Equine Neonatal Intensive Care Nursing Flashcards by Jasmine Lelliott

what is stage 1 of foaling?

30-60 mins
– Cervix relaxation. Uterine contractions
– Ends with water breaking (rupture of chorioallantois)

How well did you know this?

Not at all

Perfectly

what is stage 2 of foaling?

5-30 mins
– Delivery of foal
– If this is delayed, needs assistance

How well did you know this?

Not at all

Perfectly

what is stage 3 of foaling?

2-3 hours
– Placenta (foetal membranes) expelled
– If this is delayed, needs assistance

How well did you know this?

Not at all

Perfectly

when does a foal normally stand?

within 1 hour

How well did you know this?

Not at all

Perfectly

when does a foal start to suckle?

within 2 hours

How well did you know this?

Not at all

Perfectly

when does a foal pass meconium?

within 3 hours

How well did you know this?

Not at all

Perfectly

when does a foal first urinate?

by 8-12 hours

How well did you know this?

Not at all

Perfectly

how do foals sleep?

lying down with legs extended out

How well did you know this?

Not at all

Perfectly

what vitals do foals have immediately post-partum

rr 50-80bpm
audible lung crackles
mild nasal discharge

How well did you know this?

Not at all

Perfectly

what are a foals vital parameters up to 7 days old?

HR – 80-100bpm
RR – 30-40bpm
Temp – 37.5-39.5
Pink, moist mucous membranes
Good peripheral pulse quality with
warm extremities
MAP >70mmHg

How well did you know this?

Not at all

Perfectly

how much colostrum does a foal require?

1litre within the first 12 hours

How well did you know this?

Not at all

Perfectly

how much do foals drink per day?

20-30% their bodyweight

How well did you know this?

Not at all

Perfectly

how many calories does a foal require?

100-160kcal/kg/day approx 5000 for a 50kg foal

How well did you know this?

Not at all

Perfectly

what does colostrum contain?

antibodies from the mares blood which are absorbed by the foals gut in the first 12-24hrs of life

How well did you know this?

Not at all

Perfectly

what can go wrong during/after birth?

Trauma during birth
– E.g. Rib fractures
Congenital abnormalities
– Cleft palate
– Microphthalmia
– Limb deformities
Acquired abnormalities
– E.g. Patent urachus
Failure of passive transfer

How well did you know this?

Not at all

Perfectly

what is passive tranfer?

the act of the foal drinking the mares colostrum

How well did you know this?

Not at all

Perfectly

what are common conditions of neonatal foals?

Sepsis
Neonatal isoerythrolysis
Neonatal maladjustment syndrome
Prematurity/dysmaturity
Ruptured bladder
Diarrhoea
Pneumonia
(Meconium impaction)

How well did you know this?

Not at all

Perfectly

what are the clinical signs of sepsis?

– Pyrexia
– Petechiae
– Injected mucous membranes
– Dull/flat/unresponsive
– Recumbency
– May also get: uveitis, synovial sepsis lameness/swollen
joints, diarrhoea, pneumonia, umbilical infection

How well did you know this?

Not at all

Perfectly

what causes sepsis?

Inflammatory response to systemic bacterial infection

How well did you know this?

Not at all

Perfectly

what is neonatal isoerythrolysis?

Mare produces antibodies against the foal’s RBCs
Foal absorbs colostrum
RBCs are broken down by these antibodies

How well did you know this?

Not at all

Perfectly

what are the clinical signs of neonatal isoerythrolysis?

anaemia, icterus, weakness

How well did you know this?

Not at all

Perfectly

what is neonatal aladjustment syndrome?

foal shows neurological signs

How well did you know this?

Not at all

Perfectly

what are the clincial presentations of neonatal maladjustment syndrome?

– Poor suck reflex
– Failure to nurse, hyperaesthesia, obtundation/coma
– May be abnormal from birth or may ‘crash’ at
24-48hrs

How well did you know this?

Not at all

Perfectly

what is premature?

gestation of less than 320 days

How well did you know this?

Not at all

Perfectly

what is dysmature?

normal gestation but appear premature

how would a premature/dysmature foal look?

silky coat, floppy ears, domed head - Other organs may be immature as well musculoskeletal system - Incomplete ossification of cuboidal bones

when would you see clinical signs of a ruptured bladder?

a few days old

what are the clincial signs of ruptured bladder?

colic, abdominal distension

what is important to remember when lifting a foal?

never lift from their abdomen as can cause ruptured bladder

when is meconium usually passed?

3 hours of birth

what are the clinical signs of meconium impaction?

straining to defecate and mild colic

what are the roles of an NICU nurse?

* Patient care * Responsible for all foal’s needs * Staying organised * Keeping foal unit clean and stocked * Communication

what are the general nursing care for NICU patients?

* Maintain sternal recumbency – Prone to atelectasis * Assist to stand every 2 hours * Turn foal every 2 hours * Important to prevent decubitus ulcers developing (bed sores) * Weigh foal daily * Careful examination

how would you examine a NICU foal?

Complete physical exam * Demeanour – compared to last check * Systems/Nose-to-tail approach * Treatments * Infusions * Oxygen * Nutrition * Urine/Faecal output

hwo often should you do a full physical exam of the NICU foal?

every 4 hours

what are normal parameters for the cardiovascular system?

HR 80-100bpm, strong pulses, warm extremities

what do sick foals have insterms of their cardiovascular system?

poor HR compensation due to immature sympathetic nervous system

what cardiac conditon do foals usually have?

murmurs

how do you monitor the respiratory system?

- Observation/Auscultation – RR 30-40bpm – Regular rhythm – Louder bronchial sounds than adult - No wheezes /dullness /crackles – Respiratory effort – Nasal discharge – Rib fractures? - blood gas for oxygenation

what are the eyes a good indcationof?

systemic state

how would dehydration affect the eyes?

they ould look sunken and possible have entropian

how would they eyes look if the foal is septic?

injected, hypopyon (fibrin and pus accuulation), uveitis

how would they eyes look if there is trauma to them?

injected and swollen

what are sick foals prone to developing?

corneal ulcers

what conditions can foals get that relate to their musculoskeletal system?

- septic synovitis/osteomyelitis - incomplete ossification of the cuboidal bones - felxure deformities (dorsal, palmar, plantar) - angular limb deformity

what GI conditions can foals develop?

colic due to mecoium impaction, ileus - diarrhoea (secondary to sepsis)

how would you care for the umbilicus?

- Fill a cup with 0.5% hibitane solution to dip umbilicus into - Twice daily if otherwise WNL - QID if patent urachus

how can you provide care to the mare?

* TPR twice daily * Check mare’s perineum * Ensure adequate milk * Encourage mare-foal bond * Check placenta has been passed * Ecbolics? - Oxytocin

how would you manage an IV catheter?

– Check patency and vein integrity every 4hrs – Care when administering drugs, sedimentation – Extra vigilance when on parenteral nutrition

what should a foals IgG SNAP test reult be?

>8.0g/L

what is an IgG SNAP test for?

determines whether there has been failure of passive transfer of antibodies from the mares colostrum

if an IgG SNAP test is done in a foal that is less than 24 hours old and the reading is low what would you do?

supplement with colostrum via nasogastric tube

if an IgG SNAP test is done in a foal over 24 hours old and the reading is low what would you do?

plasma transfusion

which artery would you take a blood gas sample from?

lateral metatarsal artery

what is normal range of Pao2 IN FOALS?

80-110mmHg

what is normal range of PaCO2 in foals?

40-48mmHg

what condition is common in septic foals?

hypoglycaemia

what is normal lactate?

<3-4mmol/L in neonates, <2mmol/L by 3 days old

what is lactate measuring?

tissue perfusion

what are increased levels of lactate indicating

anaesrobic metabolism, insufficne to2 supply to tissues

what can anaerobic metabolism lead to?

- Hypovolaemia - Hypoxaemia - Sepsis

how would you provide fluid resuscitation?

warm hartmanns solution, 20ml/kg over 20 mins

what should you not bolus?

glucose-containing fluids

where would you place a blood pressure cuff on a foal?

tail

what is hypotension in foals?

MAP less than 70mmHg

what does sepsis cause?

hypotension

how does sepsis cause hypotension?

– Suppresses myocardial contractility (reduced stroke volume) – Blood vessels dilate

what medication should you give a septic foal to improve hypotension?

– Inotropes – drugs which increase force of cardiac contractions – Vasopressors – drugs which constrict blood vessels

what is normal urine output for a foal?

2ml/kg/hr or more than 50-70% of fluid input

how can you provide respiratory treatment?

- intranasal oxygen (Inotropes – drugs which increase force of cardiac contractions – Vasopressors – drugs which constrict blood vessels)

what flow rate should you use when providing respiratory treatment?

2-15L/min2 – Usually start at 5L/min then adjust

what are some complications of repiratory treatment?

Nasal irritation, rhinitis, airway drying

what does nebulisation do?

aid secretion removal, best with coupageof the chest

what can you provide with nebulisation?

bronchodilators and antibiotics

how does neurone damage occur?

prolonged seizure activity increases cerebral oxygen demand

how do you treat a seizuring foal?

– 5mg Diazepam IV - Lasts approx. 20mins – can be repeated – If seizure activity continues - Midazolam CRI - Phenobarbital - Levetiracetam

why might a foal be seizuring?

NMS, hypoglycaemia, sepsis or other causes

what enemas can you provide?

- phosphate enema - soapy water - acetycysteine retnetion enema