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Surgical Nursing > Equine emergency surgery and peri-operative care > Flashcards

Equine emergency surgery and peri-operative care Flashcards

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1
Q

What are procedures maybe considered an emergency in the horse?

A

Colics
Lacerations
Dystocia

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2
Q

What history should you take from a colic horse?

A 
How long have the symptoms being occuring? 
How serious are the symptoms
Previous colic 
Previous response 
Previous medication 
Previous surgery 
Previous foal 
Breed 
age 
geography
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3
Q

What should you look for in a clinical exam on a horse that has colic||?

A 
Abdominal discomfort 
Cardio vascular 
Heart rate 
temperature ears/feet
pulse quality 
mucous membranes 
Temperature 
Respiratory rate 
Abdominal distension 
Gastrointestinal sounds 
rectal exam 
ultrasound 
abdominocentesis
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4
Q

What do you need to prepare for a colic?

A 
Sedation 
NSAIDs
Stethoscope 
clippers 
sterile prep solution 
nasogastric tube and buckets 
rectal sleeve and lubricant 
ultrasound machine
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5
Q

What are the two types of colic?

A 
True colic (GI tract) 
False colic (UTI, Kidney infections, respiratory system)
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6
Q

How do you prepare a patient that comes in with colic?

A 
catheter 
sedation 
analgesia 
fluids 
clip abdomen
pass nasogastric tube
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7
Q

How should you prepare the operating theatre for a colic?

A 
Two tables 
clean and contaminated 
Ensure all equipment there and working 
clippers 
urinary catheter 
prep solution 
fluids 
standard set
positioning of the horse
– CMC (carboxymethylcellulose)
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8
Q

What instruments do you need to prepare for surgery on the small intestine in the horse?

A 
Doyen clamps 
penrose drains 
separate drapes 
suture material 
fluids for lavage 
staples
fresh clean table with new instruments
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9
Q

What instruments do you need to prepare for surgery on the large intestine of the horse?

A 
Colon tray 
drapes 
separate table 
hose with tap water for lavage 
sterile fluids for lavage
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10
Q

What are the two types of colic and there corresponsing post-operative care?

A

systemically compromised
-icu, endotoxemia, illeau, anostomosis not functional)
Systemically healthy
Systemic antibiotics and pain medication gradual re-feeding

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11
Q

What should you monitor post-operatively after colic surgery?

A 
Gut sounds 
MM, CRT 
HR, pulse quality
Resp rate
Temperature
appetite
faceal/urine output
Hydration status-pcv/TS/USG
Nasogastric reflux (5L/hr)
Comfort (laminitis, colic) 
Incision discharge, swelling , pain 
abdominal bandage may be necessary
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12
Q

How often should you preform a physical exam on a colic horse?

A

4-6 hours

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13
Q

How often should you monitor TS/PCV/USG in a post-operative colic horse?

A

4-6 hours

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14
Q

What must you include in the post-operative care regime of a colic horse?

A

Walking

gradual re-feeding

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15
Q

Why are distal limb wounds challenging to care for in a horse?

A 
Lack of blood supply 
difficult to immobilise
exposure of bone 
severe contamination 
extensive crushing 
less skin to mobilize
More likely to dehisce
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16
Q

Why can distal limb wounds be of concern in the horse?

A

Can involve synovial structures
poor prognosis
must examine the wound thoroughly

17
Q

How should a distal limb wound in the horse be managed?

A 
Cleansing 
exploration 
radiographs 
involvement synovial structures?
Debridement
Suture or not 
Antimicrobials 
tendon injuries 
considerations with specific locations
18
Q

How should you cleanse a horses wound?

A

Clip the area place intracyte in the wound so as to prevent any further contamination
Irrigate with sterile saline
use of povidone idoine or chloerhexidine to clean the wound

19
Q

When should you take radiographs of a horses wound?

A

Before surgery
determines if any foreign body
any further damage (Fractures/subluxations)
Do not place needle in synovial structures before radiographs have been taken

20
Q

Why is it dangerous to have synovial structures involved in a horses distal limb wound?

A

Septic joint
infection establishes quickly (6-8 hours)
Chronic injuries if not recognised

21
Q

What equipment should you prepare for a horse coming in with a wound?

A 
Clippers
Sterile saline 
Hibi scrub 
Probe
Bandage material 
X-ray equipment 
catheter 
Analgesia 
Antimicrobials
sedation
gloves
22
Q

What are the normal stages of giving birth in the horse?

A 
Stage one 
Restlessness, pawing, posture to urinate
Relaxation cervix and uterine contractions 
Stage two 
(10-15 min, range 10-70 min) 
Onset rupture of chorioallantosis
complete with delivery of the foal
Stage three (3hrs)
Passing of the fetal membranes
23
Q

What is the main reason for Dystocia in the horse?

A

Maldisposition of the foal

24
Q

If stage two during labour in the horse is longer than 30 minuets what increases in likelihood?

A

for every additional 10 minutes the liklihood of the foal dying increases by 16%

25
Q

What history is important to obtain for a mare with dystocia?

A 
Age 
gestational age 
pertinent medical history 
time of onset stage 2
any assistance already attempted
26
Q

What doe a physical exam of the dystocia mare reveal?

A

Determines fetal orientation

determines viability of the foal

27
Q

What four methods can be used to correct dystocia in the horse?

A

Assisted vaginal delivery
controlled vaginal delivery
c-section
fetotomy

28
Q

What takes place in controlled vaginal delivery in the horse?

A

General anaesthetic
hind limbs elevated
max 15 min
simultaneous prep for c-section

29
Q

How is a c-section preformed in the horse?

A 
Laparotomy ventral midling 
localise uterine horn and exteriorize 
hysterotomy 
exteriorize foal 
control hemorrhage 
routine closure 
maximum 20 min
30
Q

What should be included in the post-operative care for the dystocia horse?

A 
Systemic NSAIDs and antimicrobials 
oxytocine every hour 
Hydrotherapy vuvla
Stimulate GI system and adapt diet 
uterine lavage
31
Q

What is a terminal c-section?

A

Mother does not survive
mare with terminal ilness
full gestation

32
Q

Once born how do you stimulate a foal to survive?

A

Airway intubation and ventilation
Cardiovascular
80-120bpm cardiac compression 100/min
after 30-40 seconds give adrenaline, antagonise any medication given to the mare

33
Q

What are the complications associated with dystocia?

A 
Trauma of the reproductive tract 
-perineal laceration
-uterine rupture
-cervical laceration
Retained placenta
Delayed uterine involution 
Bladder prolapse
metritis
peritonitis 
arterial haemorrhage
uterine prolapse 
neuropraxia
pressure necrosis

Surgical Nursing (24 decks)

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