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Advanced Clinical Veterinary Nursing > Equine Nursing > Flashcards

Equine Nursing Flashcards

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1
Q

list types of elective orthopaedic surgery

A

arthroscopy/tenoscopy
angular limb deformities in foals
soft tissue surgery for neurectomy/fasciotomy, desmotomy

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2
Q

list emergency orthopaedic surgery

A

arthroscopy/tenoscopy
fracture repairs
sequestrum removal

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3
Q

define tenoscopy

A

looking at tendon sheath

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4
Q

define arthroscopy

A

looking into joint space

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5
Q

when is arthroscopy and tenoscopy commonly perfromed?

A

intra-articular fracture repair
OCD
synovial sepsis
sequestrum removal

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6
Q

why does OCD occur in horses?

A

developmental defects in cartilage and bone

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7
Q

how does arthroscopy manage OCD?

A

prevents further degeneration of the bone

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8
Q

when do horses typically present for OCD surgery?

A

3-8years
young

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9
Q

what is synovial sepsis?

A

bacterial infection leading to septic arthritis

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10
Q

how is synovial sepsis managed?

A

antibiotics alone not effective
lavage joint and arthroscopy

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11
Q

how do sequestrum form?

A

trauma results in damage to the periosteum, can result in the bone dying in this region
necrotic bone separates/sequesters and becomes FB

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12
Q

what can be consequences of sequestrum formation?

A

infection
non-healing wounds
draining tracts

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13
Q

how is sequestrum formation treated?

A

removal of sequestrum and active involucrum (bed of bone surrounding the region)

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14
Q

describe presentation of angular limb deformity

A

bendy legs - medial or lateral
foals

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15
Q

what can cause angular limb deformity?

A

nutrition
incomplete ossification
tendon/ligament laxity

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16
Q

how do you manage and treat angular limb deformities?

A

operate before 18mo
growth arresting techniques - prevent growth on longer side, transphyseal screw or plating
growth accelerating techniques - accelerates growth on side cut is made and lifted, periosteal transection

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17
Q

what make fracture repair more complicated?

A

expensive - may not be option for owners if wont return to performance
size of horse puts massive stress on fracture repair
repair needs to be strong for performance
GA recovery can be dangerous - flight animal
contamination from lack of soft tissue on distal limbs

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18
Q

what are the benefits of repairing distal limb fractures awake?

A

no GA recovery which can be dangerous

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19
Q

list considerations for healthy patients before ortho surgery

A

vaccine status - flu and tetanus
likely weight bearing on all limbs
may need x-ray and US before surgery
pre-op exam
IV catheter in jug vein
possibly pre clip site to reduce GA time

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20
Q

list nursing considerations for emergency ortho patients

A

if in doubt treat as fracture
clinical exam and stabilise
IV catheter
sedative if needed - alpha 2
wound care
isolate if not flu vaccine
limb support if needed
imaging
meds - antibiotics, tetanus antitoxin, analgesia

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21
Q

describe wound care in ortho patients

A

check CV status
consider blood loss
clip
clean with water, chlorhex

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22
Q

describe how to stabilise fractures

A

splint or bandage to restrict movement

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23
Q

what are the goals of fracture stabilisation?

A

stabilise fracture
minimise further trauma to bone, soft tissue and vasculature
prevent further contamination
reduce pain and stress

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24
Q

what is a kimsey splint and when is it used?

A

used on distal limb
usually only on racing yards as have high occurance of fractures

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25
Q

how is robert jones applied in horses?

A

layers of cotton held by elastic gauze, layers tighter than the one before
should be 3x diameter of limb
sound like watermelon
uses 10-15 rolls of cotton normally

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26
Q

list nurses roles in ortho surgery

A

scrub nurse - run table
circulating nurse - run the room

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27
Q

list theatre prep for ortho surgery

A

clippers
antibacterial scrub preps
fluids for horse and arthroscope
meds
u cath
shoe removal
anaesthetic equipment

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28
Q

why should shoes be removed for surgery?

A

cause trauma to self or room in recovery
very hard to properly clean

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29
Q

describe patient prep for ortho surgery

A

cover tail and feet - may contaminate surgical site if above
clip hair - 10-15cm away from surgical site
clean and disinfect skin

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30
Q

list skin prep solutions used

A

chlorhexadine
iodine compounds
povidone iodine
alcohol

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31
Q

what are considerations using chlorhexadine for skin prep?

A

residual activity - binds to protein in skin
low toxicity
can be toxic to fibroblasts - cover large wound with gel and clean with sterile saline

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32
Q

what are considerations for using iodine compounds for skin prep?

A

only free iodine is bactericidal
stains
radiopaque
smells

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33
Q

what are considerations for povidone iodine skin prep?

A

no free iodine unless diluted or combined with detergent
low toxicity
indicated in presence of organic debris

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34
Q

what are considerations for alcohol skin prep?

A

only effective against bacteria
inactivated by organic debris
no residual activity
commonly used as rinse after skin prep

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35
Q

list considerations for preparing theatre for ortho surgery

A

horses position
instruments needed
imaging equipment
post-op bandaging materials

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36
Q

how can horses be positioned in surgery?

A

ropes and supports for legs
padding

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37
Q

why is padding so important in positioning horses for surgery?

A

prone to myopathies/neuropathies if lying on one muscle group for long time

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38
Q

list imaging considerations for ortho surgery

A

equipment - radiography, fluroscopy, arthroscopy
sterile bags for x-ray plates
PPE

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39
Q

why is have solid bandages so important in recovery?

A

lots of forces will be exerted on it

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40
Q

describe how to recover horses from surgery

A

leave ETT in for early recovery
unassisted and rope recovery common
sling or pool recovery uncommon

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41
Q

how is rope recovery done?

A

rope on head collar and tail
guide horse up not lift

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42
Q

describe how sling recovery is done

A

similar to rope but supporting weight

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43
Q

what are benefits and risks of pool recovery?

A

benefits - no weight bearing on fractured limb
risks - infection, pulmonary oedema

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44
Q

list post-op care for ortho surgery

A

analgesia
anti-biotics as needed - contamination or infection, implants used
monitoring
hypothermia usually corrects self
feacal output and consistency
appetitie
remove IV as soon as possible
bandage care

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45
Q

list post-op care for synovial sepsis

A

antimicrobials - systemic, intrasynovial, IV regional perfusion
repeated synoviocentesis to guide antibiotics - look at WBC, TP and SAA
wound management

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46
Q

how is IV regional perfusion of antibiotics performed?

A

torniquet limb
inject lower than with high dose antibiotics to perfuse area of limb
repeat every other day

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47
Q

list possible complications following ortho surgery

A

post-op infection
incision breakdown
unacceptable pain
bandage/cast sores
supporting limb laminitis
colic

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48
Q

why are bandage and cast sores common?

A

protruding bones and low soft tissue coverage

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49
Q

how does supporting limb laminitis occur following ortho surgery?

A

excess weight bearing compresses vessels causing inflammation

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50
Q

how can you prevent supporting limb laminitis?

A

frog supports
deep bedding
rubber mats
stable bandage good leg

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51
Q

what can increase risk of bandage complications following ortho surgery?

A

horse hot
moving around a lot effecting tension of bandage
poor application

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52
Q

how can you reduce risk of bandage complications following ortho surgery?

A

cross tie
small stable

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53
Q

list cast monitoring considerations

A

twice daily
temperature of horse
change in comfort
fever
discharge
staining
wear on sole
breakage
heat
flies
smell

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54
Q

list complications associated with fracture fixation

A

post-op infection of skin, bone or implant
pain
reduced healing
breakage of implant
further fracture of limb

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55
Q

list equipment needed for fracture fiaxation

A

drill
plates and screws
bone reduction forceps
plate bender
fracture kit
general kit
drapes
mathieu retractor
hohmann retractor
gelpi retractor
weitlaner retractor

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56
Q

list equipment for arthroscopy

A

tower
camera
synovial resector
trocars
canula
screen
fluid line
scope
light cable
fluid pump

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57
Q

list other equipment needed for ortho surgery

A

bruns currette
rongeurs straight and curved

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58
Q

how many stages are there in normal foaling?

A

3

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59
Q

what is stage 1 foaling?

A

30-60 minutes
cervix relaxation
uterine contraction
water breaks/rupture of chorioallantois

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60
Q

what is stage 2 foaling?

A

5-30 minutes
delivery of foal
needs assistance if delayed

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61
Q

what is stage 3 foaling?

A

2-3 hours
placenta and foetal membranes expelled
needs assistance if delayed

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62
Q

list normal foal behaviour

A

standing in an hour
suckle in 2 hours
pass meconium in 3 hours
urinate in 8-12 hours - colts earlier than fillies
active from birth
sleep with legs extended
periods of sleeping, activity and nursing

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63
Q

list normal foal parameters 2-3 hours post partum

A

RR - 50-80bpm - due to fetal vessels closing
audible crackles on lungs
mild nasal discharge

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64
Q

list normal foal parameters upto 7 days old

A

HR 80-100
RR 30-40
temp 37.5-39.5
pink moist MM
good peripheral pulses
warm extremities
MAP over 70mmHg

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65
Q

what are nutritional requirements for foals?

A

1L colostrum in first 12 hours
20-30% BW in milk per day
100-160kcal/kg/day

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66
Q

what is the result of the high volume of milk foals drink?

A

high urination

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67
Q

why is colostrum so important to be drank in the first 12-24 hours?

A

passive transfer
contains antibodies from the mares blood which are absorbed in the GI tract to the foals blood

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68
Q

list possible complications in foaling

A

trauma
congenital abnormalities
acquired abnormalities
failure of passive transfer

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69
Q

what is a common cause of trauma to the foal in foaling?

A

dystocia leading to rib fractures

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70
Q

list common congenital abnormalities in foals

A

cleft pallette - see milk at nostrils
microphthalmia - tiny eyes
limb deformities - flexure, angular limbs

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71
Q

list example of acquired abnormality in foals

A

patent urachus

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72
Q

what causes failure of passive transfer?

A

foal not drinking enough or low quality colostrum

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73
Q

list common conditions in foals leading to ICU

A

sepsis
neonatal isoerythrolysis
neonatal maladjustment syndrome
prematurity/dysmaturity
ruptured bladder
diarrhoea
pneumonia
meconium impaction

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74
Q

what is sepsis in foals?

A

life threatening, inflammatory response to systemic bacterial infection

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75
Q

list common causes of sepsis in foals

A

failure of passive transfer
local infection

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75
Q

list clinical signs of sepsis in foals

A

pyrexia
petechiae
injected MM
dull
flat
unresponsive
recumbency
uveitis
synovial sepsis
hypotension

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76
Q

what are signs of synovial sepsis in foals?

A

lameness
swollen joints
diarrhoea
pneumonia
umbilical infection

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77
Q

what causes synovial sepsis in foals?

A

haematogenous spread

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78
Q

what is neonatal isoerythrolysis ?

A

mare produces antibodies against foals RBCs
foal absorbs these in colostrum so its RBCs are broken down

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79
Q

what causes neonatal isoerythrolysis?

A

mare has had contact with the foals same RBCs such as previous foal with same sire

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80
Q

list clinical signs of neonatal isoerythrolysis

A

anaemia
icterus
weakness

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81
Q

how is neonatal isoerythrolysis treated?

A

stop drinking milk
supportive care until regenerate RBCs
transfusion if needed

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82
Q

what are other names for neonatal maladjustment syndrome?

A

hypoxaemic ischemic encephalopathy
perinatal asphyxia syndrome
dummy foal

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83
Q

list clinical signs of neonatal maladjustment syndrome

A

neurological signs
poor suck reflex
failure to nurse
hyperaesthesia
obtundation
coma
abnormal at birth or crash at 24-48 hours

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84
Q

how is neonatal maladjustment syndrome managed?

A

supportive care
can do madager foal squeeze - pressure on thorax, helps 20%

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85
Q

list signs of prematurity/dysmaturity

A

silky coat
floppy ears
domed head
immature MSK
incomplete ossification of cuboidal bones
incompatible with life

86
Q

why is incomplete ossification of the cuboidal bones such a concern in foals?

A

bone will crush leading to joint abnormalities for life

87
Q

how do you manage incomplete ossification of cuboidal bones?

A

keep foal recumbent for as long as possible to allow bones to mature and ossify

88
Q

what is a premature foal?

A

less than 320 days gestation

89
Q

what is a dysmature foal?

A

normal gestation but appear premature

90
Q

how do foals with ruptured bladder present?

A

few days old
colic
abdo distension
hyperkalaemia
low sodium
low chloride

91
Q

how is ruptured bladder managed in the foal?

A

surgery

92
Q

why should you never lift foals by their abdomen?

A

can rupture the bladder

93
Q

list signs of meconium impaction

A

straining to defecate
mild colic

94
Q

how is meconium impaction managed?

A

IVFT
management
phosphate enema

95
Q

what is the role of ICU nurse for foals?

A

patient care
foal and mares needs
staying organised
keeping unit clean and stocked
communication of patients
wearing PPE

96
Q

list general nursing care of foals in ICU

A

maintain sternal recumbency to prevent atelectasis
assist standing every 2 hours if well enough
turn 2 hourly to prevent pressure sores
weigh daily
close examination

97
Q

what is monitored in NICU exams

A

complete physical exam
demeanour
nose to tail checks
manage treatments
nutrition
urine and fecal output
at least 4 hourly checks, more if sicker

98
Q

list CV system checks in NICU foals

A

MMs - indicate systemic health, multiple locations (buccal mucosa, conjunctiva, ear pinnae), should be pink, moist
CRT - less than 2
HR - 80-100, strong pulses, warm extremities
CO - relies on stable HR
may have murmurs until day 4 as fetal vessels closing

99
Q

why does CO rely on HR in foals?

A

cant adjust stroke volume due to immature sympathetic nervous system

100
Q

what is the result of poor compensation of heart rate in foals?

A

poor BP and oxygenation

101
Q

list respiratory system checks in NICU foals

A

RR - 30-40
regular rhythm
louder bronchial sounds than adults
no wheezes
dullness
crackles
respiratory effort
nasal discharge
check for rib fractures
blood gas for oxygenation

102
Q

list what may be seen in eye checks for unwell NICU foals

A

indicate systemic state
dehydration seen with sunken eyes and entropion
sepsis if injected MM, hypopyon (fibrin and pus accumulation), uveitis
trauma seen with injected conjunctiva and swollen eyelids

103
Q

why are corneal ulcers common in foals?

A

have reduced corneal sensitivity

104
Q

what should be assessed in NICU foals MSK?

A

lameness
septic synovitis/osteomyelitis
check all joints
reduce weight bearing if premature or dysmature
flexural deformities - laxity or contraction
angular limb deformities

105
Q

list GI system checks in NICU foals

A

colic if meconium impaction or ileus
tolerance of enteral nutrition
diarrhoea - often secondary to sepsis, or infectious cause

106
Q

describe how to care for the umbilicus in foals

A

dip in 0.5% hibitane
twice daily
four times daily if patent urachus or septic

107
Q

how should you care for mares post-partum?

A

manage any trauma or illness from birth
check TPR twice daily
manage perineum
check milk
encourage bonding with foal
check placenta passed

108
Q

how are IV catheters placed in foals?

A

over the wire
in lateral recumbency in jugular vein
needs 3 people

109
Q

why are IV catheters for foals made of polyurethane?

A

less thrombogenic

110
Q

how do you maintain catheters in foals?

A

check patency 4 hourly
care when giving drugs in case of sedimentation
lots of care if parenteral nutrition

111
Q

what should you do if you are concerned a foal has sepsis?

A

take blood sample for culture following aseptic IV placement to prevent contamination

112
Q

what is IgG snap test used for?

A

test levels of antibodies in foals blood

113
Q

what is the level of antibodies that should be in foals blood?

A

8g/L

114
Q

what should you do if foals have lower levels of antibodies than they should?

A

give colostrum if under 24 hours
give plasma transfusion if older than 24 hours

115
Q

why cant colostrum be used to increase antibodies in the blood after 24 hours old?

A

cant absorb antibodies to the GI tract

116
Q

where do you take arterial blood gas samples from in foals?

A

lateral metatarsal artery

117
Q

what are normal blood gas values in foals?

A

PaO2 - 80-110mmHg
PaCO2 - 40-80mmHg

118
Q

what is the potential effect of lateral recumbency on PaO2?

A

reduce upto 30mmHg

119
Q

what can venous blood gas be used for in foals?

A

assess electrolytes

120
Q

why is hypoglycaemia common in foals?

A

if septic
have poor glycogen and fat reserves

121
Q

how can you manage foals with hypoglycaemia?

A

fluids supplemented with dextrose

122
Q

what does lactate show?

A

measurement of tissue perfusion

123
Q

what are normal lactate levels in neonates and 3 days old?

A

neonates - less than 3-4mmol/L
3 days - less than 2 mmol/L

124
Q

what does increased lactate in foals indicate?

A

anaerobic metabolism
insufficient oxygen supply to tissues
hypovolaemia
hypoxaemia
sepsis

125
Q

how do you fluid resus foals?

A

warm hartmanns
20ml/kg over 20 mins
reassess and repeat after each litre
maximum 4 litres for 50kg foal

126
Q

how is ongoing fluid therapy managed in foals?

A

hartmans and 5% dextrose
3-5ml/kg/hr
6mg/kg/min glucose - 3ml/kg/hr 10% glucose
consider electrolytes
cant tolerate high sodium fluids
risk SC oedema
supplement potassium if not nursing

127
Q

how is NIBP measured in foals?

A

tail cuff
try not to stimulate in placement
3 readings and average

128
Q

when are foals hypotensive?

A

MAP less than 70mmHg

129
Q

why does sepsis lead to hypotension?

A

suppression of myocardial contractility so reduced SV
blood vessels dilate

130
Q

how do you manage hypotension in sepsis?

A

inotropes - dobutamine to increase cardiac contractions
vasopressors - vasopressin to constrict blood vessels

131
Q

what should a foals normal UOP be?

A

50-70% fluid input
over 2ml/kg/hr

132
Q

how can you provide intranasal oxygen?

A

through tubing into nostril up to medial canthus of the eye
taped to tongue depressor
run along face through hole in neck wrap
connect to oxygen
is run through humidifier with sterile water

133
Q

what are flow rates of providing foals oxygen?

A

2-15L/min
start at 5L/min and adjust

134
Q

how do you manage foals with oxygen cannulas?

A

clean tube daily
replace every other day

135
Q

list complications associated with intranasal oxygen

A

nasal irritation
rhinitis
airway drying

136
Q

other than oxygen how can you support respiration in foals?

A

nebulisation
ventilation

137
Q

what is the benefits of nebulisation?

A

aid secretion removal, with coupage
can give bronchodilators and antibiotics

138
Q

why is ventilation rarely done in foals?

A

if its at this point prognosis is very poor

139
Q

why should seizures be managed?

A

increases cerebral oxygen demand
can result in neurone damage

140
Q

how do you manage seizures in foals?

A

5mg diazepam - lasts 20 minutes, can be repeated
midazolam CRI, phenobarbital, levetiracetam - continued seizures
padding on bones, environment to protect from trauma

141
Q

what can cause seizures in foals?

A

neonatal maladjustment syndrome
hypoglycaemia
sepsis

142
Q

how much nutrition should you provide to foals in hospital?

A

10% body wieght
500ml every 2 hours approx
start at 50ml and build up as tolerates

143
Q

how do you feed foals?

A

feed selves if can
never bottle feed - aspiration risk
NG tube if cant feed

144
Q

how do you manage NG tube in foals?

A

check placement on radiographs
secure same as O2 tube
check for reflux before feeding

145
Q

what is the purpose of TPN in foals?

A

support energy balance
not enough for growth

146
Q

what are the types of enemas for meconium impaction?

A

phosphate - max twice in 24 hours
soapy water - 200ml
acetylcystine retention enema

147
Q

what enema may be done as a preventative measure in all foals in some yards?

A

soapy water

148
Q

how does a acetylcystine retention enema work?

A

sedated
dissolved meconium
very effective

149
Q

list common emergency surgeries

A

colic
dystocia
trauma
synovial sepsis
fracture repair

150
Q

what is colic

A

broad term for abdominal discomfort in horses
can involve GI, liver, urinary tract, repro organs

151
Q

what history should you take from owners of colic horses?

A

how long has been colicing for
severity of signs
last faeces passed
breed, age, sex
has it happened before
any management changes - turnout, stabling, worming

152
Q

what history should you take from referring vet for colic cases?

A

TPR - presentation to now
clinical findings - rectal, NGT
meds given and response
suspected lesion
if surgery is an option
financial concerns

153
Q

list equipment needed for colic assessment

A

sedation - xylazine, detomidine, butorphanol
NSAIDs - flunixin, buscopan
clippers
sterile prep solution
catheters
blood tubes
lactate reader
NG tube
rectal gloves
lube
fluids
US machine

154
Q

how may horses present with colic?

A

unpredictable
‘well’ or rolling

155
Q

where should you triage colic patients?

A

stocks
knockdown box if unsafe
have mobile box with equipment

156
Q

what is assessed in colic work up?

A

demeanour
signs of pain
abrasions - indicate severe pain
TPR
GI borborgomi
CV status
MM
abdo distension
rectal exam if safe
NG tube
bloods
AUS
abdominocentesis

157
Q

what do purple MM indicate?

A

endotoxaemia due to rupture or close to

158
Q

what may be needed to perform a rectal exam in colic patients?

A

sedation or buscopan to relax anal sphincter

159
Q

why is passing an NG tube so important in colic cases?

A

horses cant vomit
stomach has high change of rupture

160
Q

when is NG decompression indicated?

A

high HR
significant pain

161
Q

what does reflux indicate in colic cases?

A

SI obstruction

162
Q

what bloods should you perform in colic patients?

A

PCV
TP
lactate

163
Q

what can be seen in fast abdo US in colic cases?

A

stomach distension
SI motility
SI distension
displaced colon
thickened intestinal wall
free abdo fluid

164
Q

what is looked at from abdominocentesis?

A

total nucleated cell count
TP
lactate

165
Q

what indicates that colic is surgical?

A

congested MM
CRT over 3
HR over 60-80
poor pulses
uncontrollable pain
distention or displacement of small or large intestine on rectal exam
over 2L reflux on NG intubation
amotile distended loops of SI on US
high lactate

166
Q

how do you manage colic patients before moving to surgery?

A

patent IV
decompressed stomach
can leave NGT in place
clip abdo if safe when awake, 20cm either side of midline over whole ventral abdomen
remove shoes if safe

167
Q

what should you prepare before knocking down horses for surgery?

A

theatre bed ready to receive in dorsal recumbency
anaesthetic equipment
hoist
clippers
u cath
surgical scrub

168
Q

what should be prepped in theatre for colic surgery?

A

warmed fluid for lavage
carboxymethylcellulose for lubricant - prevent post-op adhesions
2x + surgical kits - replace after entering GI tract
fresh gowns and gloves - after contamination
lots of drapes
hose for colon flush
colon table and dump drum

169
Q

how is colic surgery perfromed?

A

ventral midline incision over 20cm
all of GIT assessed

170
Q

what is assessed in the GI tract of colic patients?

A

distension
thickening
viability
displacement

171
Q

how is non-viable intestine managed?

A

resected and anastomosed

172
Q

what kit is needed for resection and anastomosis of intestine?

A

buster drapes
doyen clamps
suture material
fluids for lavage

173
Q

why are enterotomy and colon dumps needed for large intestine lesions?

A

dump contents due to weight of pelvic flexure

174
Q

how is colon dump managed?

A

tilt colon table down so contents run away from surgical field

175
Q

how are abdomens closed following colic surgery?

A

3 layer closure
linea alba
SC tissue
skin

176
Q

what dressings are used following colic surgery?

A

melolin, lap bandage as stent, secured with adhesive spray
belly bandage

177
Q

how is recovery following colic surgery managed?

A

remove u cath
bandage feet if have shoes on
towel dry

178
Q

why is it so important to dry horses following colic surgery?

A

are soaked due to scrub and lavage

179
Q

list post op care for colic surgery patients

A

IVFT
lidocaine CRI
analgesia
antibiotics
incision care - monitor for infection and breakdown

180
Q

why are lidocaine CRIs good following colic surgery?

A

good for GI pain
prokinetic
reduces NSAID use

181
Q

why should opioids be avoided if possible for colic surgery pateints?

A

cause ileus

182
Q

how should refeeding be managed after colic surgery?

A

LI displacement - gradually feed when awake and alert
SI resections - no food for 48 hours
start with small amounts of fibre nuts and grass

183
Q

list possible complications following colic surgery

A

endotoxaemia
ileus
colitis
jugular thrombophlebitis
peritonitis
incisional infection

184
Q

define endotoxaemia

A

bacteria in blood due to contamination in surgery

185
Q

how is endotoxaemia managed?

A

IVFT
flunixin/polymyxin B/hyperimmune plasma
laminitis is potential so ice boots, deep bed and frog support

186
Q

how do you manage ileus following colic surgery?

A

regular NG tube decompression
promotility drugs - lidocaine, erythromycin, metoclopramide
IVFT
nil by mouth until tolerating
monitor with US

187
Q

define colitis

A

inflammation of the colon

188
Q

how do you manage colitis in colic surgery patients post-op?

A

will be pyrexic
IVFT
isolate as diarrhoea may shed salmonella
gastroprotectants - sucralfate

189
Q

how do you manage jugular thrombophlebitis?

A

remove catheter
local anti-inflammatories
antithrombolytics

190
Q

how is peritonitis diagnosed?

A

abdominocentesis

191
Q

how is peritonitis managed?

A

broad spectrum antibiotics

192
Q

how do you manage incisional infection?

A

manage oedema
may have cellulitis - inflammation of SC tissue
antimicrobials if systemically unwell
swab for culture and sensitivity
encourage drainage

193
Q

how do you monitor patients following colic surgery?

A

full exam every 2-4 hours
demeanour
GI borborgymi
fecal output
appetitie
jugular vein
feet - comfort, digital pulses
incision
ensure geldings not urinating on belly bandage

194
Q

list signs of jugular thrombophlebitis

A

heat
swelling
pain
patency of catheter

195
Q

how should IVFT be managed in horses following colic surgery?

A

crystalloids
50ml/kg/24hr maintenance
assess dehydration and losses
potassium supplements if not eating

196
Q

how do you manage patients returning to normal following colic surgery?

A

gradual reduction of analgesia
gradual refeeding of hay when coping with grass
4-6 weeks box rest, walking to grass
small paddock for 1 month
turn out for 1 month
gradual return to normal work

197
Q

what is meant by red bag delivery?

A

premature separation of placenta
foal not getting oxygen
chorioallantosis appears at vulva instead of amnion (white)

198
Q

how is red bag delivery managed?

A

chorioallantosis ruptured immediately
assisted delivery of foal

199
Q

what can cause dystocia?

A

foal malposition
foal abnormalities
1-10% incidence

200
Q

how is dystocia evaluated?

A

signalment
time of onset of stage 2 labour
gestation days
assistance attempted
medical treatment

201
Q

how do you prepare for dystocia cases?

A

assume is having c section
prepare knockdown box
warm water
lots of lube
foal ropes
hoist for controlled delivery
anaesthetist ready
theatre prepared for dorsal recumbency
foal trolley for resus

202
Q

how do you manage dystocia in mares on arrival to hospital?

A

bandage tail
IVC placed
assess delivery options
vaginal exam

203
Q

how do you manage dystocia if vaginal delivery is possible?

A

assisted if possible with mare standing
controlled assisted if not productive after 5-15 minutes - mare under GA, hindlimbs hoisted, prep for c section

204
Q

how is dystocia managed if vaginal delivery not possible?

A

c section if foal alive
foetotomy if foal dead

205
Q

how is c section performed?

A

ventral midline incision
uterine horn located and exteriorised
hysterectomy incision 35-40cm for feet and hocks to fit
umbilical cord clamped and transected
foal lifted with 2 people
foal cared for by separate team

206
Q

who manages mare during c section?

A

2 scrubbed
one running room
one anaesthetist

207
Q

how is foal managed after c section?

A

2 people to resus as has GA drugs on board
assess for abnormalities
supplement oxygen
IVC placement
umbilicus management

208
Q

what is a consideration when you have c section cases?

A

lot of people needed so manage team throughout hospital

209
Q

how should you help mares recover from GA after c section?

A

assisted as increased risk of fracture - low calcium due to milk production, exhausted

210
Q

what are outcomes of dystocia in mares and foals having controlled vaginal delivery or c section?

A

controlled mare - 87-94%
c sec mare - 87-89%
c sec foal - 10-30%

211
Q

list post op care following c section

A

similar to post colic
ensure placenta passed
oxytocin if retained placenta
check placenta intact
uterine lavage - 5-10L isotonic fluid SID/BID
check teats and mammary glands for mastitis

212
Q

list possible complications of dystocia

A

reproductive tract trauma - perineal lacerations, uterine rupture
retained placenta
delayed uterine involution (returning to normal state)
metritis (inflammation of the uterus)
peritonitis
uterine prolapse
bladder prolapse
arterial haemorrhage

Advanced Clinical Veterinary Nursing (4 decks)

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