ASAN002 - Medical Nursing Flashcards
What is the primary objective of the ASAN002 course?
To demonstrate knowledge, understanding, and ability to perform medical procedures and implement specific patient care in a veterinary setting.
What percentage of body weight in adult animals is composed of water?
On average, 60% of an adult animal’s body weight is water.
Why should fluid therapy plans for obese patients consider ideal weight rather than current weight?
Because fatty tissue contains less water, which helps avoid overhydration in fluid therapy.
What are the two main categories of body water distribution?
Intracellular fluid (ICF), within cells, and extracellular fluid (ECF), outside cells.
What is considered a normal daily water balance for dogs and cats?
Typically, 50 ml per kg of body weight per day, ranging from 40-60.
What are the main causes of abnormal fluid loss in animals?
Vomiting, diarrhea, blood loss, anorexia, evaporation (from panting), disease, and surgical procedures.
What are the primary goals of fluid therapy?
To replace lost fluid and electrolytes and to maintain normal fluid and electrolyte balance when intake is inadequate.
What are the five questions to consider when creating a fluid therapy plan?
Is fluid therapy indicated? How much fluid should be given? At what rate? By what route? What type of fluid should be given?
What clinical signs can indicate dehydration in a patient?
Tacky mucous membranes, delayed skin tenting, sunken eyes, and cold extremities.
How is dehydration level often assessed in a veterinary setting?
By patient history, physical examination, and laboratory analysis.
What does an increased packed cell volume (PCV) indicate in dehydration assessment?
It suggests fluid deficit, as higher PCV levels correspond to fluid loss.
What is the ‘rule of thumb’ formula for rehydrating a dehydrated animal?
Multiply the body weight in kg by the percentage dehydration, then by 10 to get the missing volume in milliliters.
What types of fluids are generally used for maintenance fluid therapy?
Hypotonic fluids, such as 0.45% NaCl + 2.5% dextrose or Plasmalyte 56.
What are the two main types of crystalloids?
Replacement fluids and maintenance fluids.
What is the main use of hypertonic crystalloids in fluid therapy?
To rapidly expand blood volume, especially beneficial in treating hypovolemic and hemorrhagic shock.
What are colloids, and when are they typically used?
Colloids contain large molecules that stay in the bloodstream to draw fluid into vessels; they are used for hypovolemic shock and hypoproteinemia.
What is the primary function of a syringe pump in veterinary medicine?
To administer small or precise fluid volumes at a constant rate, especially for small patients.
Why are labels essential on fluid bags used for IV administration?
They indicate the date, time, initials, and additive concentrations, ensuring that all nursing personnel are informed.
What are the potential side effects of Voluven, a synthetic colloid?
Minor allergic reactions, increased bleeding time, and, rarely, severe anaphylactic reactions.
What is Mannitol, and when is it typically used in fluid therapy?
Mannitol is an osmotic diuretic used to reduce cerebral or intraocular pressure and treat kidney-related urine output issues.
What is the preferred route for administering fluids to severely dehydrated patients?
Intravenous administration, as it allows rapid absorption and can accommodate various fluid types.
In what cases might intraosseous fluid administration be preferred?
In cases where venous access is challenging, such as with neonates or patients with collapsed circulation.
What types of catheters are typically used for short-term or less mobile patients?
Winged or butterfly catheters.
Which type of catheter is commonly used for peripheral veins in veterinary patients?
Over-the-needle catheters.
What is the primary reason for using multi-lumen catheters?
To allow simultaneous administration of multiple medications or fluids in critical care settings.
Why should central or jugular lines be considered for long-term intravenous access?
They allow for consistent access, multiple lumens if needed, and are often less irritating for the patient.
What is one potential complication of intravenous catheter use?
Phlebitis, which is inflammation of the vessel wall.
What is the primary purpose of a blood transfusion in veterinary patients?
To increase the oxygen-carrying capacity of the blood due to a decrease in circulating red blood cells.
What is acute anemia, and what are its primary causes?
Acute anemia is a sudden drop in red blood cells, often caused by severe hemorrhage due to trauma or conditions like a ruptured hemangiosarcoma.
How does chronic anemia differ from acute anemia?
Chronic anemia develops slowly over time, allowing the patient to compensate and often showing less severe clinical signs than acute anemia.
What is regenerative anemia?
Regenerative anemia occurs when the body is still producing red blood cells, but they are being lost or destroyed faster than they are replaced.
What is non-regenerative anemia, and what are two broad causes?
Non-regenerative anemia is when red blood cell production is severely reduced due to extra-bone marrow disease (e.g., renal failure) or intra-bone marrow disease (e.g., leukemia).
What is immune-mediated hemolytic anemia (IMHA)?
IMHA is a condition where the immune system attacks and destroys the body’s own red blood cells.
What role does the von Willebrand factor play in blood clotting?
It is essential for normal platelet adhesion, helping to form blood clots.
What are the main types of blood and blood products used in veterinary transfusions?
Fresh whole blood, stored whole blood, packed red blood cells, fresh frozen plasma, frozen plasma, platelet-rich plasma, and cryoprecipitate.
What is the ideal storage condition for fresh frozen plasma?
It should be stored at -20 to -30°C and is viable for up to one year.
What conditions is cryoprecipitate primarily used to treat?
Cryoprecipitate is used to treat von Willebrand’s disease as it contains von Willebrand factor, fibrinogen, and factor VIII.
What are the criteria for selecting a canine blood donor?
Ideal canine donors should weigh over 25 kg, have a PCV greater than 40%, be up-to-date with vaccinations, and have no recent medications or health issues.
Why are male desexed dogs preferred as blood donors?
They are less likely to have antibodies against other blood groups, which could cause transfusion reactions.
What is the significance of DEA 1.1 blood type in dogs?
DEA 1.1-negative dogs are universal donors, while DEA 1.1-positive dogs can receive any blood type without a life-threatening reaction.
Why must cats be blood-typed before a transfusion?
Cats have naturally occurring alloantibodies, so mismatched transfusions can cause fatal reactions.
What are the three main feline blood types?
A, B, and AB, with Type A being the most common.
What preparation steps are essential before administering a blood product?
Check the product type, ensure it is in date and undamaged, warm to 37°C, and use a filtered giving set to remove any debris.
Why is it crucial to use a filtered giving set when administering blood?
To remove any micro-thrombi or clots that may have formed during storage, ensuring safe administration.
In what situations might intraosseous blood transfusions be used?
In neonates or small pediatric patients where venous access is challenging.
What are some signs that indicate a possible transfusion reaction?
Increased heart rate, fever, vomiting, labored breathing, and a drop in blood pressure.
What is the maximum storage time for stored whole blood in veterinary medicine?
Stored whole blood can be kept for up to 28-35 days when stored at 1-6°C.
Why is central venous pressure (CVP) monitoring important in critical patients?
It helps assess blood return to the heart and guides fluid therapy adjustments.
What are potential complications of IV catheter use?
Phlebitis, thrombosis, catheter embolism, infiltration, infection, and swelling.
How often should an IV catheter be checked to prevent complications?
At least four times a day to check for cleanliness, dryness, swelling, and correct positioning.
What is fluid infiltration, and what are its signs?
Fluid infiltration is the leakage of IV fluids into surrounding tissue due to catheter displacement, causing swelling and coolness at the site.
What is catheter embolism, and how can it be prevented?
Catheter embolism occurs when a catheter fragment breaks off and travels through the bloodstream; careful cutting and avoiding reinsertion of needles into placed catheters can prevent this.
Why is monitoring fluid input and output essential in fluid therapy?
To ensure the patient is neither underhydrated nor overhydrated, which is crucial for achieving fluid therapy goals.
What should be recorded on a fluid therapy monitoring sheet?
Type, rate, and amount of fluid administered, with running totals and any changes.
What is the purpose of a blood transfusion in veterinary medicine?
To increase the blood’s oxygen-carrying capacity by replenishing red blood cells.
What is hemolysis, and what are its common types?
Hemolysis is the destruction of red blood cells, which can be immune-mediated (e.g., IMHA) or non-immune-mediated (e.g., oxidative injury from toxins).
What is IMHA, and how does it affect red blood cells?
Immune-Mediated Hemolytic Anemia (IMHA) occurs when the immune system mistakenly destroys the body’s red blood cells.
What is von Willebrand’s Disease, and how does it affect blood clotting?
It’s a genetic disorder causing deficient or dysfunctional von Willebrand factor, leading to poor platelet function and increased bleeding.
What are the main components of fresh whole blood?
Red blood cells, white blood cells, platelets, and clotting factors.
How long can fresh whole blood be stored, and at what temperature?
Fresh whole blood should ideally be used within 4 hours and not refrigerated to preserve platelet function.
What are the storage conditions and duration for stored whole blood?
Stored whole blood can be kept at 1-6°C for 28-35 days with daily agitation.
What is the purpose of fresh frozen plasma in veterinary treatment?
To provide clotting factors and plasma proteins, especially for conditions with hypoproteinemia or clotting deficiencies.
What is the significance of DEA 1.1 blood type in dogs for transfusions?
DEA 1.1-positive dogs can receive any blood type, while DEA 1.1-negative dogs are universal donors but should not receive DEA 1.1-positive blood.
Why must cats always be blood-typed before transfusions?
Cats have strong natural antibodies against other blood types, so incorrect blood typing can cause fatal reactions.
How should blood products be warmed before administration?
Blood products should be gently warmed to 37°C to avoid damaging proteins and clotting factors.
What is the benefit of using intraosseous administration for blood in neonatal patients?
Intraosseous access provides rapid absorption when venous access is difficult, making it ideal for small or critically ill patients.
What signs indicate a blood transfusion reaction?
Increased heart rate, fever, vomiting, labored breathing, and low blood pressure.
Why is 0.9% NaCl used instead of Hartmann’s solution when administering blood?
Hartmann’s solution can cause hemolysis of red blood cells, while 0.9% NaCl is safe for blood compatibility.
What are the functions of cryoprecipitate in veterinary medicine?
It provides von Willebrand factor, fibrinogen, and factor VIII, primarily for treating clotting disorders like von Willebrand’s disease.
What is the maximum blood donation volume for a canine donor?
Up to 22 ml/kg body weight.
What storage requirements are recommended for platelet-rich plasma?
Store at room temperature, protect from light, and use within 48 hours to prevent platelet dysfunction.
Why is male gender preferred for canine and feline blood donors?
Males, especially desexed ones, are less likely to have antibodies from previous pregnancies, reducing the risk of transfusion reactions.
What is the primary purpose of packed red blood cells (pRBCs) in veterinary transfusions?
To replace red blood cells in cases of anemia or blood loss without adding significant volume.
What is the recommended dose of packed red blood cells (pRBCs) to increase PCV by 2%?
2.0 ml/kg body weight.
What is the ideal storage condition and duration for frozen plasma?
Frozen plasma should be stored at -20 to -30°C and is viable for up to four years.
How is oxidative injury related to hemolysis in animals?
Oxidative injury, such as from onion toxicity, causes damage to red blood cells, leading to their premature destruction.
Why is it important to monitor heart rate when administering high concentrations of potassium in IV fluids?
High potassium levels can interfere with heart muscle contractions, potentially causing arrhythmias.
What are some common signs of hypovolemic shock in veterinary patients?
Pale mucous membranes, tachycardia, delayed capillary refill time, and weak.
What are some common signs of hypovolemic shock in veterinary patients?
Pale mucous membranes, tachycardia, delayed capillary refill time, and weak pulses.
What is thrombosis in relation to IV catheter use, and how can it be identified?
Thrombosis is a clot formation in the vein, often felt as a thick, cord-like vein that stands up without pressure.
What is an alloantibody, and why is it significant in blood transfusions for dogs?
An alloantibody is an antibody that reacts against foreign antigens within the same species, which can cause reactions if the dog receives incompatible blood.
What is meant by the term ‘central line’ in catheter placement?
A central line is a long-term intravenous catheter, often placed in the jugular vein for consistent access and monitoring, such as measuring central venous pressure.
How should intravenous catheters be maintained to prevent infection?
Regular checks should ensure bandages are clean and dry, and any signs of infection (redness, discharge, swelling) should be addressed promptly.
What are the primary benefits of using multi-lumen catheters?
They allow simultaneous administration of different fluids and medications without mixing, making them ideal for complex cases.
Why is subcutaneous fluid administration often used for mild to moderate dehydration?
It provides a slower absorption rate suitable for patients with less severe fluid deficits.
What factors influence the choice of catheter type for a veterinary patient?
Patient size, vein accessibility, treatment goals, and duration of IV access required.
Why should hypertonic crystalloids be used with caution in severely dehydrated patients?
They can draw water from extravascular spaces into the blood, potentially worsening dehydration.
What is hypoproteinemia, and how is it treated using blood products?
Hypoproteinemia is low blood protein levels, often treated with plasma or albumin-rich transfusions.
What are synthetic colloids, and when are they typically indicated?
Synthetic colloids, like Voluven, are plasma expanders used in cases of hypovolemia or when increased vascular volume is needed.
How does the use of a burette in a fluid administration set help prevent fluid overload?
It allows precise measurement of fluids, reducing the risk of over-administration, especially in small or pediatric patients.
What is the purpose of fluid therapy monitoring sheets?
To record and track fluid type, rate, amount administered, and any changes, ensuring accurate fluid therapy management.
Why is a jugular vein catheter preferred for blood sampling in small animals?
The jugular vein is larger and provides easier access for consistent blood sampling without collapsing.
What role does glucose play in maintenance fluid solutions?
Glucose provides a source of energy and helps maintain blood sugar levels in fasting or anorexic patients.
Why should the ear vein be considered for IV access in pocket pets?
It is accessible for small animals and is suitable for butterfly or small gauge catheters.
How does the osmotic diuretic Mannitol function in veterinary medicine?
Mannitol helps reduce cerebral edema and increase urine output by drawing water out of cells into the blood to be excreted.
