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Medical Nursing for Vet Techs > Diagnostic Sampling (Small Animals) > Flashcards

Diagnostic Sampling (Small Animals) Flashcards

1
Q

Successful venipuncture requires ______ and _______

A

Proper restraint + Visualization/immobilization of the vessel

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2
Q

What materials are needed for venipuncture blood sample collection?

A
  1. Needle + syringe
  2. Butterfly catheter with or without syringe or vacutainer
  3. Vacutainer collection system
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3
Q

What makes up a vacutainer collection system?

A
  1. Double-pointed needle
  2. Plastic holder
  3. Blood collection tube(s) with or without anticoagulant
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4
Q
A

Vacutainer Collection System

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5
Q

VP collection site, method of collection, and needle gauge is chosen based on:
1.
2.
3.
4.

A
  1. Vessel size
  2. Amount of blood (sample) required
  3. Intended use of the sample
  4. VT preference
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6
Q

Needle Sizes: Small Gauge

A

25 to 28 gauge

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7
Q

Needle Sizes: Medium/Average Gauge

A

22 gauge

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8
Q

Needle Sizes: Large Gauge

A

18 and 20 gauge

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9
Q

When should you use 25-28 gauge needles?

A
  1. Smaller, fragile vessels
  2. Multiple/frequent VPs
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10
Q

When should you use 22 gauge needles?

A
  1. VP on cats
  2. VP on small dogs
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11
Q

When should you use 18 and 20 gauge needles?

A
  1. VP on large breed dogs
  2. VP on most farm animals
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12
Q

the method of blood sample collection in which the colored-top tubes are filled in a certain order to allow for minimal contamination or “carry over” between tubes

A

Order of Draw

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13
Q

Blood collected from VP must be _______ and _______.

A

placed into a specific colored-top tube + filled in order of draw

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14
Q

PROCEDURE - Putting Collected Blood in Appropriate Tubes

A
  1. Removing the needle from the collection apparatus + the stopper from the tube
  2. Blood flows down the side of the blood collection tube to the “fill line” as blood is gently expelled from the collection device
  3. Tube’s contents are adequately mixed by gently rocking the tube back and forth a predetermined number of times
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15
Q

Why is it important to NOT vigorously mix or forcefully eject collected blood samples?

A

Can cause hemolysis of sample

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16
Q

the destruction of red blood cells

A

Hemolysis

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17
Q

Always label blood collection tubes with:
1.
2.
3.

A
  1. Patient’s first + last names
  2. Date of collection
  3. Owner’s first + last names
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18
Q

Give 3 examples of blood sample coagulation profiles

A
  1. Activated Clotting Time (ACT)
  2. Prothrombin Time (PT)
  3. Activated Partial Thromboplastin Time (APTT)
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19
Q

Why is it important to break the seal of the syringe plunger before venipuncture?

A

May cause:
1. Vein to collapse
2. RBC hemolysis

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20
Q

Needle is always inserted with bevel facing _____ in all VP procedures

A

up

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21
Q

PROCEDURE - Venous Blood Collection (Needle + Syringe Method)

A
  1. Attach a 20-25 gauge needle to a 1-6 mL syringe
  2. Occlude the vein with a tourniquet or digital pressure
  3. Wipe the skin and hair on top of the vein with an alcohol-soaked cotton ball to help identify the vein
  4. Break the plunger seal by pulling it half way out of the syringe
  5. Insert the needle with the bevel facing up through the skin and into the vein at a 25º angle
  6. Slowly retract the syringe plunger + collect a blood sample
  7. Release the pressure on the vein + release the syringe plunger when a sufficient volume of blood has been collected
  8. Remove the needle from the vein
  9. Apply digital pressure to the venipuncture site as soon as the needle is removed > until hemostasis occurs
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22
Q

PROCEDURE - Cephalic Venipuncture

A
  1. Place patient in sternal or lateral recumbency
  2. Grasp the leg at the metacarpus > extends the foreleg
  3. Occlude the vessel
  4. Pop the syringe plunger seal
  5. VT grasps the right foreleg of the patient with nondominant hand at the carpus > wipes the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec > evaluate site for bleeding and/or hematoma formation for several minutes

If bleeding continues:
– Apply pressure bandage – Report clotting delay to attending vet

  1. Place collected blood in appropriate blood collection tubes
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23
Q
A

Cephalic Vein

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24
Q

Why should the cephalic vein be the last choice for diagnostic sample collection?

A

Vessels need to be maintained for IVs if needed

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25
Q

Give 3 scenarios in which jugular VP would be used

A
  1. Chemistry profiles
  2. Hyperthyroid testing
  3. Cushing test
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26
Q

Give 4 scenarios in which jugular VP would NOT be used

A

Patients with:
1. Head trauma
2. Possible heat stroke
3. Clotting abnormalities
4. Snake bites

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27
Q

PROCEDURE - Jugular Venipuncture

A
  1. Place patient in sternal, lateral, or seated recumbency
  2. Grasp underneath either side of patient’s jaws > gently extend the head toward ceiling
  3. Apply digital pressure at thoracic inlet > occludes vessel
  4. Pop the syringe plunger seal
  5. Wipe the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec
  11. Place collected blood in appropriate blood collection tubes
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28
Q

If patient is in sternal recumbency > jugular VP is done in the _______ direction.

A

cephalic

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29
Q

If patient is in lateral recumbency > jugular VP is done in ________ direction.

A

caudal

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30
Q

PROCEDURE - Lateral Saphenous Venipuncture DOGS

A
  1. Place patient in lateral recumbency
  2. Grasp the upper leg at the stifle > extends the hindlimb
  3. Apply circumferential pressure to the stifle of the top hindleg > occludes the vessel
  4. Pop the syringe plunger seal
  5. VT grasps the top hindleg of the patient using nondominant hand at at the metatarsus > wipes the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec > evaluate site for bleeding and/or hematoma formation for several minutes
  • If bleeding continues:
    – Apply pressure bandage
    – Report clotting delay to attending vet
  1. Place collected blood in appropriate blood collection tubes
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31
Q

PROCEDURE - Lateral Saphenous Venipuncture CATS

A
  1. Place patient in lateral recumbency
  2. Grasp the upper leg with thumb just cranial to the patella + index finger is in the patella fold on the caudal aspect of the rear leg > extends the hindlimb
  3. Apply upward circumferential pressure behind + caudal to the patella > occludes the vessel
    - Clipping the hair in the stifle area (just cranial to the tarsal bone) may aid in vein visualization
  4. Pop the syringe plunger seal
  5. VT grasps the top hindleg of the patient using nondominant hand at at the metatarsus > wipes the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec > evaluate site for bleeding and/or hematoma formation for several minutes
    - If bleeding continues: – Apply pressure bandage – Report clotting delay to attending vet
  11. Place collected blood in appropriate blood collection tubes
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32
Q

Femoral vein is also known as the _____ vein.

A

Medial Saphenous Vein

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33
Q

PROCEDURE - Medial Saphenous Venipuncture for DOGS

A
  1. Place patient in lateral recumbency
  2. Grasp the upper leg at the stifle > extends the leg
  3. Apply circumferential pressure to the stifle of the bottom hindleg > occludes the vessel
  4. Pop the syringe plunger seal
  5. VT grasps the bottom hindleg of the patient using nondominant hand at at the metatarsus > wipes the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec > evaluate site for bleeding and/or hematoma formation for several minutes

-If bleeding continues: – Apply pressure bandage
- Report clotting delay to attending vet

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34
Q

PROCEDURE - Medial Saphenous Venipuncture for CATS

A
  1. Place patient in lateral recumbency
  2. Grasp the top hind leg > abduct + flex the upper leg > exposes medial surface of bottom hind leg
  3. Apply pressure with the side of your abducting hand along the inguinal area of the bottom hindleg (“karate chop” fashion) > occludes the vessel
  4. Pop the syringe plunger seal
  5. VT grasps the bottom hindleg of the patient using nondominant hand at at the metatarsus > wipes the VP site with 70% isopropyl alcohol
  6. VT digitally palpates the vessel > rest thumb of nondominant hand directly against + parallel to the vessel
  7. Insert the needle along the vein’s long axis on the other side from your thumb
  8. “Flash” of blood should be noted within the needle hub > stop insertion > gently pull syringe plunger to obtain predetermined amount of blood
  9. Remove needle while gently aspirating
  10. Apply pressure to insertion areas for 30 sec > evaluate site for bleeding and/or hematoma formation for several minutes
  • If bleeding continues: – Apply pressure bandage
  • Report clotting delay to attending vet
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35
Q

Which species is VP of the marginal ear vein primarily used for? And what two things does it test for?

A

Rabbits - To test for:
1. Erythropoiesis
2. Blood glucose levels

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36
Q

PROCEDURE - Marginal Ear Venipuncture

A
  1. Apply warmth to ear vein with a heated cloth for approx. 30 sec > dilates vessel
    - Heated cloth
    - Light source
    - VTs hands
  2. Apply 70% isopropyl alcohol to VP site
  3. Slightly nick the skin + vein with a 25-gauge x 3/4” needle or lancet
  4. Once blood appears on skin surface > massage pinna to obtain sufficient blood sample
  5. Apply direct pressure to stop bleeding for approx. 15 sec
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37
Q
A

Venipuncture of the Marginal Ear Vein

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38
Q

ABG Sampling is short for _______

A

Arterial Blood Gas Sampling

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39
Q

ABG samples are used to assess:
1.
2.
3.
4.

A
  1. Pulmonary function
  2. Gas exchange within the lungs
  3. Measurement of blood gases (O2 and CO2)
  4. Blood pH
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40
Q

Give 3 examples of what ABG samples can help diagnose

A
  1. Kidney failure
  2. Heart failure
  3. Diabetic ketoacidosis
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41
Q

List the 4 most common sites used to obtain an ABG sample

A
  1. Dorsal pedal artery
  2. Dorsal metatarsal artery
  3. Femoral artery
  4. Sublingual artery (unconcious/anesthetized patients)
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42
Q

What two kinds of needles + syringes can be used to collect an ABG sample?

A
  1. 22 or 25 gauge needle + 1 or 3 mL syringe + lithium or sodium heparin
  2. ABG self-filling syringe coated with lithium heparin
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43
Q

PROCEDURE - Arterial Blood Collection

A
  1. Coat dead space of a syringe (with attached needle) with heparin > expel excess heparin from the syringe
  2. Use appropriate restraint
  3. VT digitally palpates the target vessel with nondominant hand
  4. Site is clipped and/or surgically prepped
  5. Using palpating fingers to guide > insert needle with heparinized syringe bevel side up + parallel to the artery + at 45º angle
  6. Flash of blood should be noted within the needle hub
  7. Fill syringe
    - If ABG self-filling syringe > syringe will automatically fill to a predetermined volume set prior to venipuncture
    - If lithium heparin-coated syringe + needle > VT gently pulls syringe plunger to obtain 1-1.5 mL sample
  8. Remove needle gently + apply pressure to insertion areas for 1 min > monitor for hematoma formation
  9. Expel all air from the collection syringe + place rubber stopper on end of the needle
  10. Sample placed in ice water bath during transport to lab for immediate analysis OR sample can stay in ice water bath for several hours before analysis
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44
Q

What are 2 important things to avoid doing when collecting an ABG sample? Why?

A
  1. Introducing air
  2. Applying excessive negative pressure

Both affect PaO2 measurements

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45
Q

The medial saphenous vein can be easily confused with the _______.

A

femoral artery

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46
Q

_____ is the preferred artery for arterial catheter placement.

A

Dorsal Metatarsal Artery

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47
Q

What 2 scenarios would you use arterial catheter placement?

A
  1. Collection of multiple blood samples
  2. Continuous measurement of arterial BP
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48
Q

PROCEDURE - Arterial Catheter Placement

A
  1. Place patient in lateral recumbency + extend hock
  2. Site is clipped + aseptically prepped
  3. Flush a 20-22 gauge over-the-needle (OTN) catheter with heparinized normal saline
  4. Palpate the artery
  5. Using needle’s beveled edge > make a relief hole in dermis for insertion
  6. Palpate needle tip + artery simultaneously with fingers of opposite hand
  7. Insert the catheter steeply until it penetrates the upper artery wall > then move it flat against the skin surface + parallel to the artery’s long axis
  8. Flash of blood should be seen within the needle hub > then carefully advance the catheter into the artery to its full length
  9. Replace needle with a T-connector + stopcock
  10. Wrapping adhesive tape around the hub to secure catheter > Cover the insertion site with a 2”x2” piece of gauze > Apply roll gauze followed by tape
  11. Flush catheter every 2 hours with heparinized saline OR attach to a continuous flush system
  12. Check toes for warmth every 2-4 hours
    -If toes are cool > remove catheter
  13. Perform catheter care every 48 hours
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49
Q

_____ mL needed for most quantitative urinalyses

A

7-10 mL

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50
Q

_____ mL needed for strip-based urinalyses

A

< 7 mL

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51
Q

What temperature should samples be for urinalysis if they have been refrigerated?

A

Room temperature

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52
Q

List 4 methods of urine sample collection

A
  1. Voided collection
  2. Manual bladder expression
  3. Cystocentesis
  4. Urinary catheterization
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53
Q

method of urine sample collection in which the sample is gathered as or after the patient excretes the urine and is used for routine urinalysis

A

Voided Collection

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54
Q

Voided urine sample collections are NOT acceptable for ______.

A

Cultures

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55
Q

method of urine sample collection in which the sample is gathered by applying pressure directly to the bladder and is used in animals that have difficulty voiding due to neurological deficits

A

Manual Bladder Expression

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56
Q

Manual bladder expression sample collections are NOT acceptable for ______.

A

Cultures

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57
Q

Do NOT use manual bladder expression for ______. Why?

A

Urinary blockages > may result in urethral or vesicular rupture

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58
Q

PROCEDURE - Manual Bladder Expression

A
  1. Place patient in standing or lateral recumbency
  2. VT places hands on either side of the caudal abdomen
  3. Isolate the bladder between the palmar surfaces of the fingers
  4. Gently and continuously apply pressure to express the urine
  • If method does not work with moderate compression > MUST use a different method
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59
Q

method of urine sample collection in which the sample is gathered by placing a needle through the abdominal wall to draw urine directly from the bladder and is used to obtain sterile urine samples for analysis or culture and sensitivity testing

A

Cystocentesis

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60
Q

Give 4 scenarios in which cystocentesis would be used

A
  1. Urinalysis
  2. Culture and sensitivity testing
  3. Aid in localization of hematuria, pyuria, bacteriuria
  4. Relieve distended bladder if catheter cannot be placed
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61
Q

blood cells in the urine

A

Hematuria

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62
Q

pus in the urine

A

Pyuria

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63
Q

Give 4 scenarios in which cystocentesis is NOT used

A

Patients with:
1. Recent abdominal surgery or trauma
2. Suspected bleeding disorders
3. Pyometra
4. Suspected caudal abdominal or bladder tumor

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64
Q

uterine infection

A

pyometra

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65
Q

Why is it important to remove most but not ALL urine during a cystocentesis?

A

Removing all volume risks contact between needle + bladder wall > damage to bladder

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66
Q

During a cystocentesis, insert the needle _______ of the bladder instead of ______.

A

During a cystocentesis, insert the needle [cranial to the trigone region] of the bladder instead of [the apex].

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67
Q

Why should you NEVER redirect the needle once in the abdominal cavity during a cystocentesis?

A

May result in accidental viscera laceration

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68
Q

Give 3 possible complications of a cystocentesis

A
  1. Bladder laceration
  2. Bowel laceration
  3. Peritonitis (as a result of prior)
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69
Q

Give 2 contraindications for cystocentesis

A
  1. Inadequate urine volume in bladder
  2. Patient resists restraint + abdominal palpation
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70
Q

What size neddle + syringe are needed for a cystocentesis?

A
  1. 22-gauge x 1-1.5 in needle
  2. 12 mL or larger syringe
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71
Q

Preferred restraint(s) for ventrolateral cystocentesis

A
  1. Standing recumbency
  2. Lateral recumbency
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72
Q

Preferred restraint(s) for ventral cystocentesis

A
  1. Dorsal recumbency
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73
Q

PROCEDURE - Ventrolateral Cystocentesis

A
  1. Place patient in standing or lateral recumbency
  2. Palpate abdomen to determine size + location of bladder
  3. Hold the syringe with the needle in one hand + stabilize the bladder from below with the free hand
    - Press bladder dorsally + caudally to immobilize it against the pelvis
  4. Wipe insertion site with alcohol
  5. Insert needle caudomedially into abdominal cavity + bladder > 45º angle to bladder wall + toward cranial trigonal region
  6. Aspirate urine in the syringe until desired sample volume is obtained
  7. Stop aspiration or release negative pressure on the plunger of syringe BEFORE withdrawing the needle
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74
Q

PROCEDURE - Ventral Cystocentesis

A
  1. Place patient in dorsal recumbency
    - May take 2 assistants for large breeds or deep-chested dogs
  2. Palpate abdomen to determine size + location of bladder
  3. Hold the syringe with the needle in one hand + stabilize the bladder from below with the free hand
    - Press bladder dorsally + caudally to immobilize it against the pelvis
  4. Wipe insertion site with alcohol
  5. Insert needle on midline into abdominal cavity > 45º angle to bladder wall + directed caudally
  6. Aspirate urine in the syringe until desired sample volume is obtained
  7. Stop aspiration or release negative pressure on the plunger of syringe BEFORE withdrawing the needle
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75
Q

method of urine sample collection in which the sample is gathered by placing a tube directly into the urethra

A

Urinary Catheterization

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76
Q

List 4 possible complications of urinary catheterization

A
  1. Urethral inflammation
  2. Bacterial UTI
  3. Urethral and bladder irritation
  4. Trauma
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77
Q

What 2 scenarios would indwelling urinary catheters be used?

A

Patients that have:
1. Recently had urethral calculi removed
2. Neurologic impairment/traumatic conditions interfering with normal urination

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78
Q

having normal blood pressure

A

Normotensive

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79
Q

having a normal volume of blood in the body

A

Normovolemic

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80
Q

A normotensive, normovolemic patient with intact renal function has a urinary output of _____ per _____ per hour.

A

1-2 mL of urine per kg of body weight

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81
Q

PROCEDURE - Indwelling Urinary Catheter Placement and Removal

A
  1. Gently rinse prepuce or vulva twice with warm antimicrobial solution + water > dry
  2. Missing step?
  3. Connect catheter with sterile gloves to IV extension tubing OR Collection system
  4. Collection bag acts as urine reservoir > measure + empty periodically
  5. Detach catheter with sterile gloves
    - Remove as soon as possible
    - If required on long term basis > place a new catheter every 4-5 days
82
Q

If urine in reservoir bag is NOT adequate:
1.
2.
3.
4.

A
  1. Palpate bladder for distention
  2. Inspect urinary catheter for obstructions or kinks
  3. Gently compress bladder > determine whether urine can flow through catheter
  4. Flush small volume of sterile 0.9% saline solution to (attempt) to relieve obstruction
83
Q

Urethral catheter sizes are _____ sizes.

A

French (Fr) sizes

84
Q

Urethral catheters are measured to the ______ portion of the bladder.

85
Q

Use ______ urethral catheter sizes for male and female feline patients of all weights.

86
Q

Canine Urethral Catheter Size:
Male < 9kg

87
Q

Canine Urethral Catheter Size:
Male 9-23kg

A

5- or 8-Fr

88
Q

Canine Urethral Catheter Size:
Male > 23kg

A

10- or 12-Fr

89
Q

Canine Urethral Catheter Size:
Female < 9kg

90
Q

Canine Urethral Catheter Size:
Female 9-23kg

A

8- or 12-Fr

91
Q

Canine Urethral Catheter Size:
Female > 23kg

A

10- or 12-Fr

92
Q

rigid catheter for sample collection and emptying the bladder

A

Polypropylene Catheter

93
Q

flexible catheter used for indwelling catheters

A

Foley Catheter

94
Q

PROCEDURE - Urinary Catheterization for Male Dogs

A
  1. Place patient in lateral recumbency + retract the upper leg
  2. Clip hairs around preputial orifice > flush the prepuce with dilute antiseptic solution > rinse with warm sterile saline solution or water
  3. VA retracts prepuce > exposes glans (tip) of penis > wash glans of penis with antiseptic solution > rinse with warm saline solution or water
  4. Aseptically open catheter packaging
  5. To distal tip of catheter > apply sterile water-soluble lubricant OR sterile lidocaine ointment
  6. Insert + gently advance the catheter into the urethra
  7. Urine should flow into catheter as it enters the neck of the bladder > advance catheter 1 cm further OR to predetermined measurement
  8. Attach sterile syringe to catheter
  9. Slowly aspirate urine from bladder
  10. Discard first few mL of urine suctioned from catheter
  11. Store collected urine in sterile + capped tube
  12. Catheter may be withdrawn or remain in the bladder
95
Q

To guide urinary catheter around curve of ischial arch (os penis) >

A

apply digital pressure on the perineum externally

OR

pressing the catheter with index finger placed in rectum

96
Q

PROCEDURE - Urinary Catheterization for Female Dogs

A
  1. Place dog in standing, lateral, or sternal recumbency
  2. Clip hairs around vulvar areas > flush the vulvar + perineal areas with dilute antiseptic solution > rinse with warm sterile saline solution or water
  3. Instill 1.0 mL of sterile 2% lidocaine jelly into the ventral vaginal floor
  4. Apply sterile lubricant to the tip of the catheter
  5. Wearing sterile gloves > insert the catheter into the urethral papilla
  6. Advance until urine is seen in catheter OR at premeasured length
  7. Attach sterile syringe to catheter > apply gentle negative pressure to obtain sample
  8. Store collected urine in sterile + capped tube
  9. Catheter may be withdrawn or remain in the bladder
97
Q

PROCEDURE - Guiding Urinary Catheter in Female Canines (Speculum + Light Source)

A
  1. Gently insert speculum of choice vertically into vagina > then straightened to horizontal when pelvic canal is entered (2-4 cm inside the vagina) – Avoid the clitoral fossa
  2. Using light aid > locate urethral papilla + urethral orifice
  3. Insert lubricated catheter
98
Q

PROCEDURE - Guiding Urinary Catheter in Female Canines (Blind Technique)

A
  1. Placed lubricated finger into vagina > slide 2-5cm along ventral floor > until urethral papilla + external urethral orifice are located
  2. Introduce lubricated catheter into the vagina > use the finger in the vestibule to guide catheter into urethral orifice
  3. Palpate catheter within the urethral orifice > to acknowledge proper placement
    - NOT in cranial vestibule
99
Q

characterized as having reduced alertness and responsiveness

100
Q

characterized as having high levels of potassium in the blood

A

Hyperkalemic

101
Q

Male cats with obstructions for long periods of time are often ______ + _______.

A

Obtunded
Hyperkalemic

102
Q

_____ is also known as a silicone tomcat catheter.

A

3.5-Fr polypropylene catheter

103
Q

Type of urinary catheter used for male cats

A

3.5-Fr polypropylene

104
Q

PROCEDURE - Urinary Catheterization for Male Cats

A
  1. Evaluate + monitor patient prior to giving anesthetic agents > sedate or anesthetize the patient
  2. Place in lateral or dorsal recumbency + hind legs drawn cranially
  3. VA retracts prepuce > exposes glans (tip) of penis > wash glans of penis with antiseptic solution > rinse with warm saline solution or water
  4. Clip hairs around preputial orifice > flush the prepuce with dilute antiseptic solution > rinse with warm sterile saline solution or water
  5. Extend the penis dorsally + parallel to the vertebral column
  6. Wearing sterile gloves > palpate to check for distal urethral plug or calculus
    - If there is an obstruction> gently massage tip of penis with thumb + forefinger > dislodge any urethral plugs
    - If there no obstruction OR the massage is unsuccessful > proceed with catheterization
  7. Pass a lubricated 3.5 Fr polypropylene catheter into urethra
  8. Urine should flow into catheter as it enters the neck of the bladder > advance catheter 1 cm further OR to predetermined measurement
  9. Attach sterile syringe to catheter
  10. Slowly aspirate urine from bladder
  11. Discard first few mL of urine suctioned from catheter
  12. Store collected urine in sterile + capped tube
  13. Catheter may be withdrawn or remain in the bladder
  14. Using an Elizabethan collar is recommended > prevent removal of catheter + urine reservoir
105
Q

Fecal samples are used in gross and microscopic examinations to look for:
1.
2.
3.
4.

A
  1. Mucus
  2. Blood
  3. Intestinal parasites
  4. Ova
106
Q

a procedure performed to diagnose or treat pleural filling defects by aspirating air and fluid compressing the lungs in the pleural cavity and thus allowing them to re-expand

A

Thoracocentesis

107
Q

What are 5 signs of pleural filling defects?

A
  1. Tachypnea
  2. Respiratory distress
  3. Open mouth breathing
  4. Diminished breath sounds > determined via chest auscultation
  5. Cyanosis
108
Q

short shallow breaths

109
Q

Give 2 indications for thoracocentesis

A
  1. Pneumothorax
  2. Pleural effusion
110
Q

Give 3 contraindications for thoracocentesis

A
  1. Diaphragmatic hernia
  2. Presence of pleural masses
  3. Presence of a disease causing fragile lung tissue
111
Q

What materials are needed for a thoracocentesis?

A
  1. Sterile gloves
  2. 18- to 20-gauge, 2-5” OTN catheter
  3. IV extension tubing
  4. Three-way stopcock
  5. Syringe
  6. # 15 scalpel
  7. Lidocaine 2%
  8. Clippers
  9. Antiseptic scrub and solution
  10. Vacutainer blood tubes
    - Lavender-top EDTA
    - Red-top clot tubes
  11. Culture transport media
112
Q

Use the ____ to ____ intercostal space when performing a thoracocentesis.

A

7th to 8th

113
Q

When performing a thoracocentesis to aspirate AIR > enter the ______ thorax.

A

dorsal thorax

114
Q

When performing a thoracocentesis to aspirate FLUID > enter the ______ thorax.

A

ventral thorax

115
Q

PROCEDURE - Thoracocentesis

A
  1. Place animal in standing, sternal, or lateral recumbency
  2. Shave + aseptically prepare several inch diameter around target insertion site at 7th to 8th intercostal space
  3. Inject 1-2 mL lidocaine into + around target insertion site
  4. Wearing surgeon’s gloves > assemble equipment
    - Attach stopcock to syringe
    - Attach extension tubing to stopcock
    - Add additional extension tube to free port of stopcock > place distal end into a bowl to collect pleural fluid
  5. Insert needle in the caudal aspect of intercostal space + cranial to rib
  6. Keep catheter perpendicular to chest wall > advance catheter through chest wall until flash of fluid in hub or a pop is felt
  7. Advance catheter a few mm over end of needle > direct catheter + needle ventrally along thoracic wall
  8. When in position > advance ONLY catheter > remove needle > attach extension tubing
  9. Apply gentle aspiration to the syringe
    - If no fluid or air is withdrawn > withdraw catheter a few mm > redirect catheter or needle without removing it from the cavity
    - If fluid or air is withdrawn > aspirate until slight negative pressure OR until patient’s condition improves
  10. Submit lab samples for analysis
  11. Postprocedural nursing care
116
Q

What are 4 important parts of thoracocentesis postprocedural nursing care?

A
  1. Close observation
  2. RR measurement
  3. Auscultation of lung sounds
  4. Measure oxygen saturation (use pulse ox)
117
Q

Give 3 possible complications of a thoracocentesis

A
  1. Pneumothorax
  2. Lung laceration
  3. Intercostal vessel or internal thoracic artery laceration > hemothorax > hypovolemia
118
Q

condition in which blood collects in the pleural space

A

Hemothorax

119
Q

condition in which volume of blood plasma is too low

A

Hypovolemia

120
Q

Why is the needle inserted into the caudal aspect of the intercostal space and cranial to the rib?

A

To avoid intercostal vessels and nerves on the caudal aspect of the ribs

121
Q

a procedure that involves aspiration of fluid from the abdominal cavity for diagnostic and therapeutic purposes

A

Abdominocentesis

122
Q

Abdominocentesis aids in diagnosis of:
1.
2.
3.
4.

A
  1. Hemoabdomen
  2. Uroabdomen
  3. Peritonitis
  4. Ascites with cardiac or hepatic causes
123
Q

condition in which blood collects in the abdomen

A

Hemoabdomen

124
Q

condition in which urine leaks and collects in abdominal cavity

A

Uroabdomen

125
Q

What are 2 contraindications for abdominocentesis?

A
  1. Penetrating abdominal injury
  2. Suspected pyometra
126
Q

What materials are needed for an abdominocentesis?

A
  1. Sterile gloves
  2. 2 to 4 20- or 22-gauge needles OR 18- to 20-gauge OTN catheter
  3. Syringe
  4. Clippers
  5. Antiseptic scrub and solution
  6. Vacutainer blood tubes
    - Lavender-top EDTA
    - Red-top clot tubes
  7. Culture transport media
127
Q

PROCEDURE - Abdominocentesis

A
  1. Place animal in standing, sternal, or lateral recumbency
  2. Shave + aseptically prepare several inch diameter around target insertion site at right + midabdominal region
  3. Gently insert a sterile 22-gauge needle into peritoneal cavity
  4. Apply gentle aspiration
    - If no fluid is aspirated > insert a 2nd needle 2 cm away from 1st insertion site OR rotate needle
    - If still no fluid > repeat in 1 or 2 other locations
    - If fluid is aspirated + open technique used > attach test tubes
  5. Submit lab samples for analysis
  6. Postprocedural nursing care
128
Q

What are 5 important parts of abdominocentesis postprocedural nursing care?

A
  1. Close observation
  2. Vital signs
  3. Abdominal distention
  4. Continued bleeding or bruising at centesis site
  5. Pain
129
Q

Why do you perform abdominocentesis at the right and midabdominal region?

A

To avoid the liver, spleen, and urinary bladder

130
Q

a procedure that involves fluid infusion into the abdomen and then retrieval of the fluid for laboratory analysis

A

Diagnostic Peritoneal Lavage (DPL)

131
Q

Diagnostic peritoneal lavage is indicated in cases of:

A

Peritonitis

132
Q

Diagnostic peritoneal lavage is contraindicated in cases of:
1.
2.
3.

A
  1. Penetrating abdominal injury
  2. Suspected pyometra
  3. Historical, physical, or radiographic evidence suggests the need for an exploratory laparotomy
133
Q

a surgical procedure that involves opening up the abdomen to expose the organs

A

Exploratory Laparotomy

134
Q

What materials are needed for a diagnostic peritoneal lavage?

A
  1. Sterile gloves
  2. Basic surgical set
  3. Peritoneal lavage catheter OR a long OTN catheter
  4. IV administration set
  5. Isotonic crystalloid
  6. Lidocaine 2%
  7. Clippers
  8. Antiseptic scrub and solution
  9. Vacutainer blood tubes
    - Lavender-top EDTA
    - Red-top clot tubes
  10. Culture transport media
135
Q

PROCEDURE - Diagnostic Peritoneal Lavage (DPL)

A
  1. Bladder emptied + animal placed in lateral recumbency
  2. Shave ventral abdomen + aseptically prepare the area caudal to the umbilicus
  3. Inject 2% lidocaine into target insertion site
  4. If…
    - peritoneal lavage catheter is used > vet makes a 2-cm midline incision through skin, SC tissue, superficial abdominal fascia (a) Caudal to the umbilicus OR (b) Just to right of umbilicus > to minimize risk of trauma to spleen + descending colon
    - OTN catheter is used > vet makes stab incision
  5. Ligate any bleeders > to avoid false-positive results
  6. Direct catheter caudally + dorsally into the pelvis
  7. Gently aspirate the fluid
    - If fluid is aspirated > no need to perform lavage
    - If no fluid aspirated > remove syringe > connect catheter to warmed crystalloid solution > instill 20 mL/kg into abdominal cavity
  8. Rock patient gently from side to side > allow fluid to drain via gravity
    - If fluid is clear > remove catheter
    - If fluid is not clear > suture catheter in place > serial evaluations
  9. Submit lab samples for analysis
  10. Postprocedural nursing care
136
Q

What are 5 important parts of abdominocentesis postprocedural nursing care?

A
  1. Close observation
  2. Vital signs
  3. Abdominal distention
  4. Continued bleeding or bruising at centesis site
  5. Pain
137
Q

Why is it important to be cautious with patients in respiratory distress when performing a diagnostic peritoneal lavage?

A

Instilled fluid places pressure on diaphragm

138
Q

a procedure the involves fluid infusion into the trachea and then retrieval of the fluid in order to obtain laboratory samples from the tracheobronchial tree

A

Transtracheal Wash

139
Q

When is a transtracheal wash indicated?

A

Chronic productive coughs

140
Q

What are 2 contraindications for transtracheal washes?

A
  1. Patients with severe respiratory distress
  2. Patients that are compromised when manipulated
141
Q

Give a few possible complications of a transtracheal wash

A
  1. Postprocedural hemorrhage
  2. SC emphysema
  3. Acute dyspnea
  4. Pneumomediastinum
  5. Pneumothorax
  6. Iatrogenic infection
142
Q

Transtracheal washes can be performed at the _____ or ______.

A

Cricoid ligament or Intertracheal membrane

143
Q

The needle is inserted through _____ and between _____ during a transtracheal wash.

A

Through the trachea and between the cartilage rings

144
Q

Transtracheal Wash:
Measure the 3.5-Fr catheter from the _______ to ________ to _______, then mark with a sharpie

A

Measure from the [larynx] to the [caudal border of the scapula] to the [approximate distance of the tracheal bifurcation]

145
Q

the process of striking the chest gently but firmly with cupped hands to help loosen secretions trapped in the lower airways and allow them to be more effectively cleared by coughing

146
Q

You can expect to retrieve _____ of the injected saline during a transtracheal wash.

147
Q

PROCEDURE- Transtracheal Wash (Two-Catheter System)

A
  1. Place animal in sitting or sternal recumbency > extend head + nares pointed toward ceiling
  2. Shave + surgically prep insertion site > Inject 2% lidocaine up to level of the ligament > measure 3.5-Fr catheter
  3. Tent skin + introduce cath through skin BEFORE advancing through cricothyroid ligament or intertracheal membrane OR make 2-3mm stab incision
  4. Insert rigid 16-gauge indwelling catheter with stylet through SC tissues to the level of the ligament > Steady trachea with one hand + hold catheter in other hand > firmly pass catheter through ligament + into trachea lumen
  5. Once inside lumen > point catheter down 45º toward tracheal bifurcation > Advance catheter over stylet > keeping hand on catheter hub + remove stylet
  6. Attach syringe to catheter + aspirate small amounts of air to verify placement > Pass urinary cath through indwelling cath to the predetermined level
  7. Attach syringe with nonbacteriostatic saline to urinary catheter > Rapidly infuse saline > slightly move catheter back and forth in trachea + aspirate fluid > coupage animal’s chest > repeat until fluid comes out cloudy or with visible clumps of mucus
  8. Monitor patient
  9. Remove urinary catheter FIRST > then remove indwelling catheter
  10. Bandage site
148
Q

Approximately ____ to ____ mL/kg of body weight, but no more than _____ mL, of nonbacteriostatic saline is used during a transtracheal wash.

A

[0.5 to 1.0] mL/kg of body weight but no more than [10 mL]

149
Q

PROCEDURE- Transtracheal Wash (TTN Catheter)

A
  1. Place animal in sitting or sternal recumbency > extend head + nares pointed toward ceiling
  2. Shave + surgically prep insertion site > Inject 2% lidocaine up to level of the ligament > measure 3.5-Fr catheter
  3. Tent skin + introduce cath through skin BEFORE advancing through cricothyroid ligament or intertracheal membrane OR make 2-3mm stab incision
  4. Stabilize trachea with one hand + hold catheter with other hand > Insert cath needle perpendicular to trachea + bevel down through SC tissues > until it contacts ligament
  5. Firmly introduce needle through ligament > then point needle down 45º toward tracheal bifurcation > With cath sliding down enclosed plastic housing > advance cath through needle
  6. Once cath is advanced to full length > withdraw needle from trachea + skin > leaving cath in place > Place needle guard over needle > to prevent animal injury or cutting catheter
  7. Attach syringe with nonbacteriostatic saline to urinary catheter > Rapidly infuse saline > slightly move catheter back and forth in trachea + aspirate fluid > coupage animal’s chest > repeat until fluid comes out cloudy or with visible clumps of mucus
  8. Monitor patient
  9. Remove catheter
  10. Bandage insertion site
150
Q

What kind of saline is used for transtracheal and endotracheal lavages?

A

nonbacteriostatic saline

151
Q

What 3 anesthetic agents are needed to intubate for an endotracheal lavage?

A
  1. Ketamine hydrochloride + diazepam
  2. Propofol
  3. Thiopental
152
Q

PROCEDURE - Endotracheal Lavage

A
  1. Induce anesthesia deep enough only to cleanly place the ED tube > reduce to lighter plane of anesthesia once Ed tube placed + secured
  2. Patient in ventral recumbency + hold patient head > Measure polypropylene urinary catheter from larynx to caudal border of the scapula > mark with a sharpie
  3. Wearing sterile gloves > advance catheter to the predetermined distance to the tracheal bifurcation
  4. Attach syringe with nonbacteriostatic saline to urinary catheter > Rapidly infuse saline > slightly move catheter back and forth in trachea + aspirate fluid > coupage animal’s chest > repeat until fluid comes out cloudy or with visible clumps of mucus
  5. Remove catheter
  6. Provide supplemental oxygenation via ED tube (as needed) > monitor for respiratory effort + distress signs > Patient regains swallowing reflex + no longer tolerates the tube in place > remove ED tube
153
Q

a procedure performed involving the aspiration of fluid from a joint

A

Arthrocentesis

154
Q

Give 3 scenarios an arthrocentesis is used

A
  1. Cases of joint fluid and pain
  2. Attain samples for synovial fluid analysis
  3. To diagnose arthritis
155
Q

Give 7 indications for synovial fluid analysis

A
  1. Persistent or cyclic fever
  2. Generalized stiffness or limb lameness
  3. Leukocytosis
  4. Neutrophilia
  5. Hyperfibrinogenemia
  6. Malaise
  7. Anorexia
156
Q

condition in which there is excess fibrinogen in the blood

A

Hyperfibrinogenemia

157
Q

Give 2 contraindications for synovial fluid collection

A
  1. Moderate to severe pyoderma
  2. Lick granuloma
158
Q

pus in the skin

159
Q

illness caused by medical examination or treatment

A

Iatrogenic

160
Q

introduction of infective material

A

Inoculation

161
Q

What is the most common space used for carpal arthrocentesis? What do you need to avoid?

A

Medial radiocarpal joint

Avoid the cephalic vein

162
Q

PROCEDURE - Arthrocentesis (Carpus)

A
  1. Place patient in lateral recumbency
  2. Shave + aseptically prepare site
  3. Wearing sterile gloves > hold carpus in flexion > palpate any intercarpal space with index finger
    - Most common = medial radiocarpal joint
  4. Hold syringe so you can aspirate without needing to reposition hands on syringe > insert needle perpendicular to skin
    - To avoid articulating surfaces
  5. Aspirate until fluid fills needle hub > usually 0.05-0.3 mL range
    - If no fluid is aspirated > retract needle > try aspiration again
  6. Release suction > withdraw needle
    - Prevents blood contamination of sample
163
Q

PROCEDURE - Arthrocentesis (Tarsus)

A
  1. Place patient in lateral recumbency
  2. Shave + aseptically prepare site
  3. Wearing sterile gloves > hold hock in partial flexion at 90º with metatarsals + tibia > palpate medial OR lateral intertarsal space with index finger
  4. Hold syringe so you can aspirate without needing to reposition hands on syringe > insert needle parallel with metatarsals toward toes
    - If lateral approach > insert needle just caudal to lateral malleolus + dorsal to tibial tarsal bone > direct under lateral malleolus
  5. Aspirate until fluid fills needle hub > usually 0.05-0.3 mL range
    - If no fluid is aspirated > retract needle > try aspiration again
  6. Release suction > withdraw needle
    - Prevents blood contamination of sample
164
Q

What forms the “triangle” landmarks for a stifle arthrocentesis?

A
  1. Patella + Straight Patellar Ligament
  2. Tibial Tuberosity
  3. Lateral Condyle of Femur
165
Q

PROCEDURE - Arthrocentesis (Stifle)

A
  1. Place patient in lateral recumbency
  2. Shave + aseptically prepare site
  3. Wearing sterile gloves > hold stifle in partial flexion > palpate stifle “triangle” landmarks with index finger
  4. Hold syringe so you can aspirate without needing to reposition hands on syringe > insert needle just lateral to straight patellar ligament > direct medially at 35º-45º angle + slightly upward into origin of cruciate ligaments between femoral condyles
  5. Aspirate until fluid fills needle hub > usually 0.05-0.3 mL range
    - If no fluid is aspirated > retract needle > try aspiration again
  6. Release suction > withdraw needle
    - Prevents blood contamination of sample
166
Q

Synovial Fluid Analysis commonly includes:
1.
2.
3.

A
  1. Gross Appearance
  2. Histologic Analysis
  3. Bacterial Culture
167
Q

Gross appearance of SF is used to _________.

A

to indicate any issues with the joint

168
Q

How much SF is necessary to evaluate:
1. Gross Appearance
2. Histologic Analysis
3. Bacterial Culture

A
  1. Gross Appearance - 1 drop
  2. Histologic Analysis - 1 drop
  3. Bacterial Culture - 2 drops
169
Q

Histologic analysis of SF is used to ________.

A

to determine presence, types, and levels of blood cells

170
Q

The gross appearance of SF is evaluated for:
1.
2.
3.

A
  1. Color
  2. Turbidity
  3. Viscosity
171
Q

Increased number of ______ in SF may indicate inflammation of synovial joint lining.

A

Polymorphonuclear Neutrophils (PMNs)

172
Q

Bacterial culture of SF is used to _________.

A

to determine presence of infectious microorganisms

173
Q

Normal SF is:
1.
2.
3.

A
  1. Colorless
  2. Clear
  3. Viscous
    - Forms a long string between the needle + slide
    - Drop remains global on slide
174
Q

Abnormal SF:
Uniformly red indicates >

A

hemarthrosis

175
Q

bleeding into the space around the joint

A

Hemarthrosis

176
Q

Abnormal SF:
Nonhomegenously red indicates >

A

SF contaminated with blood

177
Q

Abnormal SF:
Yellow-orange indicates >

A

previous hemorrhage into the synovial membrane followed by release of hemoglobin pigment

178
Q

Abnormal SF:
White-yellow indicates >

A

increased cellularity due to sepsis, inflammation, or neoplasia

179
Q

Abnormal SF:
Increased turbidity indicates >

A

increased WBCs, microorganisms, crystals, or presence of fibrin

180
Q

Abnormal SF:
Low viscosity indicates >

A

inflammatory disorders

181
Q

hpf

A

high-power field, aka the microscopic field

182
Q

a procedure performed to provide information regarding the underlying cause of low RBC counts/many other diseases and to determine the presence/type of neoplasia

A

Bone Marrow Aspiration

183
Q

Give 2 contraindications for bone marrow aspiration

A
  1. Clotting factor abnormalities
  2. Severe thrombocytopenia
184
Q

condition in which there are low levels of platelets in the blood

A

Thrombocytopenia

185
Q

Where bone marrow is obtained is determined by the patient’s:
1.
2.
3.

A
  1. Size
  2. Age
  3. Conformation
186
Q

Bone marrow can be obtained from:
1.
2.
3.

A
  1. Iliac crest
  2. Humerus
  3. Femur (cats + small dog breeds)
187
Q

What materials are needed for bone marrow aspiration?

A
  1. # 11 scalpel
  2. 12 or 20 mL syringe
  3. Sterile gloves
  4. Sterile drape
  5. 2% lidocaine in a syringe + needle
  6. Clean glass slides
  7. EDTA collection tube
  8. Bone marrow aspiration needle
188
Q
A

18-gauge stainless steel Rosenthal bone aspiration needle

189
Q
A

16-gauge Illinois-style bone aspiration needle (with depth stop)

190
Q

PROCEDURE - Bone Marrow Aspiration (Iliac)

A
  1. Administer sedation/analgesic or general anesthesia to patient
  2. Place patient in sternal or lateral recumbency + legs drawn forward
  3. Wearing sterile gloves > shave + aseptically prepare the insertion site
  4. Inject 2% lidocaine into skin, SC tissue + periosteum of bone
  5. Make stab relief incision in skin with #11 scalpel + over iliac crest
  6. Check stylet is perfectly occluding distal tip of bone marrow needle
    - If using Rosenthal needle > place counter pressure on stylet with index finger or palm > so stylet does not back out
  7. Stabilize ilium with one hand > advance needle + stylet through incision > into the bone
  8. Advance needle into bone using wrist rotary motion + immobilized elbow > 1 to 1.5 cm or until needle is well seated
  9. Remove stylet from needle + place on a sterile field > attach 12 or 20 mL syringe to needle
  10. Apply negative pressure to syringe plunger > stop after obtaining 0.1 to 1.0 mL of sample
  11. Remove syringe from needle > reinsert sterile stylet into needle
  12. Immediately make 6-8 smears + 2 pull slides
  13. With needle still in place > add drop of new methylene blue stain to 1 pull slide + coverslip > determine if bone marrow elements are present
    - If sample not adequate > obtain another
  14. Remove needle using same wrist rotary motion > hold pressure on site until hemostasis occurs
191
Q

PROCEDURE - Bone Marrow Aspiration (Humeral)

A
  1. Administer sedation/analgesic or general anesthesia to patient
  2. Place patient in lateral recumbency
  3. Wearing sterile gloves > shave + aseptically prepare the insertion site
  4. Inject 2% lidocaine into skin, SC tissue + periosteum of bone
  5. Make stab relief incision in skin with #11 scalpel + over craniolateral aspect of greater tubercle of proximal humerus
  6. Check stylet is perfectly occluding distal tip of bone marrow needle
  7. Assistant flex patient elbow + rotate or abduct shoulder externally > advance needle + stylet perpendicular to humeral shaft through incision > into the bone
  8. Advance needle into bone using wrist rotary motion + immobilized elbow > 1 to 1.5 cm or until needle is well seated
  9. Remove stylet from needle + place on a sterile field > attach 12 or 20 mL syringe to needle
  10. Apply negative pressure to syringe plunger > stop after obtaining 0.1 to 1.0 mL of sample
  11. Remove syringe from needle > reinsert sterile stylet into needle
  12. Immediately make 6-8 smears + 2 pull slides
  13. With needle still in place > add drop of new methylene blue stain to 1 pull slide + coverslip > determine if bone marrow elements are present
    - If sample not adequate > obtain another
  14. Remove needle using same wrist rotary motion > hold pressure on site until hemostasis occurs
192
Q

PROCEDURE - Bone Marrow Aspiration (Femoral)

A
  1. Administer sedation/analgesic or general anesthesia to patient
  2. Place patient in lateral recumbency
  3. Wearing sterile gloves > shave + aseptically prepare the insertion site
  4. Inject 2% lidocaine into skin, SC tissue + periosteum of trochanteric fossa
  5. Make stab relief incision in skin with #11 scalpel
  6. Check stylet is perfectly occluding distal tip of bone marrow needle
  7. Grasp femur + hold hip in flexed position > advance needle + stylet medial to greater trochanter + parallel to femoral shaft through incision > into the bone
  8. Advance needle into bone using wrist rotary motion + immobilized elbow > 1 to 1.5 cm or until needle is well seated
  9. Remove stylet from needle + place on a sterile field > attach 12 or 20 mL syringe to needle
  10. Apply negative pressure to syringe plunger > stop after obtaining 0.1 to 1.0 mL of sample
  11. Remove syringe from needle > reinsert sterile stylet into needle
  12. Immediately make 6-8 smears + 2 pull slides
  13. With needle still in place > add drop of new methylene blue stain to 1 pull slide + coverslip > determine if bone marrow elements are present
    - If sample not adequate > obtain another
  14. Remove needle using same wrist rotary motion > hold pressure on site until hemostasis occurs
193
Q

a procedure performed to acquire cytologic samples in order to differentiate between inflammation, neoplasia, and hyperplasia in soft tissue

A

Fine-Needle Aspiration (FNA)

194
Q

thickening or enlargement of an organ or tissue

A

Hyperplasia

195
Q

abnormal and uncontrolled growth of cells that may lead to a tumor

196
Q

What are 3 possible complications of FNA?

A
  1. Minor hemorrhage
  2. Tissue damage
  3. Infection
197
Q

PROCEDURE - Fine Needle Aspiration (FNA)

A
  1. Use appropriate restraint to access the mass
  2. Prep the skin over the mass
    - Visceral aspirates > surgical scrub
    - Superficial aspirates > wipe with alcohol
  3. Secure mass with one hand + introduce needle to mass with other hand > redirect needle within tissue once or twice
  4. Attach syringe with at least 1 mL of air to needle > aspirate tissue
  5. Quickly depress syringe plunger > removes all material onto microscope slide
    - If material is liquid > make push slide
    - If material is viscous > make pull smear
198
Q

Skin Prep for FNA:
If visceral aspirates >

A

use surgical scrub

199
Q

Skin Prep for FNA:
If superficial aspirates >

A

wipe with alcohol

200
Q

_______ can be performed to obtain a sample from non-superficial tissues.

A

Ultrasound-guided FNA

Medical Nursing for Vet Techs (4 decks)

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