Chapter 17 Flashcards
with force feeding - mix food with _____, unless already syringable
water
with force feeding - allow what between syringes
time to swallow
gently pumping the stomach contents out of the stomach
gastric lavage
the “through and through” lavage, uses an enema as well as a stomach tube
gastric gavage
five placements of enteric feeding
Nasoesophageal tubes
Esophagostomy tubes
Gastrostomy tubes
Jejunostomy tubes
Orogastric intubation ( single feeding)
Administer medication, food, or fluids through a tube passed through the mouth directly into the stomach
orogastric intubation
abbreviation for orogastric intubation
OGT
which patients normally receive orogastric intubation
orphan or weak neonates can be fed milk replacer
besides feeding, what else can orogastric intubation be used for
may be passed in an attempt to decompress a patient with gastric dilation (bloated stomach)
when placing an orogastric intubation tube, the rubber or plastic tube must extend from the tip of the nose to where
13th rib
how do you know where the 13th rib is for orogastric intubation
stretch it on the outside of the animal and mark the tube with tape or marker
where is the orogastric intubation tube placed for distal esophagus placement
8th rib
three ways that fluid can be administered for orogastric intubation
60 mL syringe
drench pump
funnel
what do you need to do to the orogastric intubation tube when you are done administering fluid
occlude it before withdrawing in a downward direction
where are transdermal drugs administered
inside the ear
what kind of patches can be given by transdermal administration
fentanyl citrate patch
what needs to be done to the area before applying fentanyl patches
shave the area first
what part of the intestines is where intrarectal absorption occurs
large intestine
intrarectal administration has both _____ and _____ effects
local
systemic
intrarectal administration works best if what
the patient is free of fecal material
Antiemetic tablets or suppositories can be administered to _______ patients
vomiting
what species should you not use Fleet enemas on
cats
three reasons to disregard ophthalmic solution
appears cloudy
has particulate matter
color change
what should you do for ophthalmic meds that have been in the fridge
warm them up before administering
ophthalmic administration:
_______ should be given first and then ________, apply meds ______ mins apart
solutions
ointments
3 to 5 mins
four reasons for temporary venous access
Medications
Fluid
Electrolyte replacement therapy
Blood product transfusions
four things that site selection depends on for IV catheters
Available vessels
Condition of vessels and patient
Expense
Urgency
Medications and fluids with osmolarities less than or equal to ______ mOsm may be safely administered via a peripheral vein.
600
how do you decide on the length and gauge of an IV catheter
species
size of patient
veins available
Four categories of IV access devices
Winged needle (butterfly)
Over-the-needle
Through-the-needle
Multilumen catheter
A.
Butterfly catheter
B.
Over the Needle Catheter
C.
Multilumen Catheter
D.
Through the Needle Catheter
which catheter is for short term use
Butterfly catheter
most commonly used catheter
over the needle
which catheter is used primarily in the jugular vein
through the needle
which catheter allows for simultaneous infusions at one catheter site
multilumen
common peripheral IV sites for cats
cephalic or medial veins
common peripheral IV sites for dogs
cephalic or lateral saphenous veins
four advantages of jugular IV catheterizations
Constant rate infusions of drugs known to cause phlebitis
Measurement of Central venous pressure (CVP)
Facilitation of frequent aspiration of blood samples
Total parenteral nutrition (TPN)
two keys to jugular IV success
Patient positioning (lateral recumbency)
Vessel immobilization
how often should you inspect IV catheters
every 48 hours
six reasons why you should remove a catheter and place a new one
Phlebitis
Infection
Thrombosis
Leaking at insertion site by itself or during a flush
Pain upon injection
Any portion of the catheter is exposed
an inflammation that causes a blood clot to form in a vein
phlebitis
the formation of a blood clot (partial or complete blockage) within blood vessels
thrombosis
catheters should be removed after how many hours
72 hours (could be longer in animals if maintained)
if bandage around catheter gets wet what two things should you do
identify the reason
change the bandage
what should you do if a patient is molesting a bandage
investigate why
Catheters not continuously used should be flushed with saline every ______ hours
four
Catheters not used for prolonged period of time should be fitted with _______ or _______ locks
heparin
saline
Emergency drugs can be injected directly into the _______
trachea
what does LEAN stand for with intratracheal administration
lidocaine
epinephrine
atropine
naloxone
what does NAVEL stand for with intratracheal administration
naloxone
atropine
Valium
epinephrine
lidocaine
with intratracheal administration, Polypropylene ________ catheter or _______ feeding tube is inserted into trachea either directly or through an __________tube
urinary
rubber
endotracheal
immediately after giving drugs through intratracheal administration, what follows
10 mL of air or 3-10 mL of sterile saline solution
intraosseous administration is used for rapid fluid delivery to _______, _______ animals and patients with circulatory _______
neonates
small animals
collapse
four contraindications to intraosseous administration
Sepsis
Bones that are fractured or infected
Dermatitis
Bone cortex is punctured multiple times
five sites for intraosseous administration
tibia
femur
humerus
occasionally iliac wing
occasionally ischium
four purposes for arterial blood samples
Assess pulmonary function
Assess patient’s ability to ventilate and oxygenate
Assess partial pressure of CO2 and O2
Performed on a pH and blood gas analyzer
three percutaneous puncture sites for arterial blood samples
Dorsal metatarsal artery
Femoral artery
Sublingual artery
how long should you apply digital pressure to the puncture site for an arterial blood sample
1 minute
how long should you monitor arterial blood sample sites for bleeding/hematoma
4 minutes
two reasons for urine collection
analysis - both gross and microscopic
culture
four common techniques for urine collection
voiding
manual bladder expression
cystocentesis
catheterization
how long can urine be stored at room temp
30 mins
what kind of container does urine need to be stored in
air tight
if a urine culture can’t be ran within 30 mins, how should it be stored
in the refrigerator
if a urine sample was stored in the refrigerator, how should it be prepared before analysis
returned to room temp
voided, voluntary urine samples should be collected at what point in the stream
midstream
voided urine collection can not be used for what
cultures
two ways to collect voided urine from a dog
collection devices for shy patients
raised grates in cages
three ways to collect voided urine from a cat
Clean, dry, empty litter box
Nonabsorbable beads in box
Shredded wax paper in box
urine from manual bladder expression can be used for ______ ______ but not _______
routine urinalysis
culture
manual bladder expression is difficult on what kind of animals
awake animals
manual bladder expression is used in what kind of impairments
neurologic
where do you place your hands to do manual bladder expression
isolate bladder between palm and fingers
Percutaneous aspiration of urine from bladder
cystocentesis
what kind of sample is urine from cystocentesis
sterile sample
why is cystocentesis safer than urinary catheterization for samples
Minimizes iatrogenic urinary tract infections
what does iatrogenic mean
relating to illness caused by medical examination or treatment
what is hematuria
blood in urine
three contraindications for cystocentesis
suspected bleeding disorders
pyometra
tumors
what can you use for guidance when doing a cystocentesis
ultrasound
what can be done to relieve a urethral obstruction
catheterization
catheterization can be used for _______ studies
radiographic
catheterization can be used for quantifying what
urinary output
two complications with urinary catheterization
Urinary tract infection
Urethra/bladder irritation and trauma
how many times should the prepuce or vulva be cleaned to prepare for a urinary catheter
twice
premeasure the urinary catheter externally to where
caudal bladder
when using a urinary catheter, monitor the bladder for what
adequate output
what kind of catheter is connect to a reservoir bag and stays in place to drain urine, long term placement
Indwelling catheter
indwelling catheters are _______ to the animal
sutured
what should you inspect indwelling catheters for
obstructions or kinks
how long are indwelling catheters left in place
4 to 5 days
if indwelling catheters are advanced too far, what can happen
the catheter may tie itself in a knot within the urinary bladder
urinary catheters should be removed ______ and _______
slow and controlled
what kind of urinary catheters are used in male dogs for sample collection or emptying a bladder (not for indwelling catheters)
polypropylene catheter
polypropylene catheter
what kind of urinary catheter should be used for an indwelling catheter in a male dog
flexible feeding tube or Foley catheter (pictured)
Foley catheter
in male cats catheterization is rarely done for _____ _____ but a more common reason is to relieve a _______ ________
urine collection
urethral obstruction
what kind of catheters are used for male cats
Tomcat catheter
Tomcat catheter
two techniques to use for a urinary catheter on a female dog
blind/palpate
otoscope/speculum
what kind of catheter is used for indwelling catheters in female dogs
Foley catheter
The centesis brothers can be done for what two things
diagnostic and therapeutic
vet techs role in the centesis brothers
clip and sterile prep
post procedure care
Diagnose or treat pleural filling defects
thoracocentesis
for a thoracocentesis, Auscultation reveals diminished or absent _____ sounds and muffled _____ sounds
breath
heart
what color tubes are used for thoracocentesis collection
purple and red top
what ribs have the hair clipped over for a thoracocentesis
7th and 8th intercostal space
The correct needle placement for performing a thoracocentesis is
Cranial border of the 8th rib
what supplies are needed for thoracocentsis
syringe
three way stopcock
IV tubing
Over the Needle catheter
three complications to thoracocentesis
Pneumothorax
Lung laceration
Laceration of blood vessel
what can laceration of a blood vessel during thoracocentesis lead to
hypovolemia (blood loss) leading to hemothorax
three nursing care needs for postthoracocentesis
Respiratory rate measurement
Auscultation of lung sounds
Oxygen saturation measured with a pulse oximeter
abdominocentesis can aid in the diagnosis of what four things
hemoabdomen (blood in abdominal cavity)
uroabdomen (urine in the abdominal cavity)
peritonitis (inflammation of the abdominal lining)
ascites (fluid accumulation within the peritoneal cavity)
two contraindications for abdominocentesis
Penetrating abdominal injury
Suspected pyometra
location on the abdomen for abdominocentesis
Right, midabdominal region
three things to make sure you avoid with abdominocentesis
spleen
liver
bladder
what three positions can abdominocentesis be done in
standing
sternal
lateral
what kind of results can abdominocentesis produce
false negative
what can be done if abdominocentesis results are suspected to be false negative
peritoneal lavage
three serious complications to abdominocentesis
penetration of bowel or spleen
damage to the xiphoid process
introduction of bacteria
Infusion of fluid into the abdomen, then retrieval of the fluid for analysis
diagnostic peritoneal lavage
for peritoneal lavage, the patient must have an empty what
bladder
where is a small incision made for peritoneal lavage, caudal to what
midline caudal to umbilicus
in peritoneal lavage, what direction is the catheter directed after insertion
caudally and dorsally
how much warmed crystalloid solution is used for peritoneal lavage
20 ml/kg
how do you lavage the peritoneal cavity once solution is added
gently rock patient back and forth
Obtaining tracheobronchial materials while bypassing mouth and oropharynx
transtracheal wash
three identifications that can be made by transtracheal wash
Identification of parasite eggs or larvae
Identification of infectious agents
Identification of neoplastic cells
transtracheal wash should not be used when
in severe respiratory distress
five complications with transtracheal wash
Hemorrhage
Pneumomediastinum, pneumothorax
Subcutaneous emphysema around the trachea
Acute dyspnea
Iatrogenic infection
for transtracheal wash, keep the patient awake with ______ _____
cough reflex
three techniques for transtracheal wash
Two-Catheter system
Through-the-needle catheter
Endotracheal lavage
Aspiration of fluid from a joint
arthrocentesis
three indications for arthrocentesis
Persistent or cyclic fever, especially FUO (fever of unknown origin)
Generalized stiffness or limb lameness, especially associated with systemic signs
Specific limb lameness
two contraindications for arthocentesis
Moderate to severe pyoderma or lick granuloma
Trauma with or without hemorrhage into joint
do not attempt arthrocentesis on what kind of animal
uncooperative or one that is not immobilized
what size needles are used for arthrocentesis
25 g and 22 g
for arthrocentesis, what is important to do with the needle before withdrawing
release suction (to prevent contamination of the sample)
with arthrocentesis, this joint is held in flexion
carpus
with arthrocentesis, The hock is held in partial flexion—_____ degrees with metatarsus and tibia
90
with arthrocentesis, The ______ joint is partially flexed during the procedure
stifle
three ways to analyze joint fluid from arthrocentesis
Gross appearance
Culture
Histological appearance
how much joint fluid does it take for gross and histologic appearance
a single drop is sufficient
Evaluates the cells in the bone marrow
bone marrow aspirate
two contraindications to bone marrow aspirate
Clotting factor abnormalities
Severe thrombocytopenia
three complications to bone marrow aspirate
Infection at the aspirate site
Damage to soft tissue structures
Hematoma
bone marrow aspirate is very _______ and heavy ______ is warranted
painful
sedation
three locations for bone marrow aspirates
ilium
humerus
femur
aged patients bone marrow is less active should you should use the ________
ilium
what kind of technique has to be observed with bone marrow aspirate
strict aseptic
For a bone marrow aspirate, always do ______ and _______ count within 24 hours before or after the aspirate so the peripheral and marrow cell populations can be compared
CBC
reticulocyte
what part of the humeral bone has an advantage to bone marrow aspirate because of less tissue, fat and muscle
greater tubercle
what location for bone marrow aspirate is useful in animals with narrow iliac wings
humeral bone/greater tubercle
when is the dorsal iliac difficult to palpate for bone marrow aspirate
heavy muscle or overweight patient
where is the needle introduced for femoral bone marrow aspirate
medially into great trochanter, parallel to femoral shaft
acquiring a sample of tissue cells
fine needle aspirate
three things that fine needle aspirate helps decipher between
inflammation
neoplasia
hyperplasia
what gauge needles are used for fine needle aspirate
25 g to 22 g
for fine needle aspirate, introduce the needle into the mass and do what
redirect once or twice then remove needle
