exam 1 - intro

Question 1

medical emergency

Answer 1

urgent or pressing need for medical attention

Question 2

who determines a medical emergency

Answer 2

owner

Question 3

critical care patient

Answer 3

patient whose condition can deteriorate rapidly

Question 4

icu

Answer 4

facility for management of critical care patients

Question 5

is icu same as er

Answer 5

no

Question 6

what are the 4 obligations to the patient

Answer 6

alleviation/prevention of pain
minimization of stress and suffering
attempted correction of disease or injury with reasonable prognosis
humane euth when needed

Question 7

what are the 5 obligations to the client

Answer 7

honesty, courtesy, and respect
protection of client confidences
reasonable fees
informed consent
competent and caring services

Question 8

steps to facilitating client decision making

Answer 8

avoid hasty decisions
hard decisions in emotional times
empathetic third party can expedite these decisions

Question 9

how to deal with client disenchantment with previous vet

Answer 9

avoid criticism
listen and allow client to calm
focus on animals present condition
consider consultation with previous vets for the patient
consider reporting misdeeds after completing care

Question 10

are there major differences with clients who cant afford care

Answer 10

no - patient must receive vets best services unless client consents to lesser services
patient must be treated the same as when client is paying in full

Question 11

what to do about strays

Answer 11

good samaritan doesnt foot bill unless they want to
obligation to the animal for supportive care
owner once found can refuse to pay

Question 12

when should we make the decision to treat or not

Answer 12

in advance to treatment

Question 13

what is the decision not to treat

Answer 13

for treatable or untreatable conditions that result in poor quality of life

Question 14

what is passive euthanasia

Answer 14

decision not to treat and not actively euthanize

Question 15

what is negligence

Answer 15

deviation from accepted standards

Question 16

who is held to higher standards

Answer 16

specialists

Question 17

how does the vet-client relationship begin

Answer 17

verbal or written agreement

Question 18

when does the vet-client contractual liability end

Answer 18

treatment is complete
care is transferred to another vet
client decides to terminate contract

Question 19

who is liable if client is told over the phone to not come into the vet

Answer 19

vet is liable

Question 20

how do we deal with financials in emergencies where costs arent communicated

Answer 20

vet is entitled to a reasonable fee

Question 21

can you prescribe meds in MO without an exam

Answer 21

no

Question 22

how to deal with euth when a client cant be contacted

Answer 22

decision must be based on good judgement
defendable if action is similar to what other vets would do

Question 23

who is liable if client helps restrain their animal

Answer 23

vet is liable if injury occurs if no foresight is given

Question 24

aspects of hospital readiness

Answer 24

ready area
wall chart for dosing
training and drill sessions
maintenance of equipment and supplies

Question 25

what occurs in triage

Answer 25

1 minute
consciousness
airway and breathing
CV assessment
nervous and MS assessment

Question 26

class I triage

Answer 26

most urgent, catastrophic
immediate treatment needed

Question 27

class II triage

Answer 27

severe, critical
action needed in minutes to hours

Question 28

class III triage

Answer 28

serious
action needed in few hours

Question 29

class IV triage

Answer 29

less serious, but pressing
action needed within 24 hrs

Question 30

not classified triage

Answer 30

emergency because of owners concern or convenience
action when classified patients are controlled

Question 31

what is the minimum database for emergencies

Answer 31

PCV and TP, glucose, BUN, USG is bareminimum
usually get CBC, chem, UA

Question 32

what does buccal mucosal bleeding time assess

Answer 32

platelet function

Question 33

which is intrinsic vs extrinsic - PT and PTT

Answer 33

PT - extrinsic
PTT - intrinsic

Question 34

what clotting test when PT/PTT not available

Answer 34

activated clotting time ACT

Question 35

what is one test that assesses hypo- and hyper-coagulopathy

Answer 35

thromboelastography TEG

Question 36

what are some non-invasive monitoring tools

Answer 36

temp, pulse, myocardial performance, respiratory performance, urine output, blood pressure, ECG, lab tests, neuro exam, PE

Question 37

what are some invasive monitoring techniques

Answer 37

central venous pressure, direct arterial pressure, pulmonary artery catheter, intra-abdominal pressure

Question 38

what does central venous pressure reflect and what is it used for

Answer 38

right atrial pressure
used for early detection of fluid overload during IV fluid therapy

Question 39

normal values for central venous pressure

Answer 39

0-5 cm H2O
varies with position of catheter tip

Question 40

what could low CVP mean

Answer 40

hypovolemia, vasodilation

Question 41

what could high CVP mean

Answer 41

artifact, physiological alterations
hypervolemia, cardiac decompensation, cardiodepressant anesthesia or cardiopulmonary disease, increased intrathoracic pressure

Question 42

what artifact could elevate CVP

Answer 42

peripheral location of catheter tip
obstructed catheter

Question 43

does elevated CVP require a response

Answer 43

yes - check for artifact, slow or stop IV fluids

Question 44

where do you place catheter for direct arterial BP

Answer 44

dorsal pedal artery