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ACVN - EQUINE NURSING > Equine Neonatal Intensive Care Nursing > Flashcards

Equine Neonatal Intensive Care Nursing Flashcards

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1
Q

what is stage 1 of foaling?

A

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

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2
Q

what is stage 2 of foaling?

A

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

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3
Q

what is stage 3 of foaling?

A

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

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4
Q

when does a foal normally stand?

A

within 1 hour

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5
Q

when does a foal start to suckle?

A

within 2 hours

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6
Q

when does a foal pass meconium?

A

within 3 hours

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7
Q

when does a foal first urinate?

A

by 8-12 hours

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8
Q

how do foals sleep?

A

lying down with legs extended out

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9
Q

what vitals do foals have immediately post-partum

A
  • rr 50-80bpm
  • audible lung crackles
  • mild nasal discharge
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10
Q

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

A
  • HR – 80-100bpm
  • RR – 30-40bpm
  • Temp – 37.5-39.5
  • Pink, moist mucous membranes
  • Good peripheral pulse quality with
    warm extremities
  • MAP >70mmHg
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11
Q

how much colostrum does a foal require?

A

1litre within the first 12 hours

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12
Q

how much do foals drink per day?

A

20-30% their bodyweight

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13
Q

how many calories does a foal require?

A

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

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14
Q

what does colostrum contain?

A

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

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15
Q

what can go wrong during/after birth?

A
  • Trauma during birth
    – E.g. Rib fractures
  • Congenital abnormalities
    – Cleft palate
    – Microphthalmia
    – Limb deformities
  • Acquired abnormalities
    – E.g. Patent urachus
  • Failure of passive transfer
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16
Q

what is passive tranfer?

A

the act of the foal drinking the mares colostrum

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17
Q

what are common conditions of neonatal foals?

A
  • Sepsis
  • Neonatal isoerythrolysis
  • Neonatal maladjustment syndrome
  • Prematurity/dysmaturity
  • Ruptured bladder
  • Diarrhoea
  • Pneumonia
  • (Meconium impaction)
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18
Q

what are the clinical signs of sepsis?

A

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

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19
Q

what causes sepsis?

A

Inflammatory response to systemic bacterial infection

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20
Q

what is neonatal isoerythrolysis?

A
  • Mare produces antibodies against the foal’s RBCs
  • Foal absorbs colostrum
  • RBCs are broken down by these antibodies
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21
Q

what are the clinical signs of neonatal isoerythrolysis?

A

anaemia, icterus, weakness

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22
Q

what is neonatal aladjustment syndrome?

A

foal shows neurological signs

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23
Q

what are the clincial presentations of neonatal maladjustment syndrome?

A

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

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24
Q

what is premature?

A

gestation of less than 320 days

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25
Q

what is dysmature?

A

normal gestation but appear premature

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26
Q

how would a premature/dysmature foal look?

A

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

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27
Q

when would you see clinical signs of a ruptured bladder?

A

a few days old

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28
Q

what are the clincial signs of ruptured bladder?

A

colic, abdominal distension

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29
Q

what is important to remember when lifting a foal?

A

never lift from their abdomen as can cause ruptured bladder

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30
Q

when is meconium usually passed?

A

3 hours of birth

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31
Q

what are the clinical signs of meconium impaction?

A

straining to defecate and mild colic

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32
Q

what are the roles of an NICU nurse?

A
  • Patient care
  • Responsible for all foal’s needs
  • Staying organised
  • Keeping foal unit clean and stocked
  • Communication
33
Q

what are the general nursing care for NICU patients?

A
  • 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
34
Q

how would you examine a NICU foal?

A

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

35
Q

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

A

every 4 hours

36
Q

what are normal parameters for the cardiovascular system?

A

HR 80-100bpm, strong pulses, warm extremities

37
Q

what do sick foals have insterms of their cardiovascular system?

A

poor HR compensation due to immature
sympathetic nervous system

38
Q

what cardiac conditon do foals usually have?

A

murmurs

39
Q

how do you monitor the respiratory system?

A
  • 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
40
Q

what are the eyes a good indcationof?

A

systemic state

41
Q

how would dehydration affect the eyes?

A

they ould look sunken and possible have entropian

42
Q

how would they eyes look if the foal is septic?

A

injected, hypopyon (fibrin and pus accuulation), uveitis

43
Q

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

A

injected and swollen

44
Q

what are sick foals prone to developing?

A

corneal ulcers

45
Q

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

A
  • septic synovitis/osteomyelitis
  • incomplete ossification of the cuboidal bones
  • felxure deformities (dorsal, palmar, plantar)
  • angular limb deformity
46
Q

what GI conditions can foals develop?

A

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

47
Q

how would you care for the umbilicus?

A
  • Fill a cup with 0.5% hibitane solution to dip umbilicus into
  • Twice daily if otherwise WNL
  • QID if patent urachus
48
Q

how can you provide care to the mare?

A
  • TPR twice daily
  • Check mare’s perineum
  • Ensure adequate milk
  • Encourage mare-foal bond
  • Check placenta has been passed
  • Ecbolics? - Oxytocin
49
Q

how would you manage an IV catheter?

A

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

50
Q

what should a foals IgG SNAP test reult be?

A

> 8.0g/L

51
Q

what is an IgG SNAP test for?

A

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

52
Q

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?

A

supplement with colostrum via nasogastric tube

53
Q

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

A

plasma transfusion

54
Q

which artery would you take a blood gas sample from?

A

lateral metatarsal artery

55
Q

what is normal range of Pao2 IN FOALS?

A

80-110mmHg

56
Q

what is normal range of PaCO2 in foals?

A

40-48mmHg

57
Q

what condition is common in septic foals?

A

hypoglycaemia

58
Q

what is normal lactate?

A

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

59
Q

what is lactate measuring?

A

tissue perfusion

60
Q

what are increased levels of lactate indicating

A

anaesrobic metabolism, insufficne to2 supply to tissues

61
Q

what can anaerobic metabolism lead to?

A
  • Hypovolaemia
  • Hypoxaemia
  • Sepsis
62
Q

how would you provide fluid resuscitation?

A

warm hartmanns solution, 20ml/kg over 20 mins

63
Q

what should you not bolus?

A

glucose-containing fluids

64
Q

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

A

tail

65
Q

what is hypotension in foals?

A

MAP less than 70mmHg

66
Q

what does sepsis cause?

A

hypotension

67
Q

how does sepsis cause hypotension?

A

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

68
Q

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

A

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

69
Q

what is normal urine output for a foal?

A

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

70
Q

how can you provide respiratory treatment?

A
  • intranasal oxygen (Inotropes – drugs which increase force of cardiac contractions
    – Vasopressors – drugs which constrict blood vessels)
71
Q

what flow rate should you use when providing respiratory treatment?

A

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

72
Q

what are some complications of repiratory treatment?

A

Nasal irritation, rhinitis, airway drying

73
Q

what does nebulisation do?

A

aid secretion removal, best with coupageof the chest

74
Q

what can you provide with nebulisation?

A

bronchodilators and antibiotics

75
Q

how does neurone damage occur?

A

prolonged seizure activity increases cerebral oxygen demand

76
Q

how do you treat a seizuring foal?

A

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

77
Q

why might a foal be seizuring?

A

NMS, hypoglycaemia, sepsis or other causes

78
Q

what enemas can you provide?

A
  • phosphate enema
  • soapy water
  • acetycysteine retnetion enema

ACVN - EQUINE NURSING (3 decks)

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