Midterm Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Define CPR

A

Emergence procedure performed in order to manually maintain perfusion until spontaneous circulation can be restored

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define CPA (cardiopulmonary arrest)

A

Cessation of normal circulation due to failure of the heart to contract effectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the biggest influence on whether CPR will work or not

A

If CPA does not have a reversible cause, CPR is unlikely to be successful - example, if it is due to anesthesia it is likely reversible, if it is due to a terminal disease, it probably is not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the success rate of CRR

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 3 key features in recognizing CPR

A

Loss of consciousness, loss of normal spontaneous breathing, loss of palpable pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are common preceding events to CPR

A

Bradycardia, worsening mentation, sudden increase in vagal tone (vomiting, straining to defecate), sudden change in breathing pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which pose are you going to feel if concerned about CPA

A

Femoral pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are common diseases that predispose to CPA, warranting intense monitoring and aggressive therapy

A

Sepsis, sirs , heart failure , pulmonary disease, trauma, neoplasia, general anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 6 roles of a CPR crash team

A

Leader, ventilator, compressor, time keeper, recorder, drug administrator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When performing CPR, do you follow the ABC rule (airway, breathing , circulation)

A

No - start compressions immediately before securing airway (because it takes too long together supplies ) - it is circulation , airway and breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How many breaths per minute do you give when patient is intubated and you are giving manual breaths

A

8-12 breaths/minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What amount of oxygen do you use when giving manual breaths

A

100% oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is our ultimate goal in CPR

A

Get the heart beating again _ we con manually give breaths for while but without circulation it doesn’t matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When do you use the thoracic pump theory in CPR

A

Over 15 kg dog, wide chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do you use the cardiac pump theory

A

Less than 15 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many compressions per minute do you do with CPR

A

100 compressions per minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you give chest compressions

A

Depress the chest by one third then allow complete chest recoil to allow venous blood return to heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is open chest CPR indicated

A

Large dogs with thoracic trauma, pleural or pericardial disease, intra operative arrest, ineffective chest compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If you are successful with open chest CPR I what do you need to be prepared for

A

Thoracotomy - cut into the there to reach lungs or other organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are examples of pleural or pericardial disease that would indicate open chest CPR

A

Pneumothorax, pleural or pericardial effusion, diaphragmatic hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 4 recognized arrest rhythms

A

Ventricular tachycardia, ventricular fibrillation, systole, pulseless electrical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the two shockable rhythms

A

Ventricular fibrillation and pulse less ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is the goal of defibrillation to start the heart again

A

No - goal is to shut down the electrical activity to let the heart and sinus node do its thing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the shock dose for external defibrillation

A

2-10 joules/ kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What position is the dog in when you do defibrillation

A

Dorsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How long after defibrillation do you recheck the rhythm

A

2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common CPR drug used and how is it given

A

Epinephrine - give IV at 1 ml/10 kg every 4 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When would no use atropine in a CPA

A

Before arrest for bradycardia - give 1ml/10kg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What 2 things do you monitor with CPA

A

ECG and end tidal co2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does end tital co2 tell you during CPA

A

Confirms ET tube placement and identifies ROSC (return to spontaneous circulation) I also assesses quality of CPR compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When do you give fluids during a CPA

A

Only if the patient was hypovolemic prior to arrest - otherwise can reduce coronary perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Do yo use antiarrhytmic agents like lidocaine in CPA

A

no - can decrease success of defibrillation and suppress ventricular activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you assess brain function during triage

A

Mention - due, stuporous , comatose, death. And if patient is seizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the difference between dull and stuporous and comatose

A

Dull - responds to all stimuli with less Vigor,
Stuporous - only responds to noxious stimuli
Comatose - no response to noxious stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How do you check lung function with triage

A

Breathing rate and effort , abdominal effort on expiration , neck extension, stressed look

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Do we care about crackles or where’s on triage exam

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the only cause for panting in dog

A

Thermoregulation - trying to cool off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What do you check on triage to assess perfusion

A

Heart rate , mm, CRT, mention, temperature, pulse quality, thermometer!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

On cardiovascular triage, we are looking for - in dogs and - in cats

A

Tachycardia in dogs (60 - 120 bpm), bradycardia in-cats (180 - 240 bom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When do cats usually become bradycardic

A

When in shock and decompensating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When there is low perfusion ( in dogs especially) , what is the first thing the body does

A

Heart rate increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Where does gum color come from

A

Hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What do mm colors indicate - pink, red, brown, blue yellow, white

A

Pink - enough hemoglobin
Red -oxyhemoglobin
Brown - toxins leading to methemoglobin
Blue - deoxhemoslobin (no oxygen bonding to hemoglobin)
Yellow - bilirubin which is a by product of hemoglobin break down
While - decreased hemoglobin (anemia or vasoconstriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is CRT look like with vasoconstriction? Vasodilation?

A

Over 2 seconds with vasoconstriction
Les than one second with vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How can mentation indicate perfusion

A

Brain reeds ouch and sugar to work (gets these by blood fow) - correct perfusion then reassess the mention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Poor mention in the absence of other neuro signs indicates

A

Poor perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How can temperature indicate perfusion

A

Hypothermia concerning - when cold you vasoconstrictor and when u vasoconstriction you get cold (shunt blood away from periphery to maintain blood now to the core organs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A low body temp and cold toes can indicate

A

Perfusion problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Describe weak pulse

A

Distance between systole and diastole is shortened - less volume per bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Define shock

A

Severe imbalance between oxygen supply and demand, leading to inadequate cellar energy production significant decrease in oxygen supply to tissues or an overconsumption of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Shock is a balance between

A

Oxygen deliver and oxygen consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Oxygen delivery = - x -

A

Cardiac output times arterial content of exigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What does art trial content of oxygen mean

A

How much oxygen is in the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the 3 types of shock

A

Circulatory, hypoxic, metabolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the types of circulatory shock

A

Hypovolemic, distributive, obstructive, cardigenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The majority of shocks are - and due to

A

Most are circulatory and due to decreased oxygen delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What’s the most common type of circulatory shock? Describe it

A

Hypovolemic - decreased intravascular volume, decreased preload, decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are causes of hypovolemic shock

A

Hemorrhage, severe dehydration (GI or renal losses), third space fluid loss, severe burns (loss of proteins and electrolytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Describe distributive shock

A

Mal distribution of fluid from changes in vascular tone and increased vascular permeability (there is enough volume but it is not getting to the tissues , decreased systemic vascular resistance (deficits in preload or contractiling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are causes of distributive shocks

A

Anaphylactic Shock ( histamine induced vasodilation) , septic shock (endothelial dysfunction) , neurogenic shock, extreme fear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Describe obstructive shock

A

Compression of heart or great vessel that interferes with venous return, decreased diastolic filling and preload, decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are causes of obstructive shock

A

GDV ,obstruction of vena cava ,tension pneumothorax, cardiac tamponade from periodical effusion, positive pressure ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When there is pericardial effusion and increased pressure over the heart - which part of the heart collapses first

A

The right atrium (least pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Describe cardiogenic shock

A

Decrease in forward flow from heart due to pump failure - primer decrease in cardiac output due to an issue with the heart and tie pump failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are causes of cardiogenic shock

A

Systolic failure (dcm), diastolic failure (hcm), atrioventricular valve degeneration, Brady or tachy arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Describe hypoxia shock - what are causes

A

Decreased arterial oxygen content and decreased oxygen deliver to tissues - caused by severe pulmonary disease, anemia, dyshemoglobinemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Describe metabolic shock and its causes

A

Deranged cellular metabolism leading to inappropriate oxygen tissue use due to severe hypoglycemia and mitochondrial dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What do catecholimines cause

A

Increased heart rate, contractility and peripheral vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are 4 compensatory mechanisms of shock

A

Barocreceptor reflex, chemoreceptors I RAA S activation, antdiruetic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q
  • Is often considered hallmark for decompensatory shock
A

Hypotension - map determines peripheral perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What ave 2 types of distributive shock? Describe them

A

Anaphylactic and septic - initial vasodilation then vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are clinical signs of anaphylactic or septic shock

A

Tachycardia, CRT less than 1second (because of the vasodilation), red to injected mucus membranes , elevated temp, bounding pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

, Bradycardia in cats is - until proven other wise

A

Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the shock organ for dogs? For cats?

A

Dogs - git
Cats - lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Hypothermia in dogs indicates what type of shock

A

Crudiogenic - in cats it can indicate any type of shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the goal of shock treatment

A

Restore oxygen delivery to tissues as soon as possible - flow by oxygen, obtain IV access, IV find bolus UNLESS in cordiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are indications for peripheral venous catheters

A

Emergency like CPA, fluid admin, sedation , euthanasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

When do you often place auricular catheters

A

Mostly GDVs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What type of catheter is best for fluid administratrion and blood products especially in shock patients

A

Large bore, short catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the purpose of venous cut down for peripheral venous catheters

A

Temporary utilization to provide fluid resuscitation until routine peripheral venous catheter can be more readily replaced - emergency situations to provide stability with fluids or blood products

81
Q

What should you do after rending venous cut down catheters

A

Contaminated nature of catheter placement means you need to lavage and close aseptically

82
Q

Where is venous cut down done in dog? Cat?

A

Lateral saphenous dog, medial saphenous cat

83
Q

Define phlebitis

A

Inflammation of a vein near the surface of the skin

84
Q

If you have a dog with a fever and a catheter who is otherwise doing well, what should you do

A

Change the catheter in case of phlebitis

85
Q

When do you place intraosseous catheters and where

A

Small or neonatal patients, exotics, failure for peripheral venous catheter - placed in femoral or humeral or tibia

86
Q

Describe the efficacy of intraosseous catheters

A

Slower onset of drug admin, is for fluid resuscitation until venous peripheral access can be had, quicker time to place a venous cut down , blood samples less accurate because it is from bone marrow

87
Q

What is the Max time an intraosseuos catheter should be placed

A

24 hard max

88
Q

When are intermittent uincy catheters best

A

For contrast procedures or to relieve an obstruction

89
Q

When should you prescribe antibiotics in emergency

A

Know bacterial infection that has positive culture or suspected bacterial infection (due to signs like a fever, information)

90
Q

Does fever mean infection

A

No - fever means inflammation (not all inflammation is caused by an infection)

91
Q

Should you give antibiotics for upper respiratory tract infections

A

No-usually is due to a virus with secondary bacterial infection

92
Q

Should you give febrile patients antibiotics

A

Sometime but usually it is due to viral infections

93
Q

What are the 5 classes of analgesics used in the Er

A

Opioids, NSAIDs, alpha 2 agonists, NMDA receptor antagonists, local anesthetics

94
Q

What are pros of opioids

A

Excellent analgesia , minimal cardiovascular effects, reversible, sedation

95
Q

How do you reverse opioids

A

Naloxone

96
Q

Opioids in an Er setting are good for dogs with - and -

A

Safe for shock dogs and congestive heart failure due to the minimal cardiovascular effects

97
Q

What are the cons of opioids in Er patients

A

Possible respirators depression, parental primary (oral bioavailability low), sedation, abuse, GI upset and illus

98
Q

Summarize the use of opioids in Er and the time limit

A

Good analgesic for acute, severe pain , safe and effective but is not good for chronic use (max 24-48 hour use)

99
Q

Stop opioids at 48 hours max due to

A

Adverse GI effects

100
Q

What are the pros of NSAIDs

A

Excellent analgesia , .oral and parental, inexpensive

101
Q

What are the cons of NSAIDs

A

Possible GI ulceration, no use in dehydrated or hypovolemic patients due to decreased renal blue flow and not reversible

102
Q

What is the reversal for NSAIDs

A

No reversal

103
Q

If an animal is on NSAIDs and they stop eating , what should you do

A

Stop the NSAIDs became if they aren’t eating , they aren’t drinking so it is not safe

104
Q

Immediately after trauma, would you start a dog on NSAIDs

A

No - you reed to make sure renal perfusion is good first

105
Q

How do NSAIDs affect the kidneys

A

Renal autoregulation is mediated by prostaglandins and NSAIDs block prostaglandin production so during a trauma the kidneys are not able to adjust in the face of hypotension (leaves the kidneys unprotected)

106
Q

How do NSAIDs affect git and stomach

A

They block prostaglandins that lead the gut to be more susceptible to ulcer formation (prostagladino importat to make mucus buffers and secrete more bicarb)

107
Q

Summarize NSAIDs

A

Excellent analgesia for severe, chronic and orthopedic pain contraindicated in dehydration and hypovolemia (big risk of renal damage ) I risk of GI upset and ulcers

108
Q

When do you use NSAIDs generally? Can you give them on an empty

A

If patient is well hydrated and perfusing well for both qs

109
Q

What are pros of alpha 2 agonists

A

Effective analgesia, powerful sedation, cheap, reversible

110
Q

What are the cons of alpha 2 agonists

A

Significant decrease in cardiac output so limit use to very stable patients, profund sedation , respiratory depression, parental only

111
Q

What can be the risk with the profound sedation seen by alpha 2 agonists

A

Decreases ability to detect pain in Er patients

112
Q

Is dexmedetonidine a good option for patients with decreased cardiovascular status

A

No - significant decrease in cardiac output

113
Q

Does a lower dose of dexmedetomidine (an alpha 2 agonist) men it is safer for heart patients

A

No - no matter the dose there is always a 60-70% drop in cardiac output; it is a yes or no drug -i either the patient is stable enough or not

114
Q

What is an example of NMDA receptor agonist

A

Ketamine

115
Q

When are NMDA receptor antagonists best

A

Most effective if given before the painful stimulus (like if you give before surgery)

116
Q

What are the beeline of NMDA receptor antagonists

A

Reduces amount of opioids needed for analgesia, prevent windup can increase in pain intensity caused by the same stimulus over time

117
Q

What is a pro of NMDA receptor antagonists

A

Minimal to no GI effects so good for severe pain and GI signs

118
Q

What is the main stay therapy for shock patients

A

Fluid resuscitation with isotonic crystolloids like LRS IV over 10-20 minutes, then immediate reassessment after bonus , whole blood if bleeding or blood loss

119
Q

What are treatments for obstructive shock patients (a subcategory of distributive shock)

A

Gashed trocharization, thoracocentesis , pericordiocentesis (relieve pressure causing the obstruction)

120
Q

What ave quick treatments for patients in septic shock

A

Vasopressors like norepinephrine, broad spectrum antibiotics, fluids

121
Q

How do you treat anaphylactic shock

A

Vasopressers like epinephrine, antihistamines, fluids

122
Q

What would you not use to treat cardiogenic shock? What do youdo?

A

No IV fluids! Correct underlying disease, oxygen therapy, minimize stress

123
Q

How do you treat chf leading to cardiogenic shock

A

Diuretics like furosemide , oxygen therapy

124
Q

How do you treat life threatening arrhythmias leading to cardiogenic shock

A

Lidocaine or atropine

125
Q

What are your resuscitation endpoints for shock therapy

A

Clinical reassessment every 5 to 10 minutes or after every therapy used during stabilization - can desolate after normal perfusion parameters are reached

126
Q

What is the most sensitive indicator of Shock

A

Heart rate

127
Q

When triaging, what is usually the easiest pulses to feel

A

Femoral pulses

128
Q

What is the most common shock in poly trauma patients

A

Hemorrhagic shock - tissue hypopefusion due to decreased cardiac output and decreased mean arterial pressure

129
Q

What do you look for first in poly trauma patients

A

Check lactate, tissue perfusion, signs of hemorrhagic shock (heart rate, mm, etc)

130
Q

What is the goal of IV fluid resuscitation

A

Restore tissue perfusion and oxygen delivery

131
Q

Crystalloids are a-

A

Balanced electrolyte solution

132
Q

A benefit of colloids is that they stay

A

In the intravascuor space longer

133
Q

What is point of care ultrasonography

A

Abdominal fast scans Or thoracic fast scans

134
Q

What are benefit of pocus

A

Portable and we don’t need a radiologist to interpret, fast, can be done while other tests are being done

135
Q

What is the ultimate goat of fast scans

A

To see if there is free fluid in the thorax or abdomen and tren use as a guide for procedures like thoracocentesis, pericordiocentesis, etc

136
Q

Why is performing A fast in right lateral best

A

Decreased risk of hitting the spleen if aspirating - dorsal recumbency bad for patients with respiratory distress

137
Q

What is important to check for on an afast especially after trauma

A

Check to make sure the bladder is intact

138
Q

What are the 4 views to check on an afast

A

Diaphragmatic hepatic, spleen renal, cysto colic, hepatorenal

139
Q

How do you use abdominal fluid scores

A

Purpose is to gauge severity of abdominal effusions - a score of I men’s file seen in to 4 sites and so on (this score should correlate with CBC, PCI, etc)

140
Q

How often should you repeat afast scans and scores

A

Every 4 hours (even hour if patient is shock)

141
Q

Lung rockets on tfasf scans indicate what

A

Lung contusions, wet lung, some sort of interstitial disease

142
Q

Bar code signs on M mode on TFast could indicate

A

Pneumothorax

143
Q

Rain sign on m mode for tfast could indicate what

A

Wet lung or interstitial disease

144
Q

What is the benefit of a mushroom view on tfast

A

To see heart function and contractility

145
Q

What size should the left atrium be compared to the aorta on tfast

A

Left atrium should be 1- 1.5 times the size of the aorta (if bigger left atrial enlargement)

146
Q

Define orthopnea

A

Positional increases in difficulty breathing - head and reck extended, elbows abducted (basically trying to extend path of breathing)

147
Q

Define dyspnea

A

Sensation of breathless

148
Q

Issues breathing on inspiration localize the problem to where

A

Upper respiratory

149
Q

Issues on expiratory breathing indicates a problem where

A

Lower airway like bronchial disease

150
Q

Where is the problem localized to with increased effort during all breathing phases

A

Parenchymal

151
Q

Short shallow breathing localizes the problem to where

A

Pleural space

152
Q

What are 3 things to do over a patient is in respiratory distress

A

Minimize stress , oxygen supplementation, provide sedation (butorphanol usually) - it patient is really bad I con heavily sedate and intubate to reduce stress and the work of breathing

153
Q

It is better to - a living patient in respiratory distress than to

A

Better to intimate a living patient than a head patient who just went into respiratory arrest

154
Q

What ave possible upper airway diseases that can cause issues on inspiration

A

Laryngeal paralysis , tracheal collapse, foreign bodies, polyps, brachycephalic airway syndrome

155
Q

What can help you differentiate between cardiac and non cardiac caused

A

Temperature - if congestive heart failure, they should be hypothermic

156
Q

What are the 3 fluid compartments in the body

A

Intracellular fluid, extracellular (interstial and intravascular)

157
Q

What is the total body water

A

65% (multiply body weight by 0.65 )

158
Q

Describe the relationship between sodium and potassium intracellularly and extracellularly

A

Inside the cell, there is low sodium and high potassium, outside the cell there is high sodium and low potassium

159
Q

What determines intravascular concentration

A

Sodium because water follows sodium

160
Q

Total body sodium determines

A

Hydration

161
Q

Serum sodium concentration reflects - not-

A

Reflects total body water not total body sodium because water is freely permeable across cell membranes and sodium is not

162
Q

High sodium on bloodwork lovely means -

A

Low water and vice versa

163
Q

Huponatrenia indicates a-

A

Water excess -losing both water and electrolytes like sodium

164
Q

What does the sodium in a dehydrated animal usually look like

A

Normal or high sodium - depends on if losing water in excess or Normal amount

165
Q

Hypernatronic indicates a

A

Water deficit - severely dehydrated

166
Q

Hypotonic loss means

A

More water is lost than solute loss - usually with a polyuric patient, can lead to a huperatrenia

167
Q

A hypertonic loss means what

A

More solute is lost than water, could lead to a hyponatremia

168
Q

Fluid loss is most often

A

Isotonic and the sodium remains unchanged - isotonic to extracellular fluid

169
Q

Differentiate between dehydration and hypovolemia

A

Dehydration - loss of fluid from the interstitial space, happens slow and replaced slow
Hypovolenia - loss of fluid from the intravascular space happens rapidly

170
Q

Where do the losses occur with dehydration and hypovolemia

A

Extracellular comportment - interstitial (dehydration) and intravascular (hypovolemia)

171
Q

Which type of fluid loss requires rapid restoration and why

A

Hypovolemia fluid loss from the intravascular space - because the body can’t quickly replace the fluid

172
Q

A gradual fluid loss or lack of replacement indicates

A

Dehydration and lack of interstitial water

173
Q

What general type of replacement said do you need for dehydration and hypovolemia and why

A

High sodium because these are both extracelluar fluid losses so losing high sodium and low potassium

174
Q

What are 6 reasons to give fluids

A

Dehydration, hypovolemia, anorexia over 24 hours, severe losses, general anesthesia , as a vehicle to get other stuff in the patient

175
Q

What are the main 2 reasons to give finds

A

Dehydration and hypovolemia

176
Q

If an animal has diarrhea and they are eating/ drinking , will they need fluids

A

No -if eating will be drinking

177
Q

What are crystalloids

A

Salt water - moves freely within extracellular space and redistributes rapidly into interstium

178
Q

What are colloids

A

Contains molecules that don’t readily leave the intravascular space so should stay in the intravascular space, (more than salt in the water)

179
Q

All fluids will redistribute in the first - but - distributes faster

A

All fluid will redistribute in the first few hourrs - crystalloids redistribute faster

180
Q

The greatest absolute increase in blood volume is seen with - while the greatest increase in blood volume per volume delivered is seen with -

A

Crystalloids lead to greatest absolute volume increase, hypertonic saline leads to greatest increase in blood volume per volume

181
Q

The most sustained increase in blood volume is seen with

A

Colloids - because colloids stay in the intravascular space longer

182
Q

What are risks of colloids

A

Potential interstitial leak leading to edema , changes incoagulation, kidney injury, more expensive than crystalloids

183
Q

What are risks of crystalloids

A

Large volume, transient effect, potentates edema

184
Q

Give examples of isotonic fluid

A

LRS , normal saline, normosol R, plasma lyte A

185
Q

Describe isotonic fluids

A

Same amount salt as extracellular fluid

186
Q

Describe hypotonic fluids - what is important to note about them

A

Less salt than Extracellular fluid - can never bolus hypotonic finds became too much water can cause cells to explode

187
Q

Describe hyper tonic saline

A

Plus free water fromn interstitial and intracellaar spaces to increase the intravascular volume - excess salt compared to fluid

188
Q

When should you avoid using hypertonic fluids

A

Hypernatremic or dehydrated patients - because it could make the hypernatremia worse

189
Q

What are benefits of hypertonic fluids

A

Increased tissue oxygen delivery, sustain heart rate and cardiac output, decreased cellular edema

190
Q

You should have lower - man - in extracellular fluid

A

Lower chloride than sodium in Extracellular fluid

191
Q

Describe replacement fluid and give examples

A

Mimics extracellar fluid, high in sodium - lactated ringers, normal saline , normosol r, plasmalyte

192
Q

Describe maintenance fluids and give examples

A

Mimics daily electrolyte requirements , low in sodium and chloride higher in potassium - half strength saline , normosol m

193
Q

When are sub Q fluids appropriate

A

Only in stable patients

194
Q

How does the baroreceptors reflex compensate for shock

A

Changes in pressure lead to increased heart rate and contraction, and peripheral vasoconstriction

195
Q

How do chemoreceptors compensate for shock

A

Chases in things like pH or po2 need to increased respiratory rate and tidal volume - the bigger breaths to increase oxygen delivery to tissues

196
Q

How does RAAS activation compensate for shock

A

Increases angiotensin 2 (a potent vasoconstricter) to increase peripheral vasoconstriction and increase real sodium absorption (because water follows sodium)

197
Q

How does antidiuretic hormone compensate or shock

A

Increases renal water absorption

198
Q

Describe decompensatory shock

A

Decreased blood pressure and decreased heart rate

199
Q

Describe compensatory shock

A

Increased heart rate and normal blood pressure