Exam 1 Flashcards
Indications for urine collection by cysto
obtain uncontaminated urine samples from the bladder and to aid in localization of hematuria, pyuria, and bacteruria
Equipment for cystocentesis
22 gauge needle, 1.5 inches
6cc syringe
Ultrasound guided cysto is used when the bladder cannot be palpated because:
patient is tense
patient is obese
bladder is small
When should suction be applied during ultrasound guided cysto
once the needle is visible within the bladder lumen
In blind cysto on females, the needle should enter:
where the fluid/alcohol pools
In blind cysto on the male, insert the needle:
lateral to the penis halfway between the tip of the penis and the scrotum
When doing cystocentesis, the needle should never
be redirected once it is in the abdominal cavity
Always make sure to release ___ before withdrawing the needle
negative aspiration pressure
Contraindications for cysto
bleeding disorders
potential pyometra or prostatic abscess
suspected bladder neoplasm
empty bladder
inadequate restraint
Male cat urinary catheter equipment
3 1/2 French stiff polypropylene catheter
3 1/2 French or 5 French soft plastic tubing
Olive tip metal catheter
Sterile gloves and lube
3 1/2 French stiff polypropylene catheter
open ended tom cat catheter- for relief of urethral obstruction and collection of urine, not for indwelling. open end allows flushing to aid passage
3 1/2 French or 5 French soft plastic tubing
soft infant feeding tube for indwelling catheter, collection of urine sample
Olive tip metal catheter
for relief of urethral obstruction only, not for urine collection or indwelling catheter
When placing a U-cath in a male cat, the penis should be pulled _ _ _ so the long axis of the penile urethra is parallel to the vertebral column
straight back caudally
If resistance is met during U-cath placement for a male cat, the catheter can be
flushed during advancement with sterile saline
Equipment for placement of a U-cath in a male dog
4-10 (depending on size of dog) French stiff polypropylene catheter
4-10 French soft plastic tubing
Sterile gloves
Sterile lube
How should you estimate the length of a catheter for male dog
by holding the catheter next to the dog
When collecting urine via U-cath, the first - mls of urine should be discarded
5-6mls
Equipment for u-cath on female dog
4-10 French stiff prolypropylene catheter
4-10 French Foley self retaining catheter wire stylette (for indwelling)
Speculum
Sterile gloves
Lube
Polypropylene catheter characteristics
-rigid
-for urine collection only
-may cause bladder or urethral irritation or trauma if used long-term
Foley catheter characteristics
-soft
-wire stylet to add rigidity during catheterization
-self-retaining balloon
Ocular Procedures
Schirmer Tear test
Tonometry
Conjunctival Culture
Fluorescein staining
Flushing the Nasolacrimal Ducts
Subpalpebral lavage
Tears provide:
-Oxygen and nutrients to the cornea
-Flush away debris
-Maintain hydration of the cornea and conjunctiva
-Inhibit bacterial growth
Purpose if schirmer tear test
to measure the aqueous component of basal and reflex tear production
Indications for schirmer tear test
Patient presents with:
-a red eye
-with mucoid or purulent ocular discharge
-pigmentary keratitis
-monitoring tx of a patient with keratoconjunctivitis sicca (dry eye)
-monitoring dogs being treated w/ medications may decrease tear production
STT must be done before:
any other ocular procedures are performed to obtain accurate results
You should avoid the following before STT measurement
-excessive manipulation of the eyelids
-the administration of topical anesthetic
-systemic medications
STT equipment
STT strips
STT technique
fold the notched end of the sterile strip, inserting the strip between the lower eyelid and the cornea at the lateral third of the lower eyelid
STT strip must stay in place for
1 minute
Normal value for STT test in dogs
15-25mm/min
Normal value for STT test in cats
10-15mm/min.
Tonometry
-Important method for measuring IOP
-Important for the dx and control of glaucoma as well as uveitis
Normal value for IOP in cats and dogs
20 +/- 5 mmHg
Purpose of conjunctival culture
to identify infectious pathogens of the conjunctiva
Indication for conjunctival culture
severe chronic conjunctivitis that has not improved with antibiotic therapy
Equipment for conjunctival culture
sterile swabs for bacterial and fungal culture
transport medium
Conjunctival culture technique
-Moisten the end of a sterile cotton-tipped swab with sterile saline
-Gently swab the conjunctival sac, avoiding the eyelid margins
-Replace the swab in the transport tube or inoculate medium immediately
Purpose of fluorescein staining
to detect and characterize corneal ulcers, as well as to assess the latency of the nasolacrimal ducts
Indications for fluorescein staining
-painful or red eyes
-patient w/ clouding of the cornea
-patient w/ chronic watery ocular discharge
-mucoid or purulent discharge
Fluoroscein staining equipment
test strips
eye wash
gauze sponges/hand towel
light source/ woods lamp
Fluorescein staining technique
-moistening of the end of a strip of fluorescein w/ a few drops of sterile eye wash (or place strip in syringe contain 1-2 ml of eye wash)
-elevating the upper eyelid and touching the moistened tip of the fluorescein strip against the bulbar conjunctiva
Stain uptake on the cornea indicates
a disruption in the epithelium, suggesting a corneal ulcer or erosion
The appearance of green dye at the external nares indicates that
the nasolacrimal punch and duct are patent
Failure of stain to drain indicates
obstruction by:
cellular debris
mucus
swelling
compression by mass
Purpose for flushing the nasolacrimal ducts
to relieve minor obstructions of the nasolacrimal duct
Equipment for flushing the nasolacrimal ducts
-gauze sponges
-topical ophthalmic anesthetic
-sterile 23-27 gauge nasolacrimal cannula
-3ml syringe containing sterile saline or eye wash
Indications for orogastric intubation
-administer meds, constrast material, or nutrition directly to the stomach
-to remove or sample stomach contents and to perform gastric lavage
-to attempt decompression of a dilated stomach
Animal should be in _ recumbency for placement of orogastric tube
sternal
Measurement for placement of orogastric tube
tip at level of last rib, mark the point on the tube at the oral opening
Orogastric intubation procedure
-Moisten tip of tube w/ lubricating jelly
-Insert speculum into animal’s mouth and hold jaws closed on speculum
-Pass lubricated tube through the speculum
-Advance the tube to the remarked point
Techniques to determine proper location of orogastric tube
A. Palpate the tube w/in the neck
B.Smell the end of the tube for odor
C.Blow into the tube while asst. auscults stomach for gurgling
D.Administer of 5mls of sterile saline through stomach tube and observe for cough
Potential complications for orogastric intubation
-administration of material into the lungs
-esophageal trauma
-gastric irritation
-gastric perforation
-aspiration pneumonia
Indications for stomach tubing neonates
to provide nutrition to a neonatal puppy or kitten who is unwilling or unable to nurse
Contraindications and warnings for stomach tubing neonates
-hypothermia cause delayed gastric emptying so should not be performed when body temp is less than 94 F
-use as large a tube as possible making it more difficult to inadvertently pass the tube into the smaller trachea
Guidlines for stomach tubing neonates
5-8 French tube if <300 grams body weight
10-14 French tube if >300 grams body weight
Eliminate _ from the tube and syringe when stomach tubing neonates
air
Puppy should be in _ position when passing stomach tube
upright
You should remove the stomach tube from a neonate immediately if:
coughs, dyspnea, or crying
Average stomach volume of neonate
4-5 ml/100g body weight
After feeding neonate through stomach tube,
-wait 5-10 seconds and slowly remove the tube
-hold the puppy upright for 1-2 minutes to minimize reflux and regurgitation
Nasogastric intubation indications
administer meds, rad contrast material, or nutrition and water, bypassing the requirement for the patient to swallow or eat voluntarily
Nasogastric tube should be inserted into the _ aspect of the anesthetized nostril
ventromedial
How to check for proper placement of nasogastric tube
instill 1-2mls of sterile saline into tube. If tube was inadvertently placed into the trachea, the animal will cough
If nasogastric tube must be maintained, _ or _ in place
glue, suture
Potential complications for nasogastric tube
aspiration pneumonia
esophageal trauma
gastric irritation
Equipment for esophageal feeding tube in cats
-12-16 Fr red rubber or silicone feeding tube
-Surgical scalpel w/ no. 11blade
-Curved 5-6 inch hemostatic forceps
-Sterile gloves
-Bandage material and suture
Esophageal tube length in cats should be measured
from the mid thorax to the planned insertion point in the midcervical region and this length marked on the tube
If an esophageal tube passes into the stomach it will cause
gastroesophageal reflux and regurgitation
What is proptosis
the forward displacement of the globe
How does proptosis occur?
traumatic injury, excessive pressure in or behind eye, excessive pressure around the neck from a collar
What is exophthalmos
the protrusion of a normal-sized globe from its usual position
Descemetocele is an ulcer that has progressed to
the last layer of the cornea
what is hyphema
blood in the anterior chamber
Common breeds for Anterior lens luxation
terriers, cattle dogs, Chinese cresteds, GSD, shar pei, border collies
peripheral venous catheters are usually placed in
cephalic, medial and lateral saphenous veins
Central venous catheters are often placed
in the external jugular vein in dogs and cats
When should Intraosseous catheters be placed
only when IV catheterization is not possible
What blade should you shave the patient with before catheter placement
40
What Is used for aseptic prep of a catheter
Chlorehexidine solution
Alcohol
Betadine
Through-the-needle catheters are usually placed in
jugular vessels
Multilumen catheters are good for:
-long term fluid or drug therapy
-delivering multiple fluids or drugs
-incompatible solutions can be administered
Always start as _ as possible when placing a catheter
distal
Where is the carotid artery located to the jugular vein
ventromedial
IO catheters provides rapid vascular access into the
medullary cavity of a bone
Most common sites for IO catheterization
medullary canal of the femur or humerus
How to determine placement of IO catheter
Palpate the greater trochanter and walk the tip of the needle medially off of the greater trochanter into the trochanteric fossa
IV catheter site should be assessed during tx times every _ hours if the animal is receiving fluid therapy
2
Bandages should be changed every _ hours or if they become wet or soiled
24
IV catheters are flushed with _ _ every 6-8 hours if continuous IV drip is not being administered
heparanized saline
IV catheters should be replaced every _ days
3
IV Catheters for patients with urinary incontinence should be placed in
cephalic or jugular vessels
Patients that are vomiting should have IV Catheter placed in
lateral or medial saphenous veins, or jugular
Pediatric patients body water content
70%-80%
Geriatric patients body water content
55%-60%
Body water is lost through
respiration, urination, and excretion under normal circumstances
Excess body fluids may be lost by
vomiting, diarrhea, increased urination
Fluid therapy is used to
restore and/or maintain body water
Indications for oral route of fluid therapy
mild dehydration, short term illness, small patients, animals w/ feeding tubes
indications for SQ fluid therapy
mild dehydration and non-hospitalized animals
Indications for IV fluid therapy
Dehydration, Hypovolemia, Anorexia/V+/D+ for days, sx procedures, drug administration
Indications for IO fluid therapy route
cardiovascular collapse, lack of IV access, neonatal patients, exotic patients, short term until IV access maintained
Hypovolemia refers to
loss of circulating volume from the intravascular compartment
Hypervolemia known as fluid overload is
medical condition where there is too much fluid in the blood
Untreated, severe dehydration leads to
hypovolemia
Hypovolemia can exist in an adequately hydrated patient such as one who experiences
trauma
Heart rate typically increases in response to
decreased intravascular volume
_ _ quality may change as intravascular volume decreases
femoral pulse
Severe dehydration, poor perfusion, and marked hypovolemia typically lead to
decreased body temp.
_ can cause an increase in both PCV and TS measurements
dehydration
Dehydration may cause the _ value to appear falsely elevated in the anemic patients
PCV
Loss of body water causes the concentration of urea in the circulating blood to increase in
dehydrated patients with normal renal function
Delivery systems for fluids
Gravity feed, IV flow regulators, fluid pumps, burette
Burettes are helpful in avoiding
accidental administration of large amount of fluid volumed to small patients
IV fluid warmer is used to help reduce the risk of _ during anesthesia
hypothermia
Complications of volume overload from fluid therapy
peripheral edema, cough, increased RR, serous nasal discharge, pulmonary edema or plural effusion
Peripheral edema- changes are most obvious in the
conjunctiva and hock areas
Conjunctival edema is called
chemoses
Eyes become _ in orbits in an animals with moderate to marked dehydration
sunken
