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Guide > Chapter 4 - Clinical Care and Management > Flashcards

Chapter 4 - Clinical Care and Management Flashcards

1
Q

What SHOULD the number of qualified veterinarians be appropriate for?

A

To fulfill the program’s requirements, which vary by institution, species used, and the nature of animal use.

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2
Q

What SHOULD the veterinarian have to be effective in providing clinical care?

A

SHOULD be familiar with the species and various uses of animals in the institutional research, teaching, testing, or production programs and have access to medical and experimental treatment records.

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3
Q

There SHOULD be a timely and accurate method for communication of any abnormalities in or concerns about animal health, behavior, and well-being to who? Who does this responsibility rest with?

A

Vet or vet’s designee. Responsibility for communicating these concerns rests with all those involved with animal care and use.

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4
Q

Reports SHOULD be what in order to ensure that animals most in need receive priority attention? What type of assessment SHOULD be performed to determine an appropriate course of action?

A

Triaged. Objective.

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5
Q

For animals on research protocols, the vet SHOULD make every effort to discuss any problems with who to jointly determine the most appropriate course of treatment or action?

A

PI or project director.

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6
Q

What can SOPS be developed for?

A

For recurrent health conditions to expedite treatment.

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7
Q

Recurrent or sig. problems involving experimental animal health should be communicated to who? What SHOULD be documented?

A

IACUC. All treatments and outcomes documented.

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8
Q

Describe emergency care provision and reporting (2)

A

Procedures MUST be in place to provide for emergency vet care during and outside regularly scheduled hours.
Procedures MUST enable animal care and research staff to make timely reports of animal injury, illness, or death

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9
Q

What MUST a vet of vet designee be available for?

A

Vet or designee MUST be available to expeditiously assess animal’s condition, treat, investigate an unexpected death, or advise on euthanize

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10
Q

In the case of a pressing health program, if the responsible person is not available or a consensus cannot be reached on treatment, the vet MUST have what authority?

A

Authority, delegated by senior administration and IACUC, to treat the animal, remove from experiment, institute appropriate measures to relieve severe pain or distress, or euthanize

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11
Q

Medical records are key element of a veterinary care program and are critical for:

A

Documenting animal well-being and tracking animal care and use at a facility

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12
Q

How SHOULD a veterinarian be involved in medical records?

A

SHOULD establish, review, and oversee medical and animal use records.

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13
Q

What MUST all those involved in animal care and use comply with?

A

Federal laws and regulations regarding human and veterinary drugs and treatments.

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14
Q

When SHOULD drug records and storage procedures be reviewed?

A

During facility inspections.

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15
Q

Why SHOULD surgical outcomes be continually and thoroughly assessed?

A

To ensure appropriate procedures are followed and timely corrective changes are instituted.

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16
Q

Modification of standard techniques may be required but SHOULD not compromise what? In the event of modification, what may need to be changed?

A

Animal well-being. Close assessment of outcomes may have to incorporate criteria other than clinical morbidity and mortality. Rely on continuing communication among technical staff, investigators, vets, and IACUC.

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17
Q

What MUST occur for researchers conducting surgery?

A

Researchers conducting surgical procedures MUST have appropriate training to ensure that good surgical technique is practiced - asepsis, gentle tissue handling, minimal dissection of tissue, appropriate use of instruments, effective hemostasis, and correct use of suture materials and patterns.

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18
Q

Who is responsible for determining that personnel performing surgical procedures are appropriately qualified and trained in procedures?

A

IACUC with AV

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19
Q

Who SHOULD presurgical planning include input from? Who should be involved in discussions of of the selection of anesthetic agents and doses and the plan for perioperative analgesic use?

A

All members of surgical team. Veterinarian.

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20
Q

What SHOULD the surgical plan identify?

A

Personnel, their roles and training needs, and required equipment and supplies. Location and nature of facilities. Perioperative animal health assessment and care.

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21
Q

Routine use of antibiotics SHOULD not be considered replacement for what?

A

Aseptic surgical technique

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22
Q

Presurgical planning SHOULD specify what requirements for postsurgical care? Who shares responsibility for ensuring that postsurgical care is appropriate?

A

Monitoring, care, and recordkeeping. Investigator and veterinarian

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23
Q

Unless an exception is specifically justified as an essential component of the research protocol and approved by the IACUC, where should aseptic surgery occur?

A

Dedicated facilities or spaces

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24
Q

What factors may impact the selection of location for a surgical procedure?

A

Species, nature of procedure, potential for physical impairment of postoperative complications

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25
Q

Why SHOULD surgical facilities be maintained and operated in a manner than ensures cleanliness and minimized unnecessary traffic?

A

Most bacteria are carried on airborne particles or fomites

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26
Q

If an operating room is used for other purposes, what is imperative?

A

That it is returned to an appropriate level of hygiene before its use for major survival surgery.

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27
Q

Generally, ag animals for biomedical research SHOULD undergo surgery with techniques and in facilities compatible with these guidelines, but what procedures may take place under field conditions? What do these procedures require?

A

Minor and emergency procedures commonly performed in clinical vet practice and commercial agricultural settings. Still require aseptic technique, sedation, analgesia, anesthetics, and conditions commensurate with the risk to the animal’s health and well-being.

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28
Q

What is the difference between major and minor surgical procedures?

A

Major: Penetrates and exposes a body cavity, produces substantial impairment of physical or physiologic functions, involves extensive tissue dissection or transection
Minor: Does not expose body cavity, little or no physical impairment. Typically do not show sig. signs of post-operative pain, have minimal complications, and return to normal function in short time.

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29
Q

What other factors SHOULD be considered when differentiating major and minor procedures?

A

Potential for pain and other postoperative complications, nature of procedure and size and location of incisions, duration of procedure, species, health status, and age of animals

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30
Q

What procedures may be classified as major or minor depending on their impact on an animal?

A

Laparoscopic surgeries and some associated with neuroscience research (craniotomy, neurectomy)

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31
Q

By who and how should laparoscopic procedures be evaluated as minor or major?

A

By veterinarian and IACUC on case-by-case basis

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32
Q

What is the minimum required for nonsurvival surgery preparation? For nonsurvival surgery of extended duration, why might attention to aseptic technique bye more important?

A

Clipped surgical site, clean instruments and surrounding area, and gloves. Might be important to ensure stability of model and a successful outcome.

33
Q

Describe aseptic technique. What does it include?

A

Reduce microbial contamination to the lowest practical level. Preparation of the patient (hair removal and disinfection), prep of surgeon (PPE), sterilization of instruments, supplies, and implanted materials, and use of operative technique to reduce likelihood of infection

34
Q

General principles of aseptic technique SHOULD be followed for what surgeries?

A

All survival surgical procedures.

35
Q

Specific sterilization methods SHOULD be selected on the basis of what? What SHOULD be used to validate proper sterilization?

A

Physical characteristics of the materials to be sterilized. Sterilization indicators

36
Q

Use of liquid chemical sterilants SHOULD include:

A

Proper contact time, rinsing of instruments with sterile water or saline before use

37
Q

Care SHOULD be taken for what if using a hot bead sterilizer?

A

Working surfaces of surgical instruments have sufficiently cooled before touching animal tissue.

38
Q

Describe alcohol as a sterilant.

A

Alcohol is neither a sterilant nor a high-level disinfectant, but may be acceptable for some procedures if prolonged contact times are used.

39
Q

Describe intraoperative monitoring.

A

Includes routine evaluation of anesthetic depth and physiologic function and conditions. SHOULD be documented.

40
Q

Maintenance of normal body temperature minimized disturbances in what systems? This is of particular importance in what animals? Why?

A

Minimizes cardiovascular and respiratory disturbances caused by anesthetic agents. Important in small animals where high ratio of surface area to body weight can lead to hypothermia.

41
Q

What care SHOULD be taken for aquatic species under surgery?

A

Keep skin surfaces moist and minimize drying.

42
Q

Where SHOULD animals be in the immediate post-operative period? What SHOULD particular attention be given to? What SHOULD be maintained?

A

Clean, dry, and comfortable area where they can be observed frequently by trained personnel. Attention to thermoregulation, cardiovascular and respiratory function, electrolyte and fluid balance, management of post-operative pain or discomfort. Should maintain appropriate medical records.

43
Q

After recovery when monitoring is often less intense, what SHOULD still be monitored?

A

Basic biologic functions of intake and elimination, behavioral signs of postoperative pain, monitoring for postsurgical infections, monitoring of surgical site for dehiscence, bandaging as appropriate, and timely removal of skin sutures, clips, or staples

44
Q

Pain is a complex experience typically resulting from what type of stimuli?

A

Those that damage or have the potential to damage tissue.

45
Q

Unrelieved pain can lead to unacceptable levels of what in animals? What phenomenon can result? Describe this phenomenon.

A

Stress and distress. Wind-up or allodynia can result, in which sensitization to pain results in a pain response to otherwise nonpainful stimuli.

46
Q

What is an ethical and scientific imperative in research animals?

A

Use of anesthetics and analgesics to manage pain.

47
Q

Unless the contrary is known or established, what SHOULD be considered regarding pain in humans compared to animals? What document states this?

A

Procedures that cause pain in humans may also cause pain in other animals. US Gov Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training.

48
Q

As some species may mask signs of pain until they are severe, what is essential regarding personnel who care for and use animals?

A

They must be trained in species-specific and individual clinical, behavioral, physiologic, and biochemical indicators of well-being.

49
Q

Define distress. Why is it difficult to monitor an animal’s state when present?

A

An aversive state in which an animal fails to cope or adjust to various stressors with which it is presented. May not induce an immediate and observable pathologic or behavioral alteration, making it difficult to monitor.

50
Q

What are important considerations when trying to prioritize and treat animal distress?

A

Intensity and duration.

51
Q

What two actions can help minimize distress experienced by animals?

A

Implementation of clear, appropriate, and humane experimental endpoints and close observation during invasive periods of experimentation

52
Q

The selection of appropriate analgesics and anesthetics SHOULD reflect what? What needs to be considered?

A

Professional veterinary judgement. Meet clinical and humane requirements and needs of research protocol.

53
Q

Define preemptive analgesia. Why is it beneficial?

A

Administration of preoperative and intraoperative analgesia. Enhances intraoperative patient stability and optimizes postoperative care and well-being through pain reduction

54
Q

Chronic pain may be more difficult to alleviate than postprocedural pain. What are potential avenues for pain relief?

A

Opiate slow-release transdermal patches or implantable analgesic-containing osmotic minipumps.

55
Q

What SHOULD occur due to wide individual variation in response to analgesics?

A

Animals SHOULD be closely monitored during and after painful procedures and SHOULD receive additional drugs to ensure appropriate analgesic measurement.

55
Q

Appropriate nursing care, including a quiet, darkened recovery or resting area, timely wound or bandage maintenance, increased ambient warmth and a soft resting surface, rehydration with oral or parenteral fluids, and a return to normal feeding through the use of highly palatable foods or treats are examples of:

A

Nonpharmacologic control of pain

56
Q

What SHOULD be used to assess the adequacy of an anesthetic regimen?

A

Level of consciousness, degree of antinociception, and status of cardiovascular, respiratory, musculoskeletal, and thermoregulatory systems

57
Q

Loss of consciousness occurs at what plane of anesthesia? Anti-nociception occurs at what plane of anesthesia? What must be ascertained before surgery?

A

Light plane. Surgical plane. Anti-nociception occurs at a surgical plane of anesthesia and MUST be ascertained before surgery.

58
Q

Generally, what tools or medications increase anesthetic safety?

A

Precision vaporizers, monitoring equipment, specific reversal agents

59
Q

Guidelines for the selection and proper use of analgesic and anesthetic drugs SHOULD be developed and reviewed how often?

A

Periodically, as standards and techniques are refined

60
Q

What MUST occur for agents that provide anesthesia and analgesia?

A

MUST be used before their expiration dates and SHOULD be acquired, stored, their use recorded, and disposed of legally and safely.

61
Q

When neuromuscular blocking agents are used, what signs may indicate pain related to an inadequate depth of anesthesia?

A

Autonomic nervous system changes (HR or BP)

62
Q

It is imperative that any proposed use of neuromuscular blocking drugs be carefully evaluated by who?

A

Vet and IACUC to ensure well-being of animal

63
Q

What is a consequence of paralysis in a conscious state?

A

Acute stress, and distress in humans.

64
Q

If paralyzing agents are to be used, how should the appropriate amount of anesthetic first be defined?

A

On the basis of results of a similar procedure using the anesthetic without a blocking agent.

65
Q

Define euthanasia

A

Act of humanely killing animals by methods that induce rapid unconsciousness and death without pain or distress

66
Q

Methods of euthanasia SHOULD be consistent with the AVMA Guidelines unless:

A

Deviation is justified for scientific or medical reasons

67
Q

What criteria SHOULD be considered when evaluating methods of euthanasia? (7)

A
  1. Ability to induce loss of consciousness and death with no or only momentary pain, distress, or anxiety
  2. Reliability
  3. Irreversibility
  4. Time required to induce unconsciousness
  5. Appropriateness for the species and age
  6. Compatibility with research objectives
  7. Safety of and emotional effect on personnel
68
Q

What methods of euthanasia SHOULD be developed and approved by the AV and IACUC?

A

Standardized methods that are predictable and controllable.

69
Q

How SHOULD euthanasia be carried out?

A

In a manner that avoids animal distress.

70
Q

Special consideration SHOULD be given to euthanasia of:

A

Fetuses and larval life forms depending on species and gestational age.

71
Q

Generally, are chemical or physical agents preferred? Why may chemical agents be precluded?

A

Chemical. Scientific considerations may preclude use of chemical agents for some protocols.

72
Q

How SHOULD the acceptability of CO2 as a euthanasia agent for small rodents be evaluated? What SHOULD be considered in addition to CO2?

A

Evaluated as new data becomes available. Alternative methods SHOULD be considered as neonatal rodents are resistant to the hypoxia-inducing effects and require a longer exposure time.

73
Q

It is essential that euthanasia is performed how and by who?

A

In a professional and compassionate manner by personnel skilled in methods for the species.

74
Q

Special attention is required to ensure proficiency for what manner of euthanasia?

A

Physical

75
Q

What MUST be confirmed after euthanasia? What can also be used to ensure death?

A

Death MUST be confirmed by personnel trained to recognize cessation of vital signs in the species being euthanized. A secondary method can also be used.

76
Q

All methods of euthanasia SHOULD be reviewed and approved by:

A

Vet and IACUC

77
Q

What SHOULD supervisors be sensitive to when delegating euthanasia?

A

May be psychologically difficult, especially if staff perform euthanasia repetitively or are emotionally attached to the animals.

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