Animal care, pharmacology and surgery Flashcards
importance of patient history and client interaction
foundations on which sound medical and nursing interventions are based. Pay attention to the observations and concerns of the client, vet and staff.
communication
best clinical interview focuses on the patient.
5 vowels of a good interview
A- audition- listening carefully to the client’s story. E-evaluation- sorting data to determine which is important and which is irrelevant. I-inquiry- probing into the significant areas requiring more clarification. O-observation-observing nonverbal communication, body language, and facial expressions regardless of what is said. U-understanding- the clients concerns and apprehensions; enables interviewer to play more emphatic role
obtaining a history
info gathered while obtaining a history should alert the vet team to potential problems
introductory statement
introduce and explaining what he or she will be doing
patient characteristics
VAA obtains certain preliminary info such as patient characteristics
age
congenital diseases are predominant in young animals, and degenerative diseases can prevail in adults or older animal
breed
certain ones are predisposed to particular problems
gender
certain conditions are gender specific
reproductive status
dogs spayed at an early age are less likely to develop mammary tumours than intact dogs
questions for origin, prior ownership, and current env’t
where patient originated, where traveled, recently boarded, indoor, outdoor, free roaming or confined to house or yard, other animals, pets appetite, weight gains/losses, dry or wet food, brand name of food, amount of food consumed
past medical history
provides info about patients health before current illness, or anything else ie meds
vaccine schedule
some clients are not familiar with this, questions related to exposure to viruses or heartworm
presenting complaint
history of present complaint helps determine when animal was last normal, if condition is acute or chronic, previous meds and dosages, response to previous therapy, duration of progression of clinical signs
open ended questions
when did you first notice the problem, can you describe in detail the signs you observed, was there any change in routine
physical exam importance
all observations must be recorded accurately, including visual inspection, palpation, auscultation, and percussion.
systematic method of physical exam
- record temp, pulse and respirations. 2.evaluate disposition, activity level and overall body condition. 3. record each body system, integumentary, cardiac, genitourinary, nervous, ears, lymphatic, gastrointestinal, musculoskeletal, eyes, mucosa
vital signs
body temp, respiratory rate and effort, heart rate and rhythm and indications of perfusion
auscultation
listening to sounds produced by the body done with a stethoscope
weight
animal must be still to record an accurate weight and done at every visit regardless of reason
normothermia
maintenance of normal body temperature
hypothermia
abnormally low body temperature
hyperthermia
abnormally high body temperature
pulse
normal heart ranges: dogs 17-160 beats/ min, cats 150-210 beats/ min.
respiration
common sounds: harsh or static sounds, crackles or popping sounds, wheezing, upper airway, muffled or absent lung sounds, noisy breathing
bathing
protect eyes and ears. prevent water from entering the external ear canal by placing small cotton ball in each ear
skin care
watch for skin irritations
nail trimming
important to general care, avoid the quick
anal sac
normally secreats on its own, if not it can be emptied as part of the routine
ear care
must be examined carefully to avoid damage to the tympanic membrane
topical meds
applied to the skin. area usually shaved and cleaned (flea control)
oral meds
most commonly used and as tablets and liquid
rectal meds
inserted into the rectum
nasal meds
inserted into the nasal cavity to be absorbed through the nasal mucosa (respiratory vaccines)
opththalmic meds
applied onto the eye to treat many parts of the eye anatomy (ointments)
otic meds
instilled in the ear canal (ear mites)
parenteral meds
injected via a sterile syringe and needle
intreadermal meds
injected into the epidermis of the skin (local anesthesia)
subcutaneous meds
injected into the subcutaneous layer of the skin
intramuscular meds
into the muscle
intravenous meds and nutrition
absorbed directly into the blood stream
urinary tract catheterization
access to bladder via the urethra
gastric intubation
tubes inserted through the mouth to the stomach (short term feeding)
wound
disruption of cellular and anatomic functional continuity. can either be acute or chronic
types of acute wounds
surgical incisions, blunt trauma, bite wounds, burns, gunshots
types of chronic wounds
decubital (pressure) ulcers, diabetic ulcers, vascular ulcers
contaminated wounds become infected under the following circumstances
foreign bodies are present, excessive necrotic tissue is left in the wound, excessive bleeding results in higher levels of iron, local tissue defenses are impeded, vascular supply is altered, dirt and debris is present
clean wounds
surgical wounds
clean contaminated wounds
minor contamination
contaminated
fresh traumatic injuries
dirty
grossly infected or contaminated
using antibacterials in a surgical wounds depends on
patients condition, immune status, er or elective surgery, location of the wound, duration of procedure, surgeons experience
first aid
in the field and or before transport to a treatment facility, the wound should be protected with a bandage
wound assessment
evaluation of the wounds location, size and depth, drainage, exudate, and signs of infection
lavage
cleaning and debridement of wounds begins after the surrounding area has been cleaned. with a sterile solution ans gentle scrubbing are the primary methods for cleaning the wound
anesthesia and analgesics
local, regional or general anesthesia may be used for wound management, analgesics can help reduce hemorrhage and prolong the anesthetic effect
debridement
removal of devitalized or necrotic tissue is called debridement
wound closure
a wound should be closed only when the vet is certain that all devitalized and contaminated tissue is removed. nature provides natural bandages as part of normal healing, artificial methods assist in the process
functions of a bandage
protects, keeps wounds clean or sterile dressings in place, absorb exudate and debride a wound, vehicle for therapeutic agents, indicator of wound secretions, pack the wound, provide support for bony anatomic structures, support and stabilize soft tissues, secure splints, prevent weight bearing, provide compression to control hemorrhage, dead space and tissue edema, discourage self grooming, restrict motion, provide patient comfort, provide anesthetic appearance
discharge info
strict confinement initially and then restricted activity during healing process, prevents licking or chewing (elizabethan collar), monitor for signs of excessive discomfort
nursing care for recumbent patients
major concern id decubital (bed sores, pressure sores)
chemical name
describes the drugs chemical composition
generic name (nonproprietary)
not capitalized, most are referred to by the generic name in vet clinics
trade name (proprietary)
given by manufacturer, capitalized because it is a proper noun
generic drug names and trade
Ibuprofen, aspirin, acetaminophen. Tylenol, Excedrin, Advil
solid drug
tablet, capsule, enteric-coated tablet, sustained release, implant
semisolid
suppositories, liniment, ointment, cream, paste
liquid
syrup, elixir, tincture, lotion, injectable
enteric-coated tablets
special covering that protects the drug from the harsh acidic env’t of the stomach, prevents tablet from dissolving until it enters the intestine
elixers
solutions of drugs dissolved in sweetened alcohol
tinctures
alcohol solutions meant for topical application on the skin
valid prescription includes
name, address and telephone number of person who wrote the prescription, date it was written, owners info and animal name and species, Rx symbol, drug name,concentration and # of units dispensed, Sig directions for client, signature of person who wrote the prescription, registration # of drug id controlled substance
abbreviations used
bid, od, os, po, prn, twice daily, right eye, left eye, by mouth, as needed…q8h, qd, sid, stat, tid, every 8 hours, every day, once daily, immediately, three times daily
proper drug storage
improperly stored can degenerate or become inactivated, providing a little or no benefit
controlled substances (schedule drugs)
potential for physucal addiction, psychological addiction and or abuse. must be stored under lock and key, written records must be kept
drug classifications
manufacturers are required to identify a controlled substance on its label with an upper C, followed by a Roman numeral this denotes the drugs theoretical potential for abuse
drug classifications
C1- not used in vet medicine, C2- high potential for abuse, C3- some potential for abuse, C4- low potential for abuse, C5- over the counter meds
surgery suite
vet assistant will usually prepare the patient, surgical instruments and operatory, usually includes a prep area, scrub area and surgery room
surgery prep area
ideally adjacent to surgery room, patient prep and storage of surgical supplies
scrub area
may be a small area with the scrub sink, autoclave and room to gown and glove, transitional area where the staff can prepare to move into the surgery room
surgery room
ideally a separate room that should only be used for surgery, large enough for staff to move around and free of any clutter
aseptic technique
term used to describe all the precautions taken to prevent contamination and ultimately infection of a surgical wound
4 main factors determine whether infection occurs
number of microorganisms (high number), virulence of microorganisms (ability to cause disease_, susceptibility of the animal( natural resistance), route of exposure to microorganisms
nosocomial infections
those which are acquired in a hospital setting
4 main sources of potential contamination
operative personnel, surgical instruments and equipment, patient, surgical env’t
sterilization
destruction of all microorganisms
disinfection
destroys pathogenic microorganisms on nonliving objects
autoclave
uses high temp and pressurized steam to sterilize instruments
common terminology
-ectomy to remove, -otomy to cut into, -ostomy surgical opening, -rrhaphy surgical repair, -pexy surgical fixation, -plasty surgical alteration of shape or form
ovariohysterectomy
spay, surgical removal of the ovaries and uterus
orchiectomy
neuter or castration, surgical removal of the testes
laparotomy
incision into the abdominal cavity, often through the flank
gastrotomy
incision into the stomach
preop evaluation
patient characteristics, medical history, physical exam, diagnostic testing
patient requirements before procedure
withhold food for 8-12 hrs and water 2-4hrs before anesthesia. clipping hair and scrubbing the skin at the surgical site
staff prep
scrubbing, gowning, and gloving
