal Sacculitis/Abscess Treatment | -Expression, poss. with need for sedation -Flushing of gland & instillation of abx into gland -SX drainage or removal -Oral abx and nsaids -High fiber diet | |
| Anal Sacculitis/Abscess Nursing Care | AG expression Warm compresses Medication compliance | |
| Anal Sacculitis/Abscess Client Education | Diet changes: adding fiber & weight loss Regular expression | |
| Gastric Dilatation & Volvulus Definition/Description | Gas &/or food stretches the stomach many times its normal size, causing tremendous abdominal pain. This grossly distended stomach tends to rotate, thus twisting off not only its own blood supply but the only exit for gases | |
| Gastric Dilatation & Volvulus Cause | Classically, before bloating the dog ate a large meal & exercised heavily shortly thereafter. Still, we usually do not know why a given dog bloats on an individual basis. No specific diet or dietary ingredient has been proven to be associated with bloat. | |
| Gastric Dilatation & Volvulus Clinical Signs | The dog may have an obviously distended stomach especially near the ribs but this is not always evident depending on the dog's body configuration. The biggest clue is the vomiting: the pet appears highly nauseated and is retching but little is coming up. | |
| Gastric Dilatation & Volvulus Diagnosis | PE Radiographs Supporting blood work Clinical observation of vomiting | |
| Gastric Dilatation & Volvulus Treatment | Decompression of stomach gases IV Fluids for shock and supportive care Heart rhythm assessed and stabilized Surgery for necrosis (damage to stomach and/or spleen)and gastropexy | |
| Gastric Dilatation & Volvulus Nursing Care | Supportive care post op | |
| Gastric Dilatation & Volvulus Client Education | Deep chested dog propensity Stressed/anxious dogs propensity Avoid exercise after feeding esp. large meal Prophylactic Gastropexy poss. during spay Have a an emergency plan/s Surgery necessary to prevent recurrence Invest in pet insurance/savings fo | |
| Diarrhea Definition/Description | Frequent or loose bowel movements | |
| Diarrhea Cause | ∆ diet Food intolerance Ingestion garbage,spoiled food, poisonous substances or toxic plant material FB Allergic rxn Bacterial/viral infection Parasites IBD Kidney or liver dz Cancer/tumors in digestive tract Meds Colitis Stress HGE | |
| Diarrhea Clinical Signs | Loose or liquid, frequent stools most common Other: flatulence, blood or mucus in stool, ∆volume of stool & straining to defecate Lethargy, dehydration, fever, vomiting, decreased appetite, wt loss & ↑urgency to defecate, black stool | |
| Diarrhea Diagnosis | Fecal test Assessment for dehydration Blood work for underlying cause Examination for underlying illness Radiograph &/or Ultrasound Cultures Endoscopy &/or Biopsy | |
| Diarrhea Treatment | Determine underlying cause an tx accordingly Withhold food 12-24 hours Water/fluids to prevent dehydration Vet visit for meds/med compliance Antiemetics for symptomatic nausea | |
| Diarrhea Nursing Care | Supportive care fluids Bland diet | |
| Diarrhea Client Education | UTD on vaccines, parasite prevention, Monitor diet, consuming garbage or food/water off street Slow food change Minimize stress Vet visit if lethargy, Vt, fever, melena, straining, ↓wt, ↓appetite | |
| Clinical Sign Small Intestines Large Intestine | Small intestine | |
| Clinical Sign: Frequency of defecation | Small Intestine: Normal to slightly increased | Large Intestine: Very frequent |
| Clinical Sign: Fecal Volume | Small Intestine: Increased | Large Intestine: Normal to decreased |
| Clinical Sign: Urgency | Small Intestine: Absent | Large Intestine: Common |
| Clinical Sign: Tenesmus | Small Intestine: Absent | Large Intestine: Common |
| Clinical Sign: Mucus in Feces | Small Intestine: Uncommon | Large Intestine: Common |
| Clinical Sign: Blood in Feces | Small Intestine: Dark black = melena | Large Intestine: Red/fresh blood = hematochezia |
| Clinical Sign: Weight Loss | Small Intestine: Common | Large Intestine: Rare |
| How would you restrain the patients in order to administer medications? | ||
| • What technician interventions would be appropriate for each condition and why? | ||
| • What basic patient care would you provide? | ||
| • What information would you obtain and what parameters would you monitor in order to assess the patient? | ||
| • What information would you provide to the clients so that they could properly care for their pets at home? | ||
| • Please use the term “anal gland” or “anal sacculitis” or “anal sac abscess” vs “anal sacs”. | ||
| • When expressing anal glands, make sure to cover the opening well with a paper towel or gauze and have some odor neutralizer close by. | ||
| Chemosis | of the conjunctiva, while chemosis is a specific sign of fluid swelling (edema) in that same membrane | • Conjunctivitis: General inflammation or infection of the eye's clear outer membrane (the conjunctiva). • Chemosis: Fluid accumulation that makes the conjunctiva look puffy, gelatinous, or blister-like, sometimes ballooning over the front of the eye. |
| Indolent Ulcer | A corneal ulcer that forms a lip on the edge that impedes healing. Often tx w/ grid keratectomy Esp. seen in boxers and poodles | |
| Descemetocele | An ulcer that has penetrated penetrated thru the cornea completely except for last membrane (Descemet's membrane, where cornea attaches to the fluid under the eye) | Usually requires surgery Common in brachycephalic breeds |
Created by:
shawamber